Glucosamine Sulfate Sodium Chloride

(rINNM)

💊 Chemical information

Chemical formula: (C6H14NO5)2SO4,2NaCl = 573.3.

Pharmacopoeias.

In US.

USP 31

(Glucosamine Sulfate Sodium Chloride). A 2% solution in water has a pH of 3.0 to 5.0. Store in airtight containers. Protect from light.

💊 Profile

Glucosamine is a natural substance found in chitin, mucoproteins, and mucopolysaccharides. It is involved in the manufacture of glycosaminoglycan, which forms cartilage tissue in the body; glucosamine is also present in tendons and ligaments. Glucosamine must be synthesised by the body but the ability to do this declines with age. Glucosamine and its salts have therefore been advocated in the treatment of rheumatic disorders including osteoarthritis. Glucosamine may be isolated from chitin or prepared synthetically; glucosamine sulfate and hydriodide, have also been used.

Effects on glucose metabolism.

Glucosamine has a role in glucose metabolism, increasing insulin resistance in skeletal muscle,1,2 which has raised concerns about its safety profile in diabetic patients.3 However, alteration of glycaemic homoeostasis was not found in a 3-year randomised controlled study in patients without diabetes.4 A review5 of the literature found limited data on diabetic patients taking glucosamine supplements, and recommended close monitoring of blood glucose levels in this group until more data are available.
1. Adams ME. Hype about glucosamine. Lancet 1999; 354: 353–4
2. Chan NN, et al. Drug-related hyperglycemia. JAMA 2002; 287: 714–15
3. Chan NN, et al. Glucosamine sulphate and osteoarthritis. Lancet 2001; 357: 1618–9
4. Reginster JY, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001; 357: 251–6
5. Stumpf JL, Lin SW. Effect of glucosamine on glucose control. Ann Pharmacother 2006; 40: 694–8.

Osteoarthritis.

Glucosamine and its salts are widely available as licensed products or so-called ‘health supplements’ used for the management of osteoarthritis; they may be combined with other substances supposed to be of benefit, including chondroitin, vitamins, and various herbs. Meta-analyses1,2 of randomised placebo-controlled studies concluded that while there was some evidence for efficacy of glucosamine and chondroitin in the treatment of osteoarthritis, methodological flaws and publication bias had led to exaggeration of its potential benefit,1 and that further studies are needed to fully characterise their disease-modifying properties.2 A systematic review3 of the use of glucosamine for osteoarthritis that included later controlled studies concluded that glucosamine is as safe as placebo but there was little evidence of improvement in pain or function. A further randomised controlled study4 in 222 patients with hip osteoarthritis found no benefit after treatment with glucosamine for 2 years compared with placebo, and a meta-analysis5 of controlled studies of chondroitin for osteoarthritis of the knee or hip concluded that chondroitin had minimal or no benefit. Further research is needed to confirm whether there are differences in efficacy between glucosamine salts, preparations, or routes, and when used with other agents (e.g. chondroitin) or in different patient subgroups.3 A large multicentre double-blind study6 in 1583 patients with symptomatic knee osteoarthritis to compare glucosamine and chondroitin, either alone or in combination, found no clear evidence of benefit in pain reduction compared with placebo or celecoxib, although there was a tendency to more positive results in a subset of patients with moderate to severe knee pain.
1. McAlindon TE, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 2000; 283: 1469–75
2. Richy F, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003; 163: 1514–22
3. Towheed TE, et al. Glucosamine therapy for treating osteoarthritis. Available in The Cochrane Database of Systematic Reviews; Issu
2. Chichester: John Wiley; 2005 (accessed 14/05/08)
4. Rozendaal RM, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med 2008; 148: 268–77
5. Reichenbach S, et al. Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Ann Intern Med 2007; 146: 580–90
6. Clegg DO, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006; 354: 795–808.

Skin reactions.

The Australian Adverse Drug Reactions Advisory Committee (ADRAC)1 has received 51 reports of allergic skin reactions with glucosamine, including erythematous rash, angioedema, urticaria, rash, and pruritus. It was noted that some preparations contain glucosamine sourced from seafood and therefore people with an allergy to shellfish may be at greater risk for hypersensitivity reactions.
1. Adverse Drug Reactions Advisory Committee (ADRAC). Skin reactions with glucosamine. Aust Adverse Drug React Bull 2005; 24: 23. Also available at: http://www.tga.gov.au/adr/ aadrb/aadr0512.pdf (accessed 14/05/08)

💊 Preparations

USP 31: Glucosamine and Chondroitin Sulfate Sodium Tablets; Glucosamine and Methylsulfonylmethane Tablets; Glucosamine Tablets; Glucosamine, Chondroitin Sulfate Sodium, and Methylsulfonylmethane Tablets.

