Major interaction on record — check this product against your medications before combining. Based on 4 of 6 ingredients. Check your meds →
Dietary supplement

Super Flex Ingredients & Drug Interactions

by SNI Elite Series

Super Flex 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 Super Flex 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

Super Flex is a dietary supplement by SNI Elite Series with 6 active ingredients. Its ingredients are commonly taken for cancer support (popular use), arthritis and joint pain, psoriasis.Based on those ingredients, 1,029 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Boswella, Glucosamine, Shark Cartilage. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Super Flex by SNI Elite Series

Ask about any prescription or over-the-counter medication and we check it for interactions with Super Flex by SNI Elite Series — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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Computed from our clinical databases

HelloPharmacist Scorecard of Super Flex by SNI Elite Series

Four independent checks of what is known — a summary of the available information, not a grade of the product itself.

Evidence for Intended Use
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 assessable

The stated purpose hasn't been mapped to our evidence data yet.

Why this rating?
  • We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Ingredient Transparency
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 6 of its 6 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.
Known Interaction Concern
Major identified

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

Why this rating?
  • 3 of the 4 matched ingredients can interact with medications — Boswellia Serrata, Glucosamine, Shark Cartilage.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,030 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.
Safety Information
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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.

Assessment coverage: 4 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 23, 2012.

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 Super Flex, straight from the product label.

Brand SNI Elite Series
Barcode (UPC) 852263901484
Net contents 90 Capsule(s)
Market status Off market
Date entered into DSLD Mar 23, 2012
DSLD ID 6491
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
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 Super Flex by SNI Elite Series, 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
30
UPC/BARCODE
852263901484
IngredientAmount% DV
Shark Cartilage100 mg--
MSM250 mg--
Hyaluronic Acid100 mg--
Glucosamine750 mg--
Boswella250 mg--
Chrondroitin500 mg--

Other ingredients: Magnesium Stearate, Silica, Di-Calcium Phosphate, Maltodextrin, Microcrystalline Cellulose, Gelatin

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 Statement of Identity

DIETARY SUPPLEMENT

Suggested/Recommended/Usage/Directions

SUGGESTED USE:** As a dietary supplement, take 3 capsules (1 serving) twice daily. It is recommended to take 3 capsules in the morning and 3 capsules in the evening so that the constant supply of nutrients is flowing in your body.

Precautions

Keep out of the reach of children.

Do not use if tamper-evident seal is broken.

WARNING: Consult a physician before using this product.

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.

Storage

Store in a cool, dry place 15(0)-30(0)C (59(0)-86(0)F).

General Statements

• RAPID JOINT RECOVERY** • CONTAINS HYALURANIC ACID

PHARMACEUTICAL GRADE

RING OF CONFIDENCE

TRAIN LIKE A MACHINE

WHAT IS BOSWELLA? Boswella support the Glucosamine, Chrondroitin, MSM and Shark Cartilage in their combined efforts to rebuild cartilage. Specialty Vitamins each have a specific function and a primary goal of replenishing your muscle, bones and joints with strength.

WHAT IS CHRONDROITIN? Chrondroitin (sulfate) is a specialty supplement that attracts water into the joint space, which works to spread the lubrication created from Glucosamine.

WHAT IS GLUCOSAMINE? Glucosamine (sulfate) is a powerful supplement that lubricates damaged cartilage that tends to get torn apart with strenuous activity - such as putting medicine onto a cut.

WHAT IS MSM AND SHARK CARTILAGE? MSM and Shark Cartilage attaches itself to the damaged cartilage and works to strengthen and rebuild the tendons.

Brand IP Statement(s)

WHAT IS SUPER FLEX 5(TM)? Super Flex 5(TM) has been scientifically created with the precise ratios of Glucosamine, Chondroitin, MSM, Shark Cartilage and Boswella so your body can feel healthy and strong. These ingredients combine to provide strength to muscles, bones and joints allowing your body to avoid aches and pains that are commonly associated with working out.

Seals/Symbols

Made in the USA

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

See for yourself

Super Flex by SNI Elite Series label

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

Super Flex 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 Super Flex by SNI Elite Series

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule Servings per container30 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.

