Teraflex capsules, No. 60

• Degenerative-dystrophic diseases of the joints and spine: osteoarthritis stage I-III,

• osteochondrosis.

Inside. Adults and children over 15 years old are prescribed 1 capsule for the first 3 weeks. 3 times / day; the next days - 1 caps. 2 times / day, regardless of food intake, with a small amount of water. The recommended duration of the course of treatment is 3 to 6 months.

If necessary, it is possible to carry out repeated courses of treatment, the duration of which is set individually.

Transparent hard gelatin capsules;

the contents of the capsules are white or white with a yellowish sheen powder with crystalline particles.

1 caps.

glucosamine hydrochloride 500 mg

chondroitin sodium sulfate 400 mg

Excipients: stearic acid - 10 mg, magnesium stearate - 5 mg, manganese sulfate - 1 mg.

• Chronic renal failure of severe degree;

• pregnancy;

• lactation period;

• age up to 15 years;

• hypersensitivity.

  With caution: diabetes mellitus (it is recommended to periodically monitor blood glucose levels, especially at the beginning of treatment), bronchial asthma, heart and / or renal failure (isolated cases of edema are described when chondroitin is taken), hypersensitivity to seafood.

pharmachologic effect

A drug that stimulates the restoration of cartilage tissue.

Glucosamine and chondroitin sulfate are involved in the synthesis of connective tissue, helping to prevent the destruction of cartilage and stimulating tissue regeneration. The introduction of exogenous glucosamine enhances the production of cartilage matrix and provides nonspecific protection against chemical damage to the cartilage. Another possible effect of glucosamine is the protection of damaged cartilage from metabolic destruction caused by NSAIDs and GCS, as well as its own moderate anti-inflammatory effect.

Chondroitin sulfate serves as an additional substrate for the formation of a healthy cartilage matrix. Stimulates the formation of hyaluronan, the synthesis of proteoglycans and collagen type II, and also protects hyaluronan from enzymatic degradation (by suppressing the activity of hyaluronidase); maintains the viscosity of the synovial fluid, stimulates the mechanisms of cartilage tissue repair and suppresses the activity of those enzymes (elastase, hyaluronidase) that break down cartilage. In the treatment of osteoarthritis, it relieves the symptoms of the disease and reduces the need for NSAIDs.

Pharmacokinetics

Glucosamine

Suction

The oral bioavailability of glucosamine is 25% (due to the 'first pass' effect through the liver).

Metabolism

After absorption, radioactively labeled glucosamine is first found in plasma and later penetrates into tissues. The highest concentrations are found in the liver, kidneys and articular cartilage. About 30% of the dose taken persists for a long time in the tissues of bones and muscles.

Withdrawal

It is excreted mainly by the kidneys unchanged, partly through the intestines. T1 / 2 - 68 h.

Chondroitin sulfate

Suction

When chondroitin sulfate is ingested once in a dose of 0.8 g (or 2 times / day 0.4 g), the plasma concentration increases over 24 hours. The absolute bioavailability is 12%.

Metabolism

Metabolized by desulfurization.

Withdrawal

It is excreted by the kidneys. T1 / 2 - 310 min.

Side effect

TeraflexЃ is well tolerated by patients.

From the digestive system: pain in the epigastric region, flatulence, diarrhea, constipation.

From the nervous system: dizziness, headache, drowsiness, insomnia.

On the part of the cardiovascular system: tachycardia.

Others: allergic reactions, leg pain and peripheral edema.

Application during pregnancy and lactation

There are no clinical data on the efficacy and safety of TeraflexЃ during pregnancy and during breastfeeding.

Application for impaired renal function

Contraindicated in severe renal failure.

Application in children

The use of the drug is contraindicated in children under 15 years of age.

special instructions

If undesirable effects from the gastrointestinal tract appear, the dose of the drug should be reduced by 2 times, and if there is no improvement, the drug should be canceled.

Overdose

Overdose cases are unknown.

Symptoms: with an overdose of chondroitin sulfate, hemorrhagic rash, nausea, vomiting are possible.

Treatment: gastric lavage, symptomatic therapy.

Drug interactions

The drug improves the absorption of tetracyclines, reduces the effect of semi-synthetic penicillins and chloramphenicol.

The drug is compatible with NSAIDs and GCS.

There are limited data on the possible interaction of glucosamine and warfarin, which can lead to an increase in INR and the risk of bleeding. Therefore, when taken simultaneously, blood coagulation indicators should be monitored.