Soft Chews Chocolate Ingredients & Drug Interactions
by GNC TriFlex
What is this page for?
First and foremost: checking Soft Chews Chocolate 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
Soft Chews Chocolate is a dietary supplement by GNC TriFlex with 5 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, 375 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Sodium, Glucosamine HCl, Chondroitin Sulfate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Soft Chews Chocolate by GNC TriFlex
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HelloPharmacist Scorecard of Soft Chews Chocolate by GNC TriFlex
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.
What’s inside
Full disclosure
This chew contains four active ingredients. Sodium is an essential electrolyte your body needs, though this product contains it as a supplement rather than from food.
Glucosamine HCl and chondroitin sulfate are compounds found naturally in joint cartilage; they're included to support joint structure and function. MSM (methylsulfonylmethane) is also present, though we hold no interaction data for it.
The remaining ingredients are inactive fillers and flavoring—corn syrup, milk, chocolate, oils, and other binders that make up the chew's texture and taste.
Does it work?
Strong evidence
For glucosamine, the data shows it's likely effective for osteoarthritis, though evidence for other uses like aging skin, back pain, or liver disease is insufficient. Chondroitin is possibly effective for osteoarthritis and cataracts, but evidence for osteoporosis, high cholesterol, or colon polyps is not established in our data.
Sodium's effectiveness is rated likely effective only for cystic fibrosis and possibly effective for a rare kidney injury caused by amphotericin B—uses that fall well outside a typical joint-support supplement. We hold no effectiveness data for MSM.
How safe is it?
Well-documented data
Orally, glucosamine and chondroitin are generally well tolerated, though both can cause digestive side effects like bloating, constipation, diarrhea, nausea, and heartburn. Rare serious side effects with glucosamine include allergic reactions (ranging from mild rash to severe anaphylaxis) and asthma flare-ups, particularly in people sensitive to shellfish or with existing asthma.
Chondroitin carries rare reports of liver damage and skin reactions, including rash and swelling. Sodium is essential in small amounts, but too much is linked to high blood pressure and heart strain; the safety notes advise against sodium supplements or very high intake without medical advice.
For pregnancy, glucosamine and chondroitin both lack sufficient safety data and should be avoided unless your doctor advises otherwise. Sodium is rated possibly unsafe in pregnancy, so check with your doctor before using this product if you're pregnant or breastfeeding.
Meds to double-check
Major interaction found
If you take warfarin or another blood thinner, check with your doctor first—glucosamine carries a Major risk of increased bleeding. Anyone on blood pressure medications, lithium, corticosteroids, or didanosine should confirm the sodium content is safe with their pharmacist.
Cancer patients on topoisomerase II inhibitors, people on antidiabetes drugs, and those regularly taking acetaminophen should also verify compatibility before starting.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This product is aimed at joint health through glucosamine and chondroitin, which have some evidence for osteoarthritis. However, it contains sodium as a supplement, which carries several medication interactions—most importantly with blood pressure drugs, lithium, and certain steroids.
If you take warfarin, the glucosamine poses a Major bleeding risk. Before starting, talk with your doctor or pharmacist about your exact medications and whether this supplement fits your needs.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2017.
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
General information
Key facts about Soft Chews Chocolate, straight from the product label.
| Brand | GNC TriFlex |
|---|---|
| Barcode (UPC) | 048107036935 |
| Net contents | 60 Soft Chew(s) |
| Market status | On market |
| Date entered into DSLD | Aug 22, 2017 |
| DSLD ID | 76849 |
| Product type | Non-nutrient/non-botanical |
| Supplement form | Other (e.g. Tea Bag) |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Soft Chews Chocolate by GNC TriFlex, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 25 Calorie(s) | -- |
| Total Carbohydrates | 4 Gram(s) | 1% |
| Sugar | 2 Gram(s) | -- |
| Calories from Fat | 5 Calorie(s) | -- |
| Total Fat | 0.5 Gram(s) | 1% |
| Saturated Fat | 0.5 Gram(s) | 3% |
| Sodium | 45 mg | 2% |
| MSM | 25 mg | -- |
| Glucosamine HCl | 500 mg | -- |
| Chondroitin Sulfate | 400 mg | -- |
Other ingredients: Corn Syrup, Sweetened Condensed Whole Milk, Palm kernel Oil, Whey, Hydrogenated Starch Hydrolysate, Chocolate, Mono & Diglycerides, Artificial and Natural Flavors, Soya Lecithin
Tap any ingredient to jump to its full detail below.
