Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

No specific drug interaction studies have been performed, however, the physico-chemical and pharmacokinetic properties of glucosamine sulfate suggest a low potential for interactions. In one study glucosamine was found not to be an inhibitor of the activities of the following human cytochrome P450 enzymes: CYP1A2, CYP2E1, CYP2C19, CYP2C9, CYP2D6, CYP3A4, as tested by metabolite formation from selected substrates for each of the CYP enzymes tested.

The compound does not compete for absorption mechanisms and, after absorption, does not bind to plasma protein, while its metabolic fate as an endogenous substance incorporated in proteoglycans or degraded independently of the cytochrome enzyme system, is unlikely to give rise to drug interactions.


There are limited data on possible drug interactions with glucosamine, but increments in the INR parameter have been reported with oral vitamin K antagonists. Patients treated with oral vitamin K antagonists should therefore be closely monitored at the time of initiation or termination of glucosamine therapy.


The oral administration of glucosamine sulfate can enhance the gastrointestinal absorption of tetracyclines but the clinical relevance of this interaction is probably limited.

Steroidal or non-steriodal analgesic or anti-inflammatory agents can be administered together with glucosamine sulfate.

Analgesics and NSAIDs may be used concomitantly with glucosamine sulfate, either for rescue analgesia during possible flares of the disease, or in the initial period of treatment, since the symptomatic effects of glucosamine sulfate may be delayed for 1-2 weeks.