This combination tablet is indicated in:

• Osteoarthritis
• Rheumatoid arthritis
• Bone and Joint injuries

Glucosamine: Glucosamine (2-amino-2-deoxy-alpha-D-glucose) is a natural amino sugar, produced by the body and found in certain foods. It is the most fundamental building block required for the biosynthesis of glycosaminoglycans (GAGs) such as hyaluronic acid, keratan sulfate, and chondroitin sulfate. GAGs bind with protein and form proteoglycans, the essential building block of articular cartilage. When cartilage in a joint deteriorates, osteoarthritis develops. It also helps to form ligaments, tendons, nails, and various other connective tissues. When we take artificially synthesized glucosamine sulfate supplement, it increases glucosamine levels in the body, thus facilitating the production and repair of cartilage. Glucosamine also activates chondrocytes in the cartilage, which help produce GAGs and proteoglycans.

In humans, about 90% of glucosamine administered as an oral dose of glucosamine sulfate is absorbed from the digestive tract. It is predominantly metabolized by the liver and excreted through urine.

Diacerein: This is used for the treatment of osteoarthritis. It also has analgesic, antipyretic, and anti-inflammatory activity. It is released in vitro and directly inhibits interleukin-1 (IL-1) synthesis, which is the main cytokine involved in cartilage destruction. Due to its specific mode of action, it has been shown to have a disease-modifying effect in experimental models of osteoarthritis and in human subjects with finger joint and knee osteoarthritis.

The oral bioavailability of diacerein is 56%. Concurrent intake of food delays the time to peak concentration but is associated with a 25% increase in absorption. Therefore, diacerein is best given with food. It mainly binds to the protein albumin. Diacerein is metabolized extensively (100%) in the liver following oral dosing. Urinary excretion of diacerein in the form of its metabolites has ranged between 35% and 60%.

Use in adults: One tablet twice daily with food.

Use in children and adolescents: The safety and effectiveness in children and adolescents under the age of 18 years have not been established.

Decreased absorption of diacerein with aluminium and/or magnesium hydroxide antacids. Increased risk of diarrhoea with laxatives or antibiotics.

Contraindicated for those who show hypersensitivity to glucosamine or diacerein.

No serious adverse effect has been reported. Nausea, vomiting, diarrhoea, epigastric pain, headache, skin rashes, and intense yellow colouring of urine may occur.

This tablet is contraindicated during pregnancy and breastfeeding.

Caution should be practised when administering this tablet in patients who are allergic to glucosamine or diacerein.

There are no data available regarding overdose of this combination.

Stimulation of Cartilage formation

Store in a cool and dry place below 30°C, protect from light and moisture. Keep out of reach of children.