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 Statement of Identity
Dietary Supplement
General Statements
Promotes joint mobility & flexibility A great-tasting alternative to pills
Glucosamine and chondroitin help support joint mobility and flexibility. MSM is an organic sulfur found in joint cartilage and connective tissue.
To ensure a complete nutritional program, be sure to add one of GNC's premium multivitamins to your daily regimen.
Our quality commitment to you Since 1935, our mission as the industry leader has been to provide you with the highest-quality nutritional supplements. We continue to stand behind this mission. If you're not 100% satisfied with your purchase, return the unused portion of the product with your receipt within 30 days and we'll either refund your money or find you a replacement product that is right for you.
Formula
Glucosamine Chondroitin MSM
Natural and artificial flavors
Contains: Crustaceans (shrimp), milk and soybeans.
Three chocolate TriFlex Chews supply full potency, clinically tested amounts of glucosamine (1,500 mg) and chondroitin (1,200 mg) along with MSM.
General
CODE 310009 KQG
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement for adults, take one soft chew three times a day, preferably with meals.
Precautions
Contains: Crustaceans (shrimp), milk and soybeans.
Manufactured on equipment used to process peanut, almond, walnut, pecan, nutmeg, soy protein and wheat products.
Keep out of reach of children.
Storage
To ensure freshness, reseal container after each use. Store at room temperature.
Brand IP Statement(s)
GNC TriFlex Soft Chews are a great-tasting alternative to pills.
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.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Soft Chews Chocolate by GNC TriFlex label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in Soft Chews Chocolate by GNC TriFlex
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Soft Chew(s) Dosage formOther (e.g. Tea Bag) 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.
Sugar
Sodium
Interacts with205 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 g...
Sodium monograph & interactionsMSM
Glucosamine HCl
Interacts with170 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...
Glucosamine HCl monograph & interactionsChondroitin Sulfate
Interacts with2 drugs
Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain....
Chondroitin Sulfate monograph & interactionsOther (inactive) ingredients: Corn Syrup, Sweetened Condensed Whole Milk, Palm kernel Oil, Whey, Hydrogenated Starch Hydrolysate, Chocolate, Mono & Diglycerides, Artificial and Natural Flavors, Soya Lecithin. These complete the product’s ingredient list but are not active constituents.
Soft Chews Chocolate by GNC TriFlex Drug Interactions
HelloPharmacist Interaction Report
GNC TriFlex Soft Chews Chocolate contains sodium, glucosamine HCl, and chondroitin sulfate—three ingredients with documented interactions.
The most serious is glucosamine's Major interaction with warfarin (Coumadin), a blood thinner; glucosamine may increase warfarin's anticoagulant effect and raise bleeding risk.
Read the full breakdown — every affected drug type, severity by severity
Sodium carries Moderate interactions with antihypertensive drugs (blood pressure medications), corticosteroids, lithium, didanosine, sodium phosphates, tolvaptan, and sodium-containing medications. High sodium intake can reduce blood pressure medication effectiveness, increase the risk of high blood sodium (hypernatremia) when combined with certain drugs, and cause lithium toxicity by altering its blood levels.
Glucosamine also has Moderate interactions with topoisomerase II inhibitors (certain cancer drugs) and carries Minor interactions with antidiabetes drugs and acetaminophen. Chondroitin has a Moderate interaction with warfarin when combined with glucosamine, though its effect alone is less clear.
We could not check MSM for interactions. Altogether, these interactions span 375 individual medications.
Use the medication checker on this page to verify your exact prescriptions before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Soft Chews Chocolate?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Soft Chews Chocolate interact with 375 drugs. Click any drug to see the details.
