Major interaction on record — check this product against your medications before combining. Based on 4 of 7 ingredients. Check your meds →
Dietary supplement

Cosamin ASU Advanced Formula Ingredients & Drug Interactions

by NMx Wellness Innovations

Cosamin ASU Advanced Formula label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Cosamin ASU Advanced Formula against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Cosamin ASU Advanced Formula is a dietary supplement by NMx Wellness Innovations with 7 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 1,523 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are decaffeinated Green Tea extract, Sodium, Glucosamine HCl. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Cosamin ASU Advanced Formula by NMx Wellness Innovations

Ask about any prescription or over-the-counter medication and we check it for interactions with Cosamin ASU Advanced Formula by NMx Wellness Innovations — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Cosamin ASU Advanced Formula by NMx Wellness Innovations

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 23, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 3 of its 9 active ingredients.
  • “Proprietary Concentrated ASU Blend” is a proprietary blend — the label gives one combined amount (400 mg) without saying how much of each component you get.
  • “AKBA Complex” is a proprietary blend — the label doesn't break down how much of each component you get.
  • “Avocado/Soybean Unsaponifiables (ASU) powder” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.

Cosamin ASU Advanced Formula contains nine ingredients, of which several are active. Sodium, mixed tocopherols (vitamin E), glucosamine HCl, soy protein isolate, decaffeinated green tea extract, soy unsaponifiables, boswellia extracts, and chondroitin sulfate are the active components.

Soy protein isolate serves as a source of amino acids; glucosamine and chondroitin are structural compounds thought to support joint cartilage; boswellia extract is traditionally used for joint inflammation; avocado and soy unsaponifiables (ASU) are plant-derived compounds; green tea extract is included for its antioxidant content; vitamin E acts as an antioxidant; and sodium is a mineral. The product also contains inactive ingredients, including gelatin as a capsule material.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: Joint comfort and cartilage support.
  • We looked for evidence on: Asthma, Cartilage degradation, Joint mobility.
  • The closest evidence on file: Boswellia Serrata is rated "Insufficient Reliable Evidence To Rate" for Asthma (Natural Medicines).
  • Also on file: Vitamin E is rated "Insufficient Reliable Evidence To Rate" for Asthma.

Glucosamine is rated Likely Effective for osteoarthritis — the main joint condition this product targets. Chondroitin is rated Possibly Effective for osteoarthritis and cataracts.

Vitamin E is rated Effective for vitamin E deficiency and Possibly Effective for Alzheimer disease and several other conditions. Boswellia is rated Possibly Effective for osteoarthritis.

Green tea extract is rated Likely Effective for HPV and Possibly Effective for ovarian cancer and high cholesterol. Avocado unsaponifiables are rated Possibly Effective for high cholesterol.

For most other uses, the evidence we hold is insufficient to rate effectiveness.

The evidence, ingredient by ingredient Sodium Glucosamine Green Tea Chondroitin Sulfate

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 8 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Sodium is generally well tolerated at normal dietary amounts, but high intake is linked to high blood pressure and heart strain — avoid supplements or very high intake without medical advice. Vitamin E is generally well tolerated at dietary amounts; high-dose supplements may raise the risk of bleeding and other harms.

Glucosamine, chondroitin, boswellia, and green tea extract are generally well tolerated, though side effects can include bloating, constipation, diarrhea, nausea, and abdominal pain. Rare serious effects include liver injury with high-dose green tea extract and allergic reactions with glucosamine.

Avocado is widely eaten and considered safe as food; rare allergic reactions have been reported in people with latex sensitivity. Pregnancy and lactation safety varies by ingredient: glucosamine and boswellia should be avoided in pregnancy, while chondroitin's data are lacking; green tea is possibly safe in pregnancy at moderate doses but should be limited while breastfeeding; avocado food is fine, but safety of concentrated supplements is unknown in both.

