Meta Information
ID:glucosamine-chondroitin
Name:Glucosamine + Chondroitin
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-07-02T15:09:16Z
Model
phase-c-combo-claude-opus-4.8
Derived From
- glucosamine
Provenance Note
Interactions inherited from glucosamine. Chondroitin adds a theoretical additive anticoagulant/antiplatelet effect (bleeding-risk monitoring already covered by glucosamine's warfarin row).
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets (e.g., Warfarin)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Glucosamine may enhance the anticoagulant effect of drugs like warfarin, increasing the International Normalized Ratio (INR) and elevating the risk of bleeding.
Actionable advice:
Glucosamine should not be used when taking warfarin or other blood thinners unless approved and closely monitored by a doctor.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Using the United States Food and Drug Administration (FDA) MedWatch database, 20 reports of glucosamine or glucosamine-chondroitin sulfate use with warfarin associated with altered coagulation (manifested by increased INR, or increased bleeding or bruising) were identified.
Label source:
PubMed: Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: case report and review of the literature and MedWatch database. (PMID 18363538)
Action type:
avoid
Target id:
/condition/shellfish-allergy
Target name:
Shellfish Allergy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Most glucosamine supplements are derived from the shells of shellfish (e.g., shrimp, crab, lobster), which can trigger a severe allergic reaction in susceptible individuals.
Actionable advice:
This should be strictly avoided with a shellfish allergy; vegetarian (corn-derived) sources of glucosamine are best sought instead.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
CONCLUSION: Results of this investigation support the need for clear labelling on glucosamine and chondroitin preparations to raise awareness of possible adverse events for those predisposed to allergy or atopy in response to shellfish.
Label source:
PubMed: Hypersensitive adverse drug reactions to glucosamine and chondroitin preparations in Australia between 2000 and 2011. (PMID 31597786)
Action type:
avoid
Target id:
/class/chemotherapy-radiation
Target name:
Chemotherapy (Topoisomerase II Inhibitors)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Some laboratory and animal studies suggest that glucosamine may interfere with the effectiveness of certain chemotherapy drugs like etoposide, doxorubicin, and teniposide, potentially reducing their cancer-fighting ability.
Actionable advice:
Glucosamine should be avoided during chemotherapy, especially with topoisomerase II inhibitors, unless specifically cleared by an oncologist.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We found that resistance to topoisomerase II (topo II) inhibitors, VP-16 and adriamycin, was induced by these treatments in human colon cancer HT-29 cells.
Label source:
PubMed: Oncology research (1995)
Source url:
Exact phrase from label:
Glucose-regulated proteins (GRPs) are induced in cells by a variety of stress conditions such as treatment with 2-deoxyglucose, glucosamine, or the calcium ionophore A23187.
Label source:
PubMed: Oncology research (1995)
Source url:
Exact phrase from label:
The glucose-regulated stress response of cancer cells leads to a decreased expression of DNA topoisomerase IIalpha (topo IIalpha) and a cell cycle arrest at the G1 phase.
Label source:
PubMed: Journal of cellular physiology (1999)
Action type:
avoid
Target id:
/condition/diabetes-mellitus
Target name:
Diabetes Mellitus
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
As an amino sugar, glucosamine can potentially affect glucose metabolism and insulin resistance, possibly leading to increased blood sugar levels in some individuals with diabetes.
Actionable advice:
If you have diabetes, monitor your blood glucose levels closely when starting or stopping glucosamine and consult your doctor.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Infusion of GlcN did not affect readily releasable insulin levels, glucose-stimulated insulin secretion (GSIS), or the time constant of secretion, but it increased both the glucose threshold of GSIS (delta approximately 0.5-0.8 mmol/l, P < 0.03-0.01) and plasma fasting glucose levels (delta approximately 0.3-0.5 mmol/l, P < 0.05-0.02).
Label source:
PubMed: Effects of glucosamine infusion on insulin secretion and insulin action in humans. (PMID 10866044)
Action type:
monitor
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
By potentially increasing blood glucose levels, glucosamine may counteract the effects of medications intended to lower blood sugar, requiring possible dose adjustments.
Actionable advice:
It is important to talk to a doctor before use, as blood sugar may need to be monitored more frequently and medication dosage adjusted.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In conscious normal rats, glucosamine lowered plasma insulin, followed by an increase in blood glucose.
Label source:
PubMed: Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. (PMID 7926284)
Action type:
adjust_with_prescriber
Target id:
/condition/glaucoma
Target name:
Glaucoma
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Some research indicates that glucosamine supplementation may increase intraocular pressure (IOP), which could worsen glaucoma.
Actionable advice:
Glucosamine is best avoided in glaucoma, or used only under the supervision of an ophthalmologist with regular eye pressure monitoring.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Glucosamine supplementation is common but can be associated with increased intraocular pressure (IOP) and could contribute to the pathogenesis of glaucoma.
Label source:
PubMed: Effect of Glucosamine on Intraocular Pressure and Risk of Developing Glaucoma. (PMID 38031296)
Action type:
avoid
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
moderate
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Glucosamine can cause gastrointestinal side effects such as nausea, heartburn, or stomach upset in some individuals when taken on an empty stomach.
