Kosamine

KOSAMINE 250 MG CAPSULE: Each capsule contains Glucosamine sulfate NaCl equivalent to Glucosamine sulfate 250 mg.
KOSAMINE 500 MG CAPSULE: Each capsule contains Glucosamine sulfate NaCl equivalent to Glucosamine sulfate 500 mg.
KOSAMINE (POWDER FOR ORAL SOLUTION): Each sachet (3.95 grams) contains Glucosamine sulfate NaCl equivalent to Glucosamine sulfate 1500 mg.
Each gram of Glucosamine sulfate NaCl contains 80.2 mg (3.5 millimol) of sodium.

Pharmacology: Pharmacodynamics: Glucosamine is an amino monosaccharide, which is a precursor for glycosaminoglycans and following proteoglycans synthesis; a major component of articular cartilage. Supplemented Glucosamine therefore may help prevent cartilage degeneration; nevertheless, it has no inhibitory effect on prostaglandin synthesis.
Pharmacokinetics: Glucosamine is rapidly absorbed after oral administration and has a bioavailability of 26%. Maximum plasma concentration (C_max) is reached within 8-10 hours of administration. Glucosamine undergoes first-pass metabolism in the liver, and binds to plasma proteins. It is distributed into the tissues and organs such as liver, kidney, articular cartilage and bone. Glucosamine sulfate dissociates into D-glucosamine and a sulfate ion. The active component D-glucosamine is metabolised into carbon dioxide, water and urea. It is excreted in the urine, and partly in the feces and lung.

Use as an adjunctive therapy of osteoarthritis.

KOSAMINE should be taken 15 minutes before a meal.
The recommended duration of therapy is 3 months or longer and the treatment course may be repeated at intervals of 2 months; or according to medical prescription.
Adult dosage: Capsules: 500 mg taken 3 times daily for at least 6 weeks; or according to medical prescription.
Powder for oral solution: 1 sachet (1500 mg) dissolved in water, taken once daily for at least 6 weeks; or according to medical prescription.

Symptomatic treatment is recommended for overdosage.

Patients with hypersensitivity to Glucosamine or any other components of this drug.

No studies of Glucosamine have yet been performed in patients with renal or hepatic impairment; use with caution in these patients.
Due to sodium content in the drug, use with caution in patient who need to limit sodium intake.
Suggestions: The therapeutic effect of Glucosamine sulfate can be seen approximately 1 week after taken. Coadministration of non-steroidal anti-inflammatory drugs (NSAIDs) may be required in the patients with severe pain during the initial time.
Patients using Glucosamine should have weight control or physical therapy concomitantly.
Patients with asthma, diabetes, and shellfish allergy should take added caution.
Patients with prolonged use of Glucosamine should monitor blood sugar level and blood pressure regularly.

There are no adequate and controlled studies on safety and effectiveness of Glucosamine in pregnancy and lactation. Avoid the drug unless the benefits outweigh the potential risks.

Most commonly reported adverse effects are gastrointestinal disturbances, including nausea, vomiting, flatulence, epigastric pain, constipation, diarrhea, anorexia, and dyspepsia. Adverse effects also include edema, tachycardia, drowsiness, insomnia, headache, erythema, pruritus or skin reaction, leg swelling, flushing, fatigue, and hypertension, but rarely occur.

Glucosamine administered orally can enhance the adsorption of concomitantly administered tetracycline.
Glucosamine administered orally can decrease the adsorption of concomitantly administered penicillin or chloramphenicol.
Glucosamine coadministered with antidiabetic agents, such as acarbose, acetohexamide, chlorpropamide, glimepiride, glipizide, glyburide, metformin, miglitol, pioglitazone, repaglinide, rosiglitazone, tolazamide, tolbutamide, troglitazone, may reduce antidiabetic agents effectiveness. Closed monitoring of blood glucose levels with coadministration is advised.
Glucosamine may reduce effectiveness of coadministered doxorubicin; avoid coadministration.
Glucosamine may reduce effectiveness of coadministered etoposide; avoid coadministration.
Glucosamine may reduce effectiveness of coadministered teniposide; avoid coadministration.
Glucosamine may elevate serum International Normalized Ratio (INR) values and potentiates anticoagulant effects of coadministered warfarin, therefore increases risk of bleeding. During concomitant treatment, Warfarin dosage adjustments may be required, and closely monitoring of the INR is needed.
Glucosamine can be coadministered with steroidal agents or non-steroidal anti-inflammatory drugs (NSAIDs) for synergy.

Store below 30°C.

Other Drugs Acting on Musculo-Skeletal System

M01AX05 - glucosamine ; Belongs to the class of other non-steroidal antiinflammatory and antirheumatic products.

D