What is it?
Glucosamine is usually made from seashells, or it can be made in the laboratory. Glucosamine hydrochloride is one of several forms of glucosamine.
Glucosamine hydrochloride is used for osteoarthritis, knee pain, back pain, and glaucoma. However, no one knows yet whether it is effective for any of these conditions. There have been some preliminary studies, but more research is needed.
It is important to read the labels of glucosamine products carefully since several different forms of glucosamine are sold as supplements. These products may contain glucosamine sulfate, glucosamine hydrochloride, or N-acetyl-glucosamine. These different chemicals have some similarities; however, they may not have the same effects when taken as a dietary supplement. Most of the scientific research done on glucosamine has been done on glucosamine sulfate. See the separate listing for glucosamine sulfate. The information on this page is about glucosamine hydrochloride.
Dietary supplements that contain glucosamine often contain additional ingredients. These additional ingredients are frequently chondroitin sulfate, MSM, or shark cartilage. Some people think these combinations work better than taking just glucosamine alone. So far, researchers have found no proof that combining the additional ingredients with glucosamine adds any benefit.
Products that contain glucosamine and glucosamine plus chondroitin vary a great deal. Some do not contain what the label claims. The difference can range from 25% to 115%. Some products in the US that are labeled glucosamine sulfate are actually glucosamine hydrochloride with added sulfate. This product will likely have different effects than one which contains glucosamine sulfate.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for GLUCOSAMINE HYDROCHLORIDE are as follows:
Insufficient evidence to rate effectiveness for...
- Osteoarthritis. There is conflicting evidence about the effectiveness of glucosamine hydrochloride for osteoarthritis. Most of the evidence supporting the use of glucosamine hydrochloride comes from studies of a particular product (CosaminDS, Nutramax Laboratories) that contains a combination of glucosamine hydrochloride, chondroitin sulfate, and manganese ascorbate. Some evidence suggests that this combination can improve pain in people with osteoarthritis of the knee. This combination might work better in people with mild-to-moderate osteoarthritis than in people with severe osteoarthritis.
Other research suggests that taking glucosamine hydrochloride alone or in combination with chondroitin sulfate doesn’t reduce pain in people with osteoarthritis of the knee.
A lot more research has been done on glucosamine sulfate (see separate listing) than on glucosamine hydrochloride. There is some thought that glucosamine sulfate may be more effective than glucosamine hydrochloride for osteoarthritis. One study comparing the two showed no difference. But some researchers have criticized the quality of that study.
- Knee pain. There is some evidence that glucosamine hydrochloride might provide some pain relief for people who have regularly occurring knee pain as a result of joint injury.
- Rheumatoid arthritis. Some early research shows that taking a specific glucosamine hydrochloride product (Rohto Pharmaceuticals Co.) in combination with prescription medical treatments reduces pain compared to a sugar pill. But this product does not seem to reduce the number of painful or swollen joints or decrease inflammation.
- Back pain.
More evidence is needed to rate glucosamine hydrochloride for these uses.
Glucosamine in the body is used to make a “cushion” that surrounds the joints. In osteoarthritis, this cushion becomes thinner and stiff. Taking glucosamine hydrochloride as a supplement might help to supply the materials needed to rebuild the cushion.
Some researchers believe that glucosamine hydrochloride might not work as well as glucosamine sulfate. They think the “sulfate” part of glucosamine sulfate is the important factor because sulfate is needed by the body to produce cartilage.
Glucosamine hydrochloride is POSSIBLY SAFE for most adults when used short-term. The safety of long-term use is unknown. Glucosamine hydrochloride can cause gas, bloating, and cramps.
Some glucosamine products do not contain the labeled amount of glucosamine or contain excessive amounts of manganese. Ask your healthcare provider about reliable brands.
Some preliminary research suggests that glucosamine might raise blood sugar in people with diabetes. However, more reliable research indicates that glucosamine does not seem to significantly affect blood sugar control in people with type 2 diabetes. Glucosamine with routine blood sugar monitoring appears to be safe for most people with diabetes.