Side effects, ingredient by ingredient Sodium Glucosamine Green Tea Chondroitin Sulfate

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 8 of the 8 matched ingredients can interact with medications — Boswellia Serrata, Chondroitin Sulfate, Glucosamine, Avocado, Vitamin E, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; lithium.
  • For scale: 1,524 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your doctor or pharmacist before using this product if you take warfarin or other blood thinners (Major risk of increased bleeding), nadolol or atorvastatin (Major risk of reduced drug levels), or ephedrine (Major risk of dangerous stimulant effects). Also discuss it if you use seizure medications, heart medications processed by the liver, corticosteroids, lithium, immunosuppressants, or niacin — the product may alter how these work.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

This product combines several joint-support ingredients, of which glucosamine and chondroitin have the strongest evidence for osteoarthritis. However, it carries significant medication interactions — especially with blood thinners, heart and seizure medications, and certain chemotherapy drugs — and the sodium content makes it unsuitable if you're managing blood pressure or taking lithium.

Before taking it, check your medications with a healthcare provider or pharmacist, especially if you take warfarin, atorvastatin, nadolol, blood pressure drugs, or any seizure medication.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 8 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2019.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Cosamin ASU Advanced Formula, straight from the product label.

Brand NMx Wellness Innovations
Barcode (UPC) 755970820164
Net contents 180 Capsule(s)
Market status On market
Date entered into DSLD Aug 23, 2019
DSLD ID 205155
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Cosamin ASU Advanced Formula by NMx Wellness Innovations, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
Servings per container
60
UPC/BARCODE
755970820164
IngredientAmount% DV
Calories10 Calorie(s)--
Total Carbohydrates1 Gram(s)1%
Sodium35 mg1%
Protein1 Gram(s)2%
Mixed Tocopherols0 NP--
Glucosamine HCl1.5 Gram(s)--
Soy Protein isolate0 NP--
decaffeinated Green Tea extract0 NP--
Soy (Glycine maximus) Unsaponifiables0 NP--
Avocado (Persea gratissima) Unsaponifiables0 NP--
Boswellia extracts0 NP--
Proprietary Concentrated ASU Blend400 mg--
AKBA Complex0 NP--
Avocado/Soybean Unsaponifiables (ASU) powder0 NP--
Sodium Chondroitin Sulfate350 mg--

Other ingredients: Gelatin, Contains <2% of

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

General Statements

Professional size not for retail sale

Learn more: Cosamin.com or 1-877-COSAMIN (1-877-267-2646)

Made in the USA from globally sourced ingredients

Researched, tested & certified

Cosamin ASU for joint health

Psalm 86:12

Suggested/Recommended/Usage/Directions

Directions for use: Take 3 capsules daily until desired comfort is reached. May reduce number of capsules taken daily to maintain comfort level. Capsules may be taken all at once or divided with meals.

Formulation

Gluten-free

Precautions

If you have any condition that requires medical attention always consult your physician before taking any dietary supplement.

Important: Tamper evident seal under cap. Do not use if seal is broken or missing.

Contains: Soy; Glucosamine derived from crab and shrimp.

Storage

Keep in a cool, dry place.

Brand IP Statement(s)

U.S. Patent Nos. 6,797,289, 8,753,697, and 9,572,791. For use under U.S. Patent Nos. 8,568,803 and 8,808,770. Additional patent pending.

Formula

Glucosamine HCl (FCHG49) Chondroitin Sulfate (TRH122) ASU (NMX1000) AKBA (QUIKLOX) Green Tea

Contains: Soy; Glucosamine derived from crab and shrimp.

FDA Statement of Identity

Dietary Supplement

Seals/Symbols

NSF Certified for sport

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Cosamin ASU Advanced Formula by NMx Wellness Innovations label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Cosamin ASU Advanced Formula label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Cosamin ASU Advanced Formula by NMx Wellness Innovations

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Sodium

Interacts with
205 drugs
35 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Protein

1 Gram(s) per serving

Glucosamine HCl

Interacts with
170 drugs
1.5 Gram(s) per serving

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of...

Glucosamine HCl monograph & interactions

Proprietary Concentrated ASU Blend

400 mg per serving

Sodium Chondroitin Sulfate

Interacts with
2 drugs
350 mg per serving

Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain....

Sodium Chondroitin Sulfate monograph & interactions

Other (inactive) ingredients: Gelatin, Contains <2% of. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cosamin ASU Advanced Formula by NMx Wellness Innovations Drug Interactions

Want to check YOUR meds against Cosamin ASU Advanced Formula?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,523Drugs
15 Major 1,435 Moderate 73 Minor

Ingredients driving the most interactions

decaffeinated Green Tea extract 1,293
Sodium 205
Glucosamine HCl 170
Sodium Chondroitin Sulfate 2

Individual Drug Interactions

The ingredients in Cosamin ASU Advanced Formula interact with 1,523 drugs. Click any drug to see the details.