Proprietary Preparations

Arg.: Adaxil; Artrilase; Asoglutan; Baliartrin; Belmalen Plus; Findol; Gluco Arrumalon; Glucocartiflex; Mecanyl; Ostatac; Pertinar; Vartalon Complemento; Vartalon K; Austral.: GenFlex; Braz.: Dinaflex; Glucoreumin; Injeflex; Chile: Artridol; Bioflex; Dinaflex; Reufin; Viartril†; Cz.: Dona; Flexove; Gool; Mediflex; Voltadyn; Denm.: Ledamin; Ledflex†; Fin.: Arthryl; GLenk; Glucadol; Movere; Fr.: Oscart; Ger.: Dona 200-S; Gr.: Anarthril; Donarot; Glucosamil; Glusamon; Nerita; Recosine; Viartril; Hong Kong: Arthritil; Cartril-S; Chitaq; Doctor’s Choice for Joints; Donna; F-Vial; MarinEx; Viartril S; Vidatril; Vitoport; Vocarxil; Hung.: Dona; Gool; Indon.: Jointfit Cream; Mediflex; Reflexor; Irl.: Arthrimel; Dona; Ital.: Dona; Viartril S†; Malaysia: Artronil; Cartril-S; Cosamine; Donna; Procosa; Viartril S; Mex.: Artriman; Faximin; Vartalon; Viartril†; Neth.: Cartimin; Glucadol; Norw.: Gluxine; Movere; Philipp.: Viartril S; Pol.: Arthryl; Port.: Arthramina; Glucomed; Glucosine; Glufan; Viartril S; Singapore: ArthriCare; Artril; Artronil; Gluco-S†; Glutilage; Kudona†; Viartril S; Vital; Spain: Cartisorb; Ceremir; Coderol; Glufan; Hespercorbin; Obifax†; Xicil; Swed.: Artrox; Glucomed; Glucosine; Thai.: Artronil; Athril; Flexsa; Gluco-S; Glucosa; Glusa; Glusamine; Viartril S; UK: Alateris; Flexeze; Joint-e-Licious; Venez.: Vartalon; Viartril S. Multi-ingredient: Arg.: Artrilase Complex; Artrocaptin; Asotrex; Baliartrin Duo; Car-ti buron flex; Cartiflex Forte; Ecosamina; Etinox; Finartrit; Findol Plus; Gluco Arrumalon Duo; Glucobefol; Glucotrin VL; Mecanyl Duo; Nectar G; Sigmaflex; Vartalon Duo; Austral.: Bioglan Joint Mobility; GenFlex 3; GenFlex Plus; OsteoEze Bone & Joint Care; Braz.: Artrolive; Condroflex; Canad.: Glucosamine Joint & Muscle Cream with MSM†; Chile: Artridol Duo; Condrosamina†; Dinaflex Duo; Eniflex†; Euroflex; Flexure; Hiperflex; Osteo Bi-Flex; Hong Kong: Arthritil Plus; Procosamine†; India: Cosantin†; Kondro; Osteocip; Osteoflex; Indon.: Aptivium Optimum Joint Formula; Artriox; Artritin; Bonic; Cartin Plus; Chondro-PA; Fitbon; Fitbon Plus; Flexor; Fripos; Joint Care; Jointfit; Maxitrin; Naturica Artro; Naturica Artro Plus; OA; OA Forte; OA Plus; Osamin; Oste; Ostela; Osteoflam; Osteokom; Osteokom Forte; Osteonic; Osteor; Osteor Plus; Osteor-C; Osvion Plus; Rheumatin; Rheumatin Forte; Triflexor; Triostee; Viopor; VioporM; Viostin Com; Viostin Com DS; Vosteon; Ital.: Cartago; Fitogenase; Joint Support; Osteoclar; Reumilase SD; Mex.: Actiman; Artiflex; Vartalon Compositum; Philipp.: Flexxbon; Ruflex; Port.: Synchrocell; Synchrorose; Synchrovit; Rus.: Artra (Артра); Theraflex (Терафлекс); S.Afr.: ProFLEX; ProFLEX 750; Singapore: Arthro-Flex; Articolase (w/glucosamine); Artril C; Cartipro; Flexeze†; Glucocal; Glutilage Plus; Seven Seas JointCare; Seven Seas JointCare Max; UK: Arheumacare; BackOsamine; Flexeze; GlucOsamax; Healtheries Musseltone & Glucosamine; Joint Action; Jointace; JointCare Max; USA: Dorofen; Venez.: Artrosamin; Flexurat.
Published May 08, 2019.