There is some concern that glucosamine products might cause allergic reactions in people who are sensitive to shellfish. Glucosamine is produced from the shells of shrimp, lobster, and crabs. But allergic reactions in people with shellfish allergy are caused by the meat of shellfish, not the shell. There are no reports of allergic reactions to glucosamine in people who are allergic to shellfish. There is also some information that people with shellfish allergy can safely take glucosamine products.
Special precautions & warnings:
Pregnancy and breast-feeding: Not enough is known about the use of glucosamine hydrochloride during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Asthma: Glucosamine hydrochloride might make asthma worse. If you have asthma, use caution with glucosamine hydrochloride.
Surgery: Glucosamine hydrochloride might affect blood sugar levels and might interfere with blood sugar control during and after surgery. Stop using glucosamine hydrochloride at least 2 weeks before a scheduled surgery.
Do not take this combination.
Warfarin (Coumadin) is used to slow blood clotting. There are several reports showing that taking glucosamine hydrochloride with or without chondroitin increases the effect of warfarin (Coumadin) on blood clotting. This can cause bruising and bleeding that can be serious. Don't take glucosamine hydrochloride if you are taking warfarin (Coumadin).
Be cautious with this combination.
Medications for cancer (Antimitotic chemotherapy)
Some medications for cancer work by decreasing how fast cancer cells can copy themselves. Some scientists think that glucosamine might increase how fast tumor cells can copy themselves. Taking glucosamine hydrochloride along with some medications for cancer might decrease the effectiveness of these medications.
Be watchful with this combination.
Acetaminophen (Tylenol, others)
There is some concern that taking glucosamine hydrochloride and acetaminophen (Tylenol, others) together might affect how well each works. But more information is needed to know if this interaction is a big concern.
Medications for diabetes (Antidiabetes drugs)
There has been concern that glucosamine hydrochloride might increase blood sugar in people with diabetes. There was also the concern that glucosamine hydrochloride might decrease how well medications used for diabetes work. However, research now indicates that glucosamine hydrochloride probably does not increase blood sugar in people with diabetes. Therefore, glucosamine hydrochloride probably does not interfere with diabetes medications. To be cautious, if you take glucosamine hydrochloride and have diabetes, monitor your blood sugar closely.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
There are no known interactions with herbs and supplements.
There are no known interactions with foods.
The appropriate dose of glucosamine hydrochloride depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for glucosamine hydrochloride. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
2-amino-2-deoxyglucose hydrochloride, 2-Amino-1-Deoxy-Beta-D-Glucopyranose, Amino Monosaccharide, Chitosamine, Chlorhidrato de Glucosamina, Chlorhydrate de Glucosamine, D-Glucosamine HCl, Glucosamine, Glucosamine HCl, Glucosamine KCl, Glucosamine-6-Phosphate.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
To see all references for the Glucosamine hydrochloride page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/747.html.
- Nakamura H, Masuko K, Yudoh K, et al. Effects of glucosamine administration on patients with rheumatoid arthritis. Rheumatol Int 2007;27:213-8.
- Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine may potential the effect of warfarin. The Uppsala Monitoring Centre. Available at: www.who-umc.org/graphics/9722.pdf (Accessed 28 April 2008).
- Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8.
- Muniyappa R, Karne RJ, Hall G, et al. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes 2006;55:3142-50.
- Tannock LR, Kirk EA, King VL, et al. Glucosamine supplementation accelerates early but not late atherosclerosis in LDL receptor-deficient mice. J Nutr 2006;136:2856-61.
- Pham T, Cornea A, Blick KE, et al. Oral glucosamine in doses used to treat osteoarthritis worsens insulin resistance. Am J Med Sci 2007;333:333-9.
- Messier SP, Mihalko S, Loeser RF, et al. Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study. Osteoarthritis Cartilage 2007;15:1256-66.
- Stumpf JL, Lin SW. Effect of glucosamine on glucose control. Ann Pharmacother 2006;40:694-8.
- Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
- Qiu GX, Weng XS, Zhang K, et al. [A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis]. Zhonghua Yi Xue Za Zhi 2005;85:3067-70.
Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808.
- McAlindon T. Why are clinical trials of glucosamine no longer uniformly positive? Rheum Dis Clin North Am 2003;29:789-801.
- Gray HC, Hutcheson PS, Slavin RG. Is glucosamine safe in patients with seafood allergy (letter)? J Allergy Clin Immunol 2004;114:459-60.
