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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.

• Osteoarthritis.
• Temporomandibular joint (TMJ) arthritis.
• Glaucoma.

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

• Decreased pain and improved joint function.

Absorption: 0.9% absorbed.

Distribution: Unknown.

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

Half-life: Unknown.

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)

GI: nausea, heartburn, diarrhea, constipation.

Derm: skin reactions.

Endo: hyperglycemia.

Neuro: headache, drowsiness.

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.

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

• Administer prior to meals.

2-amino-2-deoxyglucose sulfate, chitosamine

Therapeutic Classification: antirheumatics

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

• 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.

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

• Chronic pain (Indications).
• Impaired physical mobility (Indications).

• 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.

• Improvement in pain and range of motion.