Glucosamine, Diacerein is commonly used as a treatment for osteoarthritis, although its acceptance as a medical therapy varies. It is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may help to rebuild cartilage and treat arthritis.
Glucosamine is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Glucosamine is part of the structure of the polysaccharides chitosan and chitin, which compose the exoskeletons of crustaceans and other arthropods, as well as the cell walls of fungi and many higher organisms. Glucosamine is one of the most abundant monosaccharides. It is produced commercially by the hydrolysis of crustacean exoskeletons or, less commonly, by fermentation of a grain such as corn or wheat. It is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may help to rebuild cartilage and treat arthritis.
Mechanism of Action of Glucosamine
Glucosamine is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Oral glucosamine is commonly used for the treatment of osteoarthritis. Since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may help to rebuild cartilage and treat arthritis. Its use as a therapy for osteoarthritis appears safe, but there is conflicting evidence as to its effectiveness with more recent studies showing limited to no clinical benefit of use. In the United States, glucosamine is not approved by the Food and Drug Administration for medical use in humans. Since glucosamine is classified as a dietary supplement, safety and formulation are solely the responsibility of the manufacturer; evidence of safety and efficacy is not required as long as it is not advertised as a treatment for a medical condition.
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When taken up by living cells, glucosamine reacts with ATP to form glucosamine-6-phosphate, the natural precursor of glycosaminoglycans (GAGs) that contain N-acetylglucosamine (keratan sulfate and Hyaluronan) and those that have N-acetylgalactosamine (heparan sulfate and chondroitin sulfate). These GAGs are polysaccharides composed of hexosamines and monosaccharides (e.g., galactose and glucuronic acid) arranged as a linear chain of repeating disaccharide units (such as the glucuronic acid and N-acetylgalactosamine-6-sulfate of chondroitin sulfate). With the exception of hyaluronan, GAGs do not exist alone in nature but are attached to specific “core” proteins, and the composite structures are called proteoglycans (protein-glycosaminoglycans). Both hyaluronan and many different kinds of proteoglycans (such as aggrecan, versican, and syndecan) are abundant throughout the body where they perform diverse functions.
Indications of Glucosamine
- Osteoarthritis of Knee & Spine
- Cervical spondylosis
- Back pain
- Lumbergo
- PLID
- Fibromyelgia
- Glaucoma
- Weight loss
- Degeneration of cartilage
- Road Traffic accident,
- Post operative joint injury
- Joints pain
- Joint pain, such as knee pain
- Multiple sclerosis (MS)
- Glucosamine may be indicated for the treatment and prevention of osteoarthritis, either by itself or in combination with chondroitin sulfate.
Side Effects of Glucosamine
- Yellow coloration of urine
- stomach upsets
- constipation
- diarrhea
- headaches
- rashes
- nousia- vomiting
Drug Interactions Glucosamine
Ask your doctor about whether glucosamine is safe for you if you’re taking any of the following:
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
- Drugs that stop platelets from sticking together, such as clopidogrel
- Blood thinners, such as warfarin , heparin, apixaban , rivaroxaban , and fondaparinux
- Medications for depression like citalopram and venlafaxine
- Cancer chemotherapy drugs, such as etoposide and doxorubicin
- Diabetes medications, such as pioglitazone , rosiglitazone , and insulin
Pregnancy & Lactation of Glucosamine
Glucosamine is an amino-monosaccharide that is either derived from shellfish or synthetically produced. Glucosamine sulfate has no specific lactation-related uses. It is most commonly used to treat osteoarthritis. A glucosamine derivative, N-acetylglucosamine, is a normal component of human breastmilk. Glucosamine sulfate is well tolerated with occasional gastrointestinal discomfort (e.g., diarrhea, heartburn, nausea, vomiting) reported.
Does glucosamine help with osteoarthritis?
Many people take glucosamine supplements for OA, and especially OA of the hip or knee.
Some studies suggest that glucosamine may have the following effects:
- Reduce osteoarthritis-related pain, stiffness, and swelling in the joints.
- Improve function in people with knee or hip osteoarthritis.
- Provide continued relief of symptoms for up to 3 months after someone stops treatment.
In advance formula that are very helpful in combination of Diacerein
Uses of Diacerein 50mg + Glucosamine 750mg
Glucosamine helps in building cartilage, tendon, and tendon around the bones & joints. Thereby It enhances joint lubrication, cushioning of joints, and elevates pain around joints. It is used along with other medicines like chondroitin or diacerein for better joint cushioning and lubrication. Its uses include the treatment of pain associated with osteoarthritis or other joint pains related to cartilage damage.
Side Effects of Diacerein 50mg + Glucosamine 750mg:
- Diarrhea,
- Epigastric
- Pain,
- Nausea,
- Vomiting,
- Intense Yellow Colouring Of Urine.