- Tannis AJ, Barban J, Conquer JA. Effect of glucosamine supplementation on fasting and non-fasting plasma glucose and serum insulin concentrations in healthy individuals. Osteoarthritis Cartilage 2004;12:506-11.
- Weimann G, Lubenow N, Selleng K, et al. Glucosamine sulfate does not crossreact with the antibodies of patients with heparin-induced thrombocytopenia. Eur J Haematol 2001;66:195-9.
- Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307.
- Guillaume MP, Peretz A. Possible association between glucosamine treatment and renal toxicity: comment on the letter by Danao-Camara. Arthritis Rheum 2001;44:2943-4.
- Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853.
- Yu JG, Boies SM, Olefsky JM. The effect of oral glucosamine sulfate on insulin sensitivity in human subjects. Diabetes Care 2003;26:1941-2.
- Hoffer LJ, Kaplan LN, Hamadeh MJ, et al. Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism 2001;50:767-70.
- Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med 2003;37:45-9.
- Scroggie DA, Albright A, Harris MD. The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized clinical trial. Arch Intern Med 2003;163:1587-90.
- Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4.
- Du XL, Edelstein D, Dimmeler S, et al. Hyperglycemia inhibits endothelial nitric oxide synthase activity by post-translational modification at the Akt site. J Clin Invest 2001;108:1341-8.
- Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: A 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002;162:2113-23.
- Adebowale AO, Cox DS, Liang Z, et al. Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials. JANA 2000;3:37-44.
- Nowak A, Szczesniak L, Rychlewski T, et al. Glucosamine levels in people with ischaemic heart disease with and without type II diabetes. Pol Arch Med Wewn 1998;100:419-25.
- Olszewski AJ, Szostak WB, McCully KS. Plasma glucosamine and galactosamine in ischemic heart disease. Atherosclerosis 1990;82:75-83.
- Yun J, Tomida A, Nagata K, Tsuruo T. Glucose-regulated stresses confer resistance to VP-16 in human cancer cells through a decreased expression of DNA topoisomerase II. Oncol Res 1995;7:583-90.
- Pouwels MJ, Jacobs JR, Span PN, et al. Short-term glucosamine infusion does not affect insulin sensitivity in humans. J Clin Endocrinol Metab 2001;86:2099-103.
- Monauni T, Zenti MG, Cretti A, et al. Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes 2000;49:926-35.
- Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage 2000;8:343-50.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Available at: www.nap.edu/books/0309072794/html/.
- Does glucosamine increase serum lipid levels and blood pressure? Pharmacist's Letter/Prescriber's Letter 2001;17:171115.
- Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled trial. Lancet 2001;357:251-6.
- Almada A, Harvey P, Platt K. Effects of chronic oral glucosamine sulfate on fasting insulin resistance index (FIRI) in non-diabetic individuals. FASEB J 2000;14:A750.
- Leffler CT, Philippi AF, Leffler SG, et al. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med 1999;164:85-91.
- Shankar RR, Zhu JS, Baron AD. Glucosamine infusion in rats mimics the beta-cell dysfunction of non-insulin-dependent diabetes mellitus. Metabolism 1998;47:573-7.
- Rossetti L, Hawkins M, Chen W, et al. In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Invest 1995;96:132-40.
- Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.
- Kim YB, Zhu JS, Zierath JR, et al. Glucosamine infusion in rats rapidly impairs insulin stimulation of phosphoinositide 3-kinase but does not alter activation of Akt/protein kinase B in skeletal muscle. Diabetes 1999;48:310-20.
- Holmang A, Nilsson C, Niklasson M, et al. Induction of insulin resistance by glucosamine reduces blood flow but not interstitial levels of either glucose or insulin. Diabetes 1999;48:106-11.
- Giaccari A, Morviducci L, Zorretta D, et al. In vivo effects of glucosamine on insulin secretion and insulin sensitivity in the rat: possible relevance to the maladaptive responses to chronic hyperglycaemia. Diabetologia 1995;38:518-24.
- Balkan B, Dunning BE. Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. Diabetes 1994;43:1173-9.
- Adams ME. Hype about glucosamine. Lancet 1999;354:353-4.
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Last reviewed - 08/11/2011
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