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Glucosamine
Aka: Glucosamine, Glucosamine Sulfate
See AlsoOsteoarthritis Chondroitin
PathophysiologyGlucosamine is endogenous amino sugar, a precursor of glycosaminoglycans Glycosaminoglycans are present in joint structures such as Synovial Fluid EffectsStimulates chondrocyte metabolism May have anti-inflammatory effects at higher dose
SourceMarine exoskeleton or Synthetically derived
EfficacyAppears more effective than Placebo at relieving pain Effect requires at least one month of therapy Less Knee Joint space narrowing with Glucosamine over Placebo in 3 yearsReginster (2001) Lancet 357:251-6
DosingGlucosamine 500 mg orally three times daily
Adverse EffectsGastrointestinal upset Hemoglobin A1C and Serum Glucose are NOT impacted (contrary to initial reports)Scroggie (2003) Arch Intern Med 163:1587-90 Glucosamine is safe in shellfish allergy (despite marine exoskeleton source)Gray (2004) J Allergy Clin Immunol 114:459-60
Drug InteractionsWarfarin (Coumadin )Warfarin 's Anticoagulation effect is increased
ReferencesDelafuente (2000) Rheum Dis Clin North Am 26:1-11 McAlindon (2000) JAMA 283:1469-75 Richy (2003) Arch Intern Med 163:1514-22