4 of the 7 ingredients in Cosamin ASU Advanced Formula interact with drugs. Each result below shows which ingredient is responsible. decaffeinated Green Tea extract Sodium Glucosamine HCl Sodium Chondroitin Sulfate

Each ingredient & the kinds of drugs it affects

For each ingredient in Cosamin ASU Advanced Formula with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

decaffeinated Green Tea extract58 drug types · 1,293 drugs

Atorvastatin (Lipitor)

Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.

Likelihood Likely Evidence B
Ephedrine

Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.

Likelihood Probable Evidence D
Nadolol (Corgard)

Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.

Likelihood Likely Evidence B
5-Fluorouracil

Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.

Likelihood Possible Evidence D
Adenosine (Adenocard)

Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Possible Evidence B
Anticoagulant/Antiplatelet Drugs

Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.

Likelihood Unlikely Evidence D
Beta-Adrenergic Agonists

Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.

Likelihood Probable Evidence D
Bortezomib (Velcade)

Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.

Likelihood Possible Evidence D
Celiprolol (Celicard)

Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.

Likelihood Possible Evidence D
Cimetidine (Tagamet)

Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.

Likelihood Likely Evidence B
Clozapine (Clozaril)

Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.

Likelihood Possible Evidence B
Contraceptive Drugs

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Inhibitors

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.

Likelihood Possible Evidence D
Dipyridamole (Persantine)

Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Probable Evidence B
Disulfiram (Antabuse)

Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.

Likelihood Probable Evidence B
Diuretic Drugs

Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.

Likelihood Possible Evidence D
Estrogens

Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.

Likelihood Probable Evidence B
Ethosuximide (Zarontin)

Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Felbamate (Felbatol)

Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Fexofenadine (Allegra)

Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.

Likelihood Probable Evidence B
Flutamide (Eulexin)

Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.

Likelihood Possible Evidence D
Fluvoxamine (Luvox)

Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..

Likelihood Unlikely Evidence D
Imatinib (Gleevec)

Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.

Likelihood Possible Evidence D
decaffeinated Green Tea extract full monograph & all 58 interactions

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Glucosamine HCl4 drug types · 170 drugs

Warfarin (Coumadin)

Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in international normalized ratio (INR) in patients previously stabilized on warfarin. In one case, the increase in INR occurred only after tripling the dose of a glucosamine/chondroitin supplement from 500 mg/400 mg daily to 1500/1200 mg daily. Additionally, 20 voluntary case reports to the U.S. Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone to increased INR in patients taking warfarin. The mechanism of this interaction is unclear. Glucosamine is a small component of heparin, but is not thought to have anticoagulant activity; however, animal research suggests that it might have antiplatelet activity.

Likelihood Probable Evidence D
Topoisomerase Ii Inhibitors

Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.
In vitro research suggests that glucosamine might induce resistance to etoposide (VP16, VePesid) and doxorubicin (Adriamycin) by reducing inhibition of topoisomerase II, an enzyme required for DNA replication in tumor cells. This effect has not been reported in humans.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.
Anecdotal reports suggest that adding glucosamine to an acetaminophen regimen might decrease pain control in patients with osteoarthritis. Some research suggests that the sulfate portion of glucosamine sulfate might contribute to its effect in osteoarthritis. Since acetaminophen metabolism requires sulfur and reduces serum sulfate concentrations, acetaminophen could theoretically interfere with the action of glucosamine sulfate. Conversely, the administration of sulfate could theoretically decrease the effectiveness of acetaminophen in sulfate-deficient people by increasing its clearance.

Likelihood Possible Evidence B
Antidiabetes Drugs

Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
In vitro and animal research has suggested that glucosamine might increase insulin resistance or decrease insulin production. This has raised concerns that taking glucosamine might worsen diabetes and decrease the effectiveness of diabetes drugs. However, clinical research suggests that glucosamine does not have adverse effects on blood glucose or glycated hemoglobin (HbA1C) in healthy, obese, or type 2 diabetes patients.