3 of the 5 ingredients in Soft Chews Chocolate interact with drugs. Each result below shows which ingredient is responsible. Sodium Glucosamine HCl Chondroitin Sulfate
Insulin Glargine (rdna)Lantus
How Insulin Glargine (rdna) interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Glargine (rdna) interactionInsulin Glargine RecombinantToujeo Solostar
How Insulin Glargine Recombinant interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Glargine Recombinant interactionInsulin Glargine, LixisenatideSoliqua 100/33
How Insulin Glargine, Lixisenatide interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Glargine, Lixisenatide interactionInsulin Glulisine (rdna)Apidra
How Insulin Glulisine (rdna) interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Glulisine (rdna) interactionInsulin Human, Sodium ChlorideMyxredlin
How Insulin Human, Sodium Chloride interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Human, Sodium Chloride interactionInsulin LisproAdmelog, Admelog Solostar
How Insulin Lispro interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Lispro interactionInsulin Lispro RecombinantHumalog Kwikpen
How Insulin Lispro Recombinant interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Lispro Recombinant interactionInsulin Lispro-aabcLyumjev
How Insulin Lispro-aabc interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Lispro-aabc interactionInsulin DetermirLevemir
How Insulin Determir interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Insulin Determir interactionLinagliptinTradjenta
How Linagliptin interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Linagliptin interactionLinagliptin, Metformin HydrochlorideJentadueto XR
How Linagliptin, Metformin Hydrochloride interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Linagliptin, Metformin Hydrochloride interactionLiraglutideVictoza
How Liraglutide interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Liraglutide interactionLiraglutide RecombinantSaxenda
How Liraglutide Recombinant interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Liraglutide Recombinant interactionLixisenatideAdlyxin
How Lixisenatide interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Lixisenatide interactionMetforminGlucophage, Metformin
How Metformin interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Metformin interactionMetformin HydrochlorideRiomet ER
How Metformin Hydrochloride interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Metformin Hydrochloride interactionMetformin XrGlucophage XR
How Metformin Xr interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Metformin Xr interactionMetformin, LinagliptinJentadueto
How Metformin, Linagliptin interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Metformin, Linagliptin interactionMetformin, RosiglitazoneAvandamet
How Metformin, Rosiglitazone interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Metformin, Rosiglitazone interactionMetformin, SitagliptinJanumet, Janumet XR
How Metformin, Sitagliptin interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Metformin, Sitagliptin interactionMiglitolGlyset
How Miglitol interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Miglitol interactionMuraglitazarPargluva
How Muraglitazar interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Muraglitazar interactionNateglinideStarlix
How Nateglinide interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Nateglinide interactionParacetamolPanadol
How Paracetamol interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAcetaminophen (tylenol, Others) Minor
Interaction Summary
Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.
Read the full Glucosamine Hcl + Paracetamol interactionPioglitazoneActos
How Pioglitazone interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Pioglitazone interactionPramlintideSymlin
How Pramlintide interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Pramlintide interactionRepaglinideGlucoNorm, Prandin
How Repaglinide interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Repaglinide interactionRosiglitazone MaleateAvandia
How Rosiglitazone Maleate interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Rosiglitazone Maleate interactionSaxagliptinOnglyza
How Saxagliptin interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Saxagliptin interactionSaxagliptin, Metformin XrKombiglyze
How Saxagliptin, Metformin Xr interacts with Soft Chews Chocolate — through 1 ingredient. Tap an ingredient for the detail:
Glucosamine HclAntidiabetes Drugs Minor
Interaction Summary
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
Read the full Glucosamine Hcl + Saxagliptin, Metformin Xr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Soft Chews Chocolate 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.
Sodium
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.
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.
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.
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.
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.
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.
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.
Glucosamine HCl
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.
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.
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.
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.
Chondroitin Sulfate
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.
Brand information
Manufacturer and brand details for Soft Chews Chocolate, from the product label.
GNC TriFlex
- Name
- General Nutrition Corporation
- City
- Pittsburgh
- State
- PA
- ZipCode
- 15222
- Phone Number
- 1-888-462-2548
- Web Address
- www.gnc.com
Soft Chews Chocolate by GNC TriFlex: Common Questions
Does Soft Chews Chocolate by GNC TriFlex interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Will this help my osteoarthritis?
Can I take this if I'm pregnant or breastfeeding?
What digestive side effects might I see?
Why does a joint supplement have sodium in it?
I'm allergic to shellfish—is this safe for me?
Can I use this with acetaminophen for pain?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Soft Chews Chocolate is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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.