- Diarrhea,
- constipation,
- epigastric pain,
- heartburn,
- nausea,
- vomiting,
- headache,
- skin rashes,
- drowsiness,
- intense yellow coloring of urine
Drug Interactions of Diacerein 50mg + Glucosamine 750mg:
- Decrease the absorption of aluminum or magnesium HCl, Antacids. Increase the risk of Diarrhoea with laxatives, antibiotic
Contraindications of Diacerein 50mg + Glucosamine 750mg:
- Pregnancy, Lactation. hypersensitivity ho anthraquinone derivatives
What the Science Says About Glucosamine and Chondroitin for Osteoarthritis
For the Knee or Hip
Glucosamine
Major studies of glucosamine for osteoarthritis of the knee have had conflicting results.
- A large National Institutes of Health (NIH) study, called the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT), compared glucosamine hydrochloride, chondroitin, both supplements together, celecoxib (a prescription drug used to manage osteoarthritis pain), or a placebo (an inactive substance) in patients with knee osteoarthritis. Most participants in the study had mild knee pain.
- Those who received the prescription drug had better short-term pain relief (at 6 months) than those who received a placebo.
- Overall, those who received the supplements had no significant improvement in knee pain or function, although the investigators saw evidence of improvement in a small subgroup of patients with moderate-to-severe pain who took glucosamine and chondroitin together.
- For more information on the trial, see the NCCIH Web page.
- In several European studies, participants reported that their knees felt and functioned better after taking glucosamine. The study participants took a large, once-a-day dose of a preparation of glucosamine sulfate sold as a prescription drug in Europe.
- Researchers don’t know why the results of these large, well-done studies differ. It may be because of differences in the types of glucosamine used (glucosamine hydrochloride in the NIH study vs. glucosamine sulfate in the European studies), differences in the way they were administered (one large daily dose in the European studies vs. three smaller ones in the NIH study), other differences in the way the studies were done, or chance.
Chondroitin
In general, research on chondroitin has not shown it to be helpful for pain from knee or hip osteoarthritis.
- More than 20 studies have looked at the effect of chondroitin on pain from knee or hip osteoarthritis. The quality of the studies varied and so did the results. However, the largest and best studies (including the NIH study discussed under the heading “Glucosamine” above) showed that chondroitin doesn’t lessen osteoarthritis pain.
Joint Structure
A few studies have looked at whether glucosamine or chondroitin can have beneficial effects on the joint structure. Some but not all studies found evidence that chondroitin might help, but the improvements may be too small to make a difference to patients. There is little evidence that glucosamine has beneficial effects on joint structure.
Experts’ Recommendations
Experts disagree on whether glucosamine and chondroitin may help knee and hip osteoarthritis. The American College of Rheumatology (ACR) has recommended that people with knee or hip osteoarthritis not use glucosamine or chondroitin. But the recommendation was not a strong one, and the ACR acknowledged that it was controversial.
For Other Parts of the Body
Only a small amount of research has been done on glucosamine and chondroitin for osteoarthritis of joints other than the knee and hip. Because there have been only a few relatively small studies, no definite conclusions can be reached.
- Chondroitin for osteoarthritis of the hand
A 6-month trial of chondroitin in 162 patients with severe osteoarthritis of the hand showed that it may improve pain and function. - Glucosamine for osteoarthritis of the jaw
One study of 45 patients with osteoarthritis of the jaw showed that that given glucosamine had less pain than that given ibuprofen. But another study, which included 59 patients with osteoarthritis of the jaw, found that those taking glucosamine did no better than those taking a placebo (pills that don’t contain the active ingredient). - Glucosamine for chronic low-back pain and osteoarthritis of the spine
A Norwegian trial involving 250 people with chronic low-back pain and osteoarthritis of the lower spine found that participants who received glucosamine fared the same at 6 months as those who received placebo.
What the Science Says About Safety and Side Effects
- No serious side effects have been reported in large, well-conducted studies of people taking glucosamine, chondroitin, or both for up to 3 years.
- However, glucosamine or chondroitin may interact with the anticoagulant (blood-thinning) drug warfarin (Coumadin).
- A study in rats showed that long-term use of moderately large doses of glucosamine might damage the kidneys. Although results from animal studies don’t always apply to people, this study does raise concerns.
- Glucosamine might affect the way your body handles sugar, especially if you have diabetes or other blood sugar problems, such as insulin resistance or impaired glucose tolerance.
If you use dietary supplements, such as glucosamine and chondroitin, read and follow the label instructions, and recognize that “natural” does not always mean “safe.”
The U.S. Food and Drug Administration regulates dietary supplements, but the regulations for dietary supplements are different and less strict than those for prescription or over-the-counter drugs.
Some dietary supplements may interact with medications or pose risks if you have medical problems or are going to have surgery. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.
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