Likelihood Unlikely Evidence B
Glucosamine HCl full monograph & interactions

Sodium Chondroitin Sulfate1 drug type · 2 drugs

Warfarin (Coumadin)

Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin. However, the effect of chondroitin alone is unclear.
There have been multiple reports of increased international normalized ratio (INR) in patients taking warfarin with glucosamine, with or without chondroitin. The lack of reports with chondroitin alone seem to suggest that the interactions occurring in these reports may have been due to glucosamine. In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in INR in patients previously stabilized on warfarin. Additionally, 20 voluntary case reports to the US Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone, without chondroitin, to increased INR in patients taking warfarin.

Likelihood Unlikely Evidence D
Sodium Chondroitin Sulfate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Cosamin ASU Advanced Formula, from the product label.

NMx Wellness Innovations

See all NMx Wellness Innovations products
Name
Nutramax Laboratories Consumer Care, Inc.
City
Edgewood
State
MD
ZipCode
21040
Phone Number
1-800-925-5187
Web Address
NutramaxLabs.com
Pharmacist Counseling Corner

Cosamin ASU Advanced Formula by NMx Wellness Innovations: Common Questions

Does Cosamin ASU Advanced Formula by NMx Wellness Innovations interact with any medications?
Yes. Based on its ingredients, Cosamin ASU Advanced Formula has a known interaction with 1,523 medications, including 15 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Cosamin ASU Advanced Formula contains 7 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this safe to take while pregnant?
The safety data vary by ingredient. Glucosamine and boswellia should be avoided — the safety information advises against them. Green tea extract is possibly safe at moderate doses. Chondroitin and avocado unsaponifiables lack enough data to know either way. Talk with your doctor or pharmacist about whether this product is right for you during pregnancy.
Can I take this while breastfeeding?
Again, it depends on the ingredient. Boswellia and chondroitin should be avoided — not enough safety data. Green tea extract is possibly safe but caffeine passes into breast milk, so intake should be moderate. Vitamin E is likely safe during lactation. Discuss this product with your doctor or pharmacist to be sure.
What is glucosamine supposed to do?
Glucosamine is a compound found naturally in cartilage. It is rated Likely Effective for osteoarthritis — the wear-and-tear joint condition. The product also contains chondroitin, which is rated Possibly Effective for osteoarthritis and cataracts.
Will this help my joint pain?
Glucosamine and chondroitin are the main joint-support ingredients here and have evidence for osteoarthritis. Boswellia and the avocado/soy unsaponifiables are added for their anti-inflammatory properties, though the evidence is less strong. Results vary widely between people — talk with your doctor about whether it's worth trying for your specific situation.
Does this product have a lot of sodium?
The product contains sodium as an ingredient. If you manage high blood pressure, take blood pressure medications, or use lithium, the sodium content is a concern — it can interfere with how these drugs work. Ask your pharmacist how much sodium is in each dose and whether it's safe for you.
What are the most common side effects?
The main ingredients can cause bloating, constipation, diarrhea, nausea, and abdominal pain — especially glucosamine and chondroitin. These are usually mild and temporary. Serious side effects are rare but can include liver injury with high-dose green tea extract and allergic reactions in sensitive people.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Cosamin ASU Advanced Formula label
Go deeper

The Full Monographs Behind Cosamin ASU Advanced Formula’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Glucosamine

Interacts with 170 drugs

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of the knee. The evidence is mixed, with so...

Read the full Glucosamine monograph → Herb & supplement monograph

Green Tea

Interacts with 1,293 drugs

Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...

Read the full Green Tea monograph → Herb & supplement monograph

Chondroitin Sulfate

Interacts with 2 drugs

Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain. The evidence is mixed—some people report...

Read the full Chondroitin Sulfate monograph →
Sources

Sources & How We Checked

Cosamin ASU Advanced Formula's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 432 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Sodium 38 references
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  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
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  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
  31. Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
  32. Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
  33. Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
  34. Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
  35. Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
  36. Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
  37. George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
  38. Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed

See these in context on the Sodium monograph →

Vitamin E 64 references
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See these in context on the Vitamin E monograph →

Glucosamine 58 references
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See these in context on the Glucosamine monograph →

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Glycine 5 references
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Avocado 10 references
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See these in context on the Avocado monograph →

Boswellia Serrata 16 references
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See these in context on the Boswellia Serrata monograph →

Chondroitin Sulfate 22 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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