The Full Monographs Behind Soft Chews Chocolate’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sodium
Interacts with 205 drugsSodium 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 monographGlucosamine
Interacts with 170 drugsGlucosamine 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 monographChondroitin Sulfate
Interacts with 2 drugsChondroitin 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 & How We Checked
Soft Chews Chocolate'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 118 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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- Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
- Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
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- Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
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- Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
- Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
- D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
- Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
- Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
- Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
- Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
- Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
- Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
- Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
- O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
- Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
- Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
- Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
Glucosamine 58 references
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- Balkan B, Dunning BE. Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. Diabetes 1994;43:1173-9. PubMed
- Giaccari A, Morviducci L, Zorretta D, et al. In vivo effects of glucosamine on insulin secretion and insulin sensitivity in the rat: possible relevance to the maladaptive responses to chronic hyperglycaemia. Diabetologia 1995;38:518-24. PubMed
- Holmang A, Nilsson C, Niklasson M, et al. Induction of insulin resistance by glucosamine reduces blood flow but not interstitial levels of either glucose or insulin. Diabetes 1999;48:106-11. PubMed
- Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.
- Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother 1998;32:574-9.
- Shankar RR, Zhu JS, Baron AD. Glucosamine infusion in rats mimics the beta-cell dysfunction of non-insulin-dependent diabetes mellitus. Metabolism 1998;47:573-7.
- Almada A, Harvey P, Platt K. Effects of chronic oral glucosamine sulfate on fasting insulin resistance index (FIRI) in non-diabetic individuals. FASEB J 2000;14:A750.
- Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled trial. Lancet 2001;357:251-6.
- Does glucosamine increase serum lipid levels and blood pressure? Pharmacist's Letter/Prescriber's Letter 2001;17(11):171115.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Monauni T, Zenti MG, Cretti A, et al. Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes 2000;49:926-35. PubMed
- Pouwels MJ, Jacobs JR, Span PN, et al. Short-term glucosamine infusion does not affect insulin sensitivity in humans. J Clin Endocrinol Metab 2001;86:2099-103. DOI
- Yun J, Tomida A, Nagata K, Tsuruo T. Glucose-regulated stresses confer resistance to VP-16 in human cancer cells through a decreased expression of DNA topoisomerase II. Oncol Res 1995;7:583-90.
- Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: A 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002;162:2113-23. PubMed
- Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4..
- Scroggie DA, Albright A, Harris MD. The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized clinical trial. Arch Intern Med 2003; PubMed
- Hoffer LJ, Kaplan LN, Hamadeh MJ, et al. Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism 2001;50:767-70.. PubMed
- Yu JG, Boies SM, Olefsky JM. The effect of oral glucosamine sulfate on insulin sensitivity in human subjects. Diabetes Care 2003;26:1941-2. PubMed
- Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. PubMed
- Guillaume MP, Peretz A. Possible association between glucosamine treatment and renal toxicity: comment on the letter by Danao-Camara. Arthritis Rheum 2001;44:2943-4. PubMed
- Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. PubMed
