Interactions

Interactions with Drugs

Glucosamine may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as vitamin K antagonists (warfarin, Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Glucosamine may affect insulin and blood sugar levels. Caution is advised when using medications that may affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Glucosamine may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Glucosamine may also interact with acetaminophen; agents applied to the skin; agents eliminated by the kidneys; agents for the stomach or intestines; agents that increase sun sensitivity; agents that may increase urine flow; alcohol; anticancer agents; antidepressants; anti-hemorrhage agents; caffeine; chitosan; doxorubicin; etoposide; nicotine; nonsteroidal anti-inflammatory drugs (NSAIDs); pain relievers; rosiglitazone; teniposide; thiazolidinediones.

Interactions with Herbs and Dietary Supplements

Glucosamine may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Glucosamine may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

Glucosamine may affect insulin and blood sugar levels. Caution is advised when using herbs or supplements that may affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Glucosamine may also interact with anticancer herbs and supplements; antidepressants; anti-hemorrhage herbs and supplements; antioxidants; avocado or soybean oils or extracts; bromelain; celadrin; Chinese skullcap; chondroitin sulfate; fish oil; ginger; green-lipped mussel extract; herbs and supplements applied to the skin; herbs and supplements eliminated by the kidneys; herbs and supplements for the stomach or intestines; herbs and supplements that increase sun sensitivity; herbs and supplements that may increase urine flow; Lindera aggregata; manganese; pain relievers; potassium; vitamin C.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com