II. Pathophysiology
- Glucosamine is endogenous amino sugar, a precursor of glycosaminoglycans
- Glycosaminoglycans are present in joint structures such as Synovial Fluid
- Effects
- Stimulates chondrocyte metabolism
- May have anti-inflammatory effects at higher dose
III. Source
- Marine exoskeleton or
- Synthetically derived
IV. Efficacy
- Appears more effective than Placebo at relieving Osteoarthritis-related Joint Pain
- Effect requires at least one month of therapy
- Less Knee Joint space narrowing with Glucosamine over Placebo in 3 years
V. Dosing
- Glucosamine 500 mg orally three times daily
VI. Adverse Effects
- Gastrointestinal 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)
VII. Drug Interactions
-
Warfarin (Coumadin)
- Warfarin's Anticoagulation effect is increased