- Tannis AJ, Barban J, Conquer JA. Effect of glucosamine supplementation on fasting and non-fasting plasma glucose and serum insulin concentrations in healthy individuals. Osteoarthritis Cartilage 2004;12:506-11. PubMed
- Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
- Stumpf JL, Lin SW. Effect of glucosamine on glucose control. Ann Pharmacother 2006;40:694-8. PubMed
- Pham T, Cornea A, Blick KE, et al. Oral glucosamine in doses used to treat osteoarthritis worsens insulin resistance. Am J Med Sci 2007;333:333-9. PubMed
- Muniyappa R, Karne RJ, Hall G, et al. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes 2006;55:3142-50. PubMed
- Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8. PubMed
- Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine potentiates the effect of warfarin. Jan 2006. Drug Safety 29(10):911-1010. DOI
- Rozendaal RM, Koes BW, van Osch GJVM, et al. Effect of glucosamine sulfate on hip osteoarthritis: A randomized trial. Ann Intern Med 2008;148:268-77. PubMed
- Baron AD, Zhu JS, Zhu JH, et al. Glucosamine induces insulin resistance in vivo by affecting GLUT 4 translocation in skeletal muscle. Implications for glucose toxicity. J Clin Invest 1995;96(6):2792-801. PubMed
- Nelson BA, Robinson KA, Buse MG. High glucose and glucosamine induce insulin resistance via different mechanisms in 3T3-L1 adipocytes. Diabetes 2000;49(6):981-91. PubMed
- Giordano N, Fioravanti A, Papakostas P, et al. The efficacy and tolerability of glucosamine sulfate in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled trial. Curr Ther Res Clin Exp 2009;70(3):185-196. PubMed
- Shaygannejad, V., Janghorbani, M., Savoj, M. R., and Ashtari, F. Effects of adjunct glucosamine sulfate on relapsing-remitting multiple sclerosis progression: preliminary findings of a randomized, placebo-controlled trial. Neurol Res 2010;32(9):981-985. PubMed
- Cahlin, B. J. and Dahlstrom, L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(6):760-766. PubMed
- Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol 2013;19(32):5381-4. PubMed
- Hochberg MC, Martel-Pelletier J, Monfort J, Möller I, Castillo JR, Arden N,Berenbaum F, Blanco FJ, Conaghan PG, Doménech G, Henrotin Y, Pap T, Richette P, Sawitzke A, du Souich P, Pelletier JP; on behalf of the MOVES Investigation Group. Combined chondroi
- von Felden J, Montani M, Kessebohm K, Stickel F. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Int J Clin Pharmacol Ther 2013;51(3):219-23. PubMed
- Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62. PubMed
- Ossendza RA, Grandval P, Chinoune F, Rocher F, Chapel F, Bernardini D. [Acute cholestatic hepatitis due to glucosamine forte]. Gastroenterol Clin Biol. 2007 Apr;31(4):449-50.
- Audimoolam VK, Bhandari S. Acute interstitial nephritis induced by glucosamine. Nephrol Dial Transplant 2006;21(7):2031. PubMed
- Greenlee H, Crew KD, Shao T, Kranwinkel G, Kalinsky K, Maurer M, Brafman L, Insel B, Tsai WY, Hershman DL. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 201 PubMed
- Wilkens, P., Scheel, I. B., Grundnes, O., Hellum, C., and Storheim, K. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial. JAMA 2010;304(1):45-52. PubMed
- Simon RR, Marks V, Leeds AR, Anderson JW. A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals. Diabetes Metab Res Rev 2011;27(1):14-27. PubMed
- Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AM. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010;38(5):422-35. PubMed
- Wangroongsub Y, Tanavalee A, Wilairatana V, Ngarmukos S. Comparable clinical outcomes between glucosamine sulfate-potassium chloride and glucosamine sulfate sodium chloride in patients with mild and moderate knee osteoarthritis: a randomized, double-blind
- Chopra A, Saluja M, Tillu G, Venugopalan A, Sarmukaddam S, Raut AK, Bichile L, Narsimulu G, Handa R, Patwardhan B. A Randomized Controlled Exploratory Evaluation of Standardized Ayurvedic Formulations in Symptomatic Osteoarthritis Knees: A Government of I
- Swinburne LM. Glucosamine sulphate and osteoarthritis. Lancet 2001;357(9268):1617. PubMed
- Murphy RK, Ketzler L, Rice RD, Johnson SM, Doss MS, Jaccoma EH. Oral glucosamine supplements as a possible ocular hypertensive agent. JAMA Ophthalmol 2013;131(7):955-7. PubMed
- Kimball AB, Kaczvinsky JR, Li J, et al. Reduction in the appearance of facial hyperpigmentation after use of moisturizers with a combination of topical niacinamide and N-acetyl glucosamine: results of a randomized, double-blind, vehicle-controlled trial.