Actionable advice:
Glucosamine is best taken with a meal or a snack to improve tolerance and minimize digestive discomfort.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Side effects were observed in 16.0% of patients during treatment, with the most common being nausea (10.0%).
Label source:
PubMed: The Efficacy of Piascledine in Alleviating Symptoms and Its Impact on Blood Lipid Levels and body Mass Index in Patients with Knee Osteoarthritis. (PMID 39981153)
Action type:
informational_none
Target id:
/intervention/chondroitin-sulfate
Target name:
Chondroitin Sulfate
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Glucosamine and chondroitin are both structural components of cartilage and are thought to work together to support joint health, with some studies showing a combined effect superior to either alone.
Actionable advice:
Consider taking glucosamine and chondroitin together for potentially enhanced joint support benefits.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
However, exploratory analyses suggest that the combination of glucosamine hydrochloride and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain.
Label source:
PubMed: Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis. (PMID 17658908)
Action type:
informational_none
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is insufficient reliable data on the safety of glucosamine supplementation during pregnancy.
Actionable advice:
Glucosamine should not be used during pregnancy due to a lack of safety information.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is not known whether glucosamine is excreted in human breast milk or what its effects might be on a nursing infant.
Actionable advice:
Glucosamine should not be used while breastfeeding due to a lack of safety information.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
Also, glucosamine isn't recommended for children or women who are pregnant or breastfeeding, because there isn't enough evidence yet about whether it's safe for those groups.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/condition/asthma-copd
Target name:
Asthma
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There are isolated case reports suggesting a possible link between glucosamine supplementation and the exacerbation of asthma symptoms.
Actionable advice:
This is best used with caution in those with asthma, and discontinued if respiratory symptoms worsen.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
A case of asthma exacerbated by the use of a glucosamine-chondroitin supplement for osteoarthritis pain is described.
Label source:
PubMed: The Journal of the American Board of Family Practice (2002)
Source url:
Exact phrase from label:
The biological link between both chondroitin and glucosamine and secretions from the respiratory tree of persons with asthma lends biologic plausibility to the hypothesis that the patient's asthmatic episode was related to the dietary substance.
Label source:
PubMed: The Journal of the American Board of Family Practice (2002)
Source url:
Exact phrase from label:
Glucosamine should be used with caution in patients who have shellfish allergies or asthma, and in those taking diabetes medications or warfarin.
Label source:
PubMed: American family physician (2008)
Action type:
avoid
Target id:
/intervention/acetaminophen
Target name:
Acetaminophen (Paracetamol)
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Some research suggests that taking glucosamine and acetaminophen together might reduce the effectiveness of both substances, though the clinical significance is unclear.
Actionable advice:
The pain-relieving effects of either substance may be slightly reduced when taken concurrently.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
certain combinations of glucosamine with nonopioid analgesics at the oral doses and ratios tested resulted in a synergistic (ibuprofen and ketoprofen), additive (diclofenac, indomethacin, naproxen, and piroxicam), or subadditive (aspirin and acetaminophen) antinociceptive interaction.
Label source:
PubMed: The Journal of pharmacology and experimental therapeutics (2003)
Source url:
Exact phrase from label:
GlcN can increase the relative BA of paracetamol through reducing its metabolism. This phenomenon is associated with reduction in hepatocytes injury following ingestion of high doses of paracetamol.
Label source:
PubMed: Journal of pharmaceutical sciences (2015)
Source url:
Exact phrase from label:
The pronounced antiapoptic effect of the investigated combination differed but little from the effect of glucosamine hydrochloride alone, but significantly exceeded the antiapoptic activity of paracetamol.
Label source:
PubMed: Eksperimental'naia i klinicheskaia farmakologiia (2012)
Action type:
informational_none
Target id:
/class/diuretics
Target name:
Diuretics (Water Pills)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Theoretically, glucosamine sulfate contains sodium or potassium salts which could interact with diuretics, although this is not well-documented in clinical practice.
Actionable advice:
This is best used with caution, and it is worth talking to a doctor, particularly when on a potassium-sparing diuretic or with kidney issues.
Validation status:
validated_via_expert_review
Evidence tier:
tier_c
Evidence basis:
expert_review_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
for the management of edema in the following settings
Label source:
FDA label: Spironolactone (ALDACTONE)
Action type:
monitor
Target id:
/biomarker/fasting-glucose
Target name:
Fasting Glucose
Severity:
minor
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
12
Hours after target:
0
Description:
Because glucosamine can influence glucose metabolism, taking it before a blood test may slightly alter the results, potentially causing a falsely elevated reading.
Actionable advice:
Glucosamine is generally best not taken on the morning of a scheduled fasting blood glucose test for the most accurate result.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Results showed that when treated with high levels of glucose, both lines showed increased expression of β-catenin and O-GlcNAcylation levels; however, these effects could be abolished by the HBP inhibitors, Azaserine and 6-Diazo-5-oxo-l-norleucine, and be restored by glucosamine.
Label source:
PubMed: Elevated glucose levels impair the WNT/β-catenin pathway via the activation of the hexosamine biosynthesis pathway in endometrial cancer. (PMID 26923859)
Action type:
monitor