Ibuprufen may increase blood levelsof lithium

Osteoarthritis

Ibuprofen may cause - Rashes Ringing in the ears Headaches Dizziness Drowsiness Abdominal Pain Nausea Diarrrhea Constipation Heartburn

Glucosamine may cause- Nausea Diarrhea Gastrointestinal upset

Glucosamine may increase insulin resistance and consequently affect glucose level. Glucosamine should not be given to those who are allergic to shellfish

Indication-

Osteoarthritis

Dosage-

 500mg 3 to 4 times daily Max dose 1500mg /day

Pharmacokinetics

Ibuprofen inhibits cyclooxygenase ( COX)) thus blocking the conversion of arachidonic acid to prostaglandin which are mediators of inflammation. Its analgesic, antipyretic and anti-inflammatory activities are acheived principally through COX-1 and COX-2 inhibiotrs Glucosamie an endogenous amino monosaccharide stimulates the synthetic activity of the chondrocytes and inhibits the chondrolysis provoked bty degrading enzymes released into the articular cavity during OA Glucosamine stimulates the system for the production of glycosamine glycans ( GAGs ) resulting in cartlige regeneration and joint repair It inhibits the breakdown of proteoglycans. It makes synovial fluid thick and gelatinous thereby increasing cushioning ability, decreasing friction and pain in the joint It also prevents the joint space loss in osteoarthiritis and minimizes joint narrowing

Pharmacokinetics

Ibuprofen is rapidly absorbed afte oral administration with peak serum of plasma levels generally appearing within 1.5 to 2 hours Both the rate of absorption and peak plasma concentration is reduced when the drug is taken with food.

Glucosamine- About 90% of glucosamine administered orally as glucosamine salts gets absorbed from the small intestine and it is transported via the portal circulation to the liver.

Rationale for combination- Compaaritive effcicacy of oral treatment with 1.5 g glucosamine sulphate or 1.2g Ibuprofen daily over a period of 8 weeks Ibuprofen group showed faster decrease in pain but the patients taking glucosammine reported lower rates of pain over a longer period of time and eventually less pain than those Ibuprofen. Glucosamine is well tolerated with negligable side effects.

Ibuprofen- Both the rate of absorption and peak plasma concentration is reduced when the drug is taken with food