- Ma H, Li X, Sun D, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019 May 14;365:l1628. PubMed
- Hoban C, Byard R, Musgrave I. Hypersensitive adverse drug reactions to glucosamine and chondroitin preparations in Australia between 2000 and 2011. Postgrad Med J. 2019 Oct 9. pii: postgradmedj-2019-136957. PubMed
- Tenti S, Veronese N, Cheleschi S, et al. Prescription-grade crystalline glucosamine sulfate as an add-on therapy to conventional treatments in erosive osteoarthritis of the hand: results from a 6-month observational retrospective study. Aging Clin Exp Res PubMed
- Yu H, Wu J, Chen H, et al. Glucosamine use is associated with a higher risk of cardiovascular diseases in patients with osteoarthritis: results from a large study in 685,778 subjects. Nutrients 2022;14(18):3694. PubMed
- Chu EC, Huang KHK, Cheung G, Ng G, Lin A. Delayed Skin Allergy to Glucosamine Chondroitin Supplement. Cureus 2023;15(3):e36310. PubMed
- Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop 2023;14(6):443-457. PubMed
- Lehrer S, Morello T, Karrasch C, Rheinstein PH, Danias J. Effect of Glucosamine on Intraocular Pressure and Risk of Developing Glaucoma. J Glaucoma 2023. PubMed
- Rabade A, Viswanatha GL, Nandakumar K, Kishore A. Evaluation of efficacy and safety of glucosamine sulfate, chondroitin sulfate, and their combination regimen in the management of knee osteoarthritis: a systematic review and meta-analysis. Inflammopharmac PubMed
Chondroitin Sulfate 22 references
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4..
- Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. PubMed
- Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. PubMed
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808. DOI
- Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8. PubMed
- Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine potentiates the effect of warfarin. Jan 2006. Drug Safety 29(10):911-1010. DOI
- Nordling, J. and van, Ophoven A. Intravesical glycosaminoglycan replenishment with chondroitin sulphate in chronic forms of cystitis. A multi-national, multi-centre, prospective observational clinical trial. Arzneimittelforschung. 2008;58(7):328-335. PubMed
- Nickel, J. C., Egerdie, B., Downey, J., Singh, R., Skehan, A., Carr, L., and Irvine-Bird, K. A real-life multicentre clinical practice study to evaluate the efficacy and safety of intravesical chondroitin sulphate for the treatment of interstitial cystit
- Oliviero, U., Sorrentino, G. P., De Paola, P., Tranfaglia, E., D'Alessandro, A., Carifi, S., Porfido, F. A., Cerio, R., Grasso, A. M., Policicchio, D., and . Effects of the treatment with matrix on elderly people with chronic articular degeneration. Drug
- Crowley, D. C., Lau, F. C., Sharma, P., Evans, M., Guthrie, N., Bagchi, M., Bagchi, D., Dey, D. K., and Raychaudhuri, S. P. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int.J.Med.Sc PubMed
- Nickel, J. C., Egerdie, R. B., Steinhoff, G., Palmer, B., and Hanno, P. A multicenter, randomized, double-blind, parallel group pilot evaluation of the efficacy and safety of intravesical sodium chondroitin sulfate versus vehicle control in patients with
- Sawitzke, A. D., Shi, H., Finco, M. F., Dunlop, D. D., Harris, C. L., Singer, N. G., Bradley, J. D., Silver, D., Jackson, C. G., Lane, N. E., Oddis, C. V., Wolfe, F., Lisse, J., Furst, D. E., Bingham, C. O., Reda, D. J., Moskowitz, R. W., Williams, H. J.
- Wildi, L. M., Raynauld, J. P., Martel-Pelletier, J., Beaulieu, A., Bessette, L., Morin, F., Abram, F., Dorais, M., and Pelletier, J. P. Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starti
- Pavelka and et al. Double-blind, dose effect study of oral cs 4 & 6 1200mg, 800mg, 200mg against placebo in the treatment of femorotibial osteoarthritis. Wular Rheumatol Liter 1998;27(suppl 2):63.
- Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol 2013;19(32):5381-4. PubMed
- von Felden J, Montani M, Kessebohm K, Stickel F. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Int J Clin Pharmacol Ther 2013;51(3):219-23. PubMed
- Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62. PubMed
- Ossendza RA, Grandval P, Chinoune F, Rocher F, Chapel F, Bernardini D. [Acute cholestatic hepatitis due to glucosamine forte]. Gastroenterol Clin Biol. 2007 Apr;31(4):449-50.
- Greenlee H, Crew KD, Shao T, Kranwinkel G, Kalinsky K, Maurer M, Brafman L, Insel B, Tsai WY, Hershman DL. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 201 PubMed
- Chu EC, Huang KHK, Cheung G, Ng G, Lin A. Delayed Skin Allergy to Glucosamine Chondroitin Supplement. Cureus 2023;15(3):e36310. PubMed
- Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop 2023;14(6):443-457. PubMed
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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.
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