glucosamine

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Osteoarthritis.
Temporomandibular joint (TMJ) arthritis.
Glaucoma.

Action ⬆ ⬇

May stop or slow osteoarthritis progression by stimulating cartilage and synovial tissue metabolism.

Therapeutic effects:

Decreased pain and improved joint function.

Pharmacokinetics ⬆ ⬇

Absorption: 0.9% absorbed

Distribution: Unknown

Metabolism/Excretion: 74% eliminated via first-pass metabolism

Half-Life: Unknown

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Shellfish allergy (glucosamine is often derived from marine exoskeletons)
Pregnancy and lactation.

Use Cautiously in:

Diabetes (may worsen glycemic control)
Asthma (may exacerbate symptoms)
Surgery (may affect blood glucose levels, discontinue glucosamine 2 wk before elective procedures)

Adv. Reactions/Side Effects ⬆ ⬇

GI: constipation, diarrhea, heartburn, nausea

CNS: drowsiness, headache

Derm: skin reactions

Endo: hyperglycemia

Interactions ⬆ ⬇

Natural-Drug Products:

May antagonize the effects of antidiabetics.
May induce resistance to some chemotherapy drugs such as etoposide, teniposide, and doxorubicin.
May increase anticoagulant effects of warfarin.

Natural-Natural Products:

None known.

Route/Dosage ⬆ ⬇

PO (Adults ): 500 mg three times daily.
(Adults ): use cream as needed for up to 8 wk.

Availability ⬆ ⬇

Tablets : 500 mg^OTC
Capsules : 500 mg^OTC
Topical cream : 30 mg/g in combination with other ingredients^OTC

Assessment ⬆ ⬇

Assess for shellfish allergy prior to initiating therapy.
Monitor pain (type, location, and intensity) and range of motion periodically during therapy.
Assess bowel function periodically during therapy. Constipation may be reduced by increased fluid intake and bulk in diet; bulk laxatives may be added if necessary.

Lab Test Considerations:

Monitor serum glucose levels periodically during therapy for patients with diabetes.

Implementation ⬆ ⬇

Administer prior to meals.

Patient/Family Teaching ⬆ ⬇

Instruct patients that effects of this drug come from stimulating cartilage and synovial tissue metabolism and that the supplement must be taken on a regular basis to achieve benefit. Do not use as an intermittent pain medication.
Caution patients with a shellfish allergy that this herbal supplement should not be used.
Advise patient to notify health care professional if gastric discomfort develops and persists.
Advise diabetic patients to monitor glucose values closely during initial therapy.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