Glucosamine Sulfate (glucosamine sulfate)
Oral Tablet
Last reviewed · Source: First Databank (FDB) drug data
Overview
USES: Glucosamine has been used for arthritis (osteoarthritis). Some herbal/diet supplement products have been found to contain possibly harmful impurities/additives. Check with your pharmacist for more details about the brand you use.
The FDA has not reviewed this product for safety or effectiveness. Consult your doctor or pharmacist for more details.
Generic name: glucosamine sulfate
Pronunciation: (gloo-KOSE-a-meen)
Therapeutic class: Alternative Therapy
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Glucosamine Sulfate
Indications
No indications are available for this drug.
Dosing
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Drug interactions
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There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
Moderate Interaction: Assess the risk to the patient and take action as needed.
Glucosamine And-Or Chondroitin/Coumarin Anticoagulants
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: The exact mechanism is unknown, but may be the result of additive or synergistic effects on coagulation. Glucosamine is a component of heparin(1) and chondroitin is a component of danaparoid.(2) Glucosamine has been shown not to inhibit CYP2C9,(3) thus inhibition of warfarin metabolism is thought to be unlikely.
CLINICAL EFFECTS: Concurrent use of glucosamine-chondroitin may result in increased effects on coagulation, including elevated International Normalized Ratio (INR) and bleeding.
PREDISPOSING FACTORS: The risk for bleeding episodes may be greater in patients with disease-associated factors (e.g. thrombocytopenia). Drug associated risk factors include concurrent use of multiple drugs which inhibit anticoagulant/antiplatelet metabolism and/or have an inherent risk for bleeding (e.g. NSAIDs).
PATIENT MANAGEMENT: Use caution with adding or discontinuing glucosamine-chondroitin to warfarin therapy. Monitor patients receiving concurrent therapy closely for elevated INR and signs of bleeding. Patients who discontinue glucosamine-chondroitin may need their warfarin dosage adjusted to maintain therapeutic INRs. If concurrent therapy is warranted, monitor patients receiving concurrent therapy for signs of blood loss, including decreased hemoglobin, hematocrit, fecal occult blood, and/or decreased blood pressure and promptly evaluate patients with any symptoms. When applicable, perform agent-specific laboratory test (e.g. INR, aPTT) to monitor efficacy and safety of anticoagulation. Discontinue anticoagulation in patients with active pathologic bleeding. Instruct patients to report any signs and symptoms of bleeding, such as unusual bleeding from the gums or nose; unusual bruising; red or black, tarry stools; red, pink or dark brown urine; acute abdominal or joint pain and/or swelling. The time of highest risk for a coumarin-type drug interaction is when the precipitant drug is initiated or discontinued. Contact the prescriber before initiating, altering the dose or discontinuing either drug.
DISCUSSION: There have been numerous reports of increased INR following the addition of glucosamine, glucosamine-chondroitin, or chondroitin alone to warfarin therapy, including 20 from the United States Food Drug Administration (US FDA), 22 from the World Health Organization (WHO), 3 from the Australian Therapeutic Goods Association (TGA), and 2 published reports. INR values typically increased between two and 20 days after the addition of glucosamine and/or chondroitin to warfarin therapy. In most cases, patients were asymptomatic; however, there were at least two reports of bleeding.(4-8) There has also been one report involving glucosamine and acenocoumarol.(9)
Contraindications
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There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
- No disease contraindications
Adverse reactions
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There are no severe adverse reactions for this drug.
More Frequent
- Abdominal pain with cramps
- Diarrhea
- Gastric acid hypersecretory conditions
- Heartburn
- Nausea
Precautions
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ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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