Almost all known pharmaceutical company in Malaysia come out with their own glucosamine and claim theirs to be the best. So how do we choose which brand to buy?
Here is a list of glucosamine brands in Malaysia.
|Different brands||1 tab|
|11||Move Free Advance (US only)||750mg|
|15||Viartril-S capsule (brand)||250mg|
|16||Viartril-S powder (brand)||1500mg|
|17||Consulf Sulphate (taken together)||400mg|
Total of 16 products in Malaysia....how to choose?
Lets looks at the Evidence based support:
Based on the clinical studies done by Rottapharm Viartril-S (glucosamine sulphate) have proven to show not only an improvement in symptoms but also an improvement in joint space narrowing on radiograph.
But National Institute of Health study (not using glucosamine sulphate) concluded that there is no statistically significant improvements comparing to placebo.
This lead to the argument below, becoz glucosamine exist in the market in 2 forms, so
Sulfate vs hydrochloride: Which one better?
Group 1(support sulphate): Sulfate moiety in glucosamine sulphate might be responsible for the effect. Sulphate is required for articular cartilage glycosaminoglycan synthesis. That is why Viartril-S (sulphate) is proven to be effective.
Group2(support HCL): Glucosamine hydrochloride contains more glucosamine. A dose of 1500mg of glucosamine hydrochloride is equivalent to 1985mg of glucosamine sulphate. This is because HCL form carries 83.1% of glucosamine, where the sulphate form carries only 62.8%. Therefore glucosamine HCL is better and cheaper as well. Claim that Rotta use sulphate to protect their patent on the manufacture of Viartril-S.
Group3(support non): The counter anion of the glucosamine salt (i.e. chloride or sulfate) is unlikely to play any role in the action or pharmacokinetics of glucosamine.
**Panadol metabolism requires sulfur so if glucosamine sulphate is taken together with panadol, by right the patients will feel less effectiveness of the glucosamine sulphate. But the pain maybe relieved by panadol and not glucosamine.
Ask the pharmacist!
1) Glucosamine sulfate might not be effective for more severe, long standing, older, and heavier patients. So for heavy people having pain at the knee, loose weight should be the first option.
2) There is no research showing glucosamine is absorbed topically. Do not apply on the knee.
3) You are free to experience any brand you like. If u want the best, buy the one with proven clinical studies or buy the one with promotion/offer.
4)So far there is no head to head studies comparing glucosamine hydrochloride and glucosamine sulphate with placebo as control....so it is still a question which one is actually better?Of all the products registered in Malaysia, all are using sulphate. How do we compare? Even the famous Move Free Glucosamine HCL Combinations (only available in US) also contains sulphate in the form of Chondroitin sulphate.
5)From what i heard from my good friend, Glucosamine HCL will be classed under Controlled Medicine if it is available. Reason? I also dont know.
6) Leave a comment here if u support HCL or sulphate. Correct me if i am wrong or u disagree. Pls share your experience here.