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 arthritis.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

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

Use Cautiously in:

Diabetes (may worsen glycemic control);
Asthma (may exacerbate symptoms);
Surgery ( discontinue ≥2 wk before procedure);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: skin reactions

Endo: hyperglycemia

GI: constipation, diarrhea, heartburn, nausea

Neuro: drowsiness, headache

Interactions ⬆ ⬇

Natural-Drug Products:

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

Natural-Natural Products:

May ↑ risk of bleeding of ginkgo, garlic, ginger, willow bark, and omega-3 fatty acids.May ↑ risk of hypoglycemia with aloe vera (oral).

Availability ⬆ ⬇

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

Route/Dosage ⬆ ⬇

PO (Adults ): 500 mg 3 times daily.
(Adults ): Apply as needed for up to 8 wk.

US Brand Names ⬆ ⬇

2-amino-2-deoxyglucose sulfate, chitosamine

Action ⬆ ⬇

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

Therapeutic effects:

Decreased pain and improved joint function.

Classifications ⬆ ⬇

Therapeutic Classification: antirheumatics

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of herb to patient.
Advise patient to consult with health care provider before using any herbal supplement, especially when taken concurrently with Rx or OTC medications or vitamins.
Advise patient that effects of this herb come from stimulating cartilage and synovial tissue metabolism. The supplement must be taken on a regular basis and may take 2–8 wk to achieve benefit. Do not use as an intermittent pain medication.
Advise patient with a shellfish allergy not to use this herbal supplement.
Advise patient to notify health care provider if GI discomfort develops and persists.
Advise patients with diabetes to monitor glucose closely during initial therapy.
If constipation occurs, advise patient to ↑ fluid intake and fiber in diet; bulk laxatives may be added if necessary.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or breastfeeding before using this herb.

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Indications ⬇