Shark Cartilage

Interacts with
121 drugs
100 mg per serving

Shark cartilage is a supplement made from the skeletal tissue of sharks that was heavily promoted for cancer and joint conditions, but good-quality cl...

Shark Cartilage monograph & interactions

MSM

250 mg per serving

Hyaluronic Acid

No known
interactions
100 mg per serving

Hyaluronic acid is a natural substance in the body that helps hold water in the skin, joints, and eyes. Oral and topical products are popular for skin...

Hyaluronic Acid monograph & interactions

Glucosamine

Interacts with
170 drugs
750 mg per serving Form: Glucosamine Sulfate

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 monograph & interactions

Boswella

Interacts with
952 drugs
250 mg per serving

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...

Boswella monograph & interactions

Chrondroitin

500 mg per serving Form: Chrondroitin Sulfate

Other (inactive) ingredients: Magnesium Stearate, Silica, Di-Calcium Phosphate, Maltodextrin, Microcrystalline Cellulose, Gelatin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Super Flex by SNI Elite Series Drug Interactions

Super Flex contains 6 ingredients, and 3 of them have known drug interactions. Altogether they interact with 1,029 medications. Here’s the picture, then you can look up your own drug.

Want to check YOUR meds against Super Flex?

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
1,029Drugs
2 Major 958 Moderate 69 Minor

Ingredients driving the most interactions

Boswella 952
Glucosamine 170
Shark Cartilage 121

Individual Drug Interactions

The ingredients in Super Flex interact with 1,029 drugs. Click any drug to see the details.

3 of the 6 ingredients in Super Flex interact with drugs. Each result below shows which ingredient is responsible. Boswella Glucosamine Shark Cartilage

Each ingredient & the kinds of drugs it affects

For each ingredient in Super Flex 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.

Boswella6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
Boswella full monograph & interactions

Glucosamine4 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 full monograph & interactions

Shark Cartilage1 drug type · 121 drugs

Immunosuppressants

Theoretically, shark cartilage might interfere with immunosuppressive therapy.
In vitro evidence suggests that shark cartilage might stimulate immune responses. This effect has not been reported in humans.

Likelihood Possible Evidence D
Shark Cartilage full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Super Flex, from the product label.

SNI Elite Series

See all SNI Elite Series products
Phone Number
1(888) 663-1113
Web Address
www.sniglobal.com
Pharmacist Counseling Corner

Super Flex by SNI Elite Series: Common Questions

Does Super Flex by SNI Elite Series interact with any medications?
Yes. Based on its ingredients, Super Flex has a known interaction with 1,029 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Super Flex contains 6 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.

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

Not sure if Super Flex is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

Super Flex label
Go deeper

The Full Monographs Behind Super Flex’s Ingredients

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

Herb & supplement monograph

Shark Cartilage

Interacts with 121 drugs

Shark cartilage is a supplement made from the skeletal tissue of sharks that was heavily promoted for cancer and joint conditions, but good-quality clinical trials have not shown meaningful...

Read the full Shark Cartilage monograph → Herb & supplement monograph

Hyaluronic Acid

Hyaluronic acid is a natural substance in the body that helps hold water in the skin, joints, and eyes. Oral and topical products are popular for skin moisture and joint comfort, and the evi...

Read the full Hyaluronic Acid 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

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph →
Sources

Sources & How We Checked

Super Flex'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 90 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.

Shark Cartilage 12 references
  1. Ashar B, Vargo E. Shark cartilage-induced hepatitis [letter]. Ann Intern Med 1996;125:780-1. PubMed
  2. Lane IW, Comac L. Sharks don't get cancer. Garden City, NY: Avery Publishing Group; 1992.
  3. Miller DR, Anderson GT, Stark JJ, et al. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-55. PubMed
  4. Leitner SP, Rothkopf MM, Haverstick L, et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients (pts) with either metastatic breast or prostate cancer refractory to standard treatment. Proc Am Soc Clinical Oncol 1998;17:A240.
  5. Batist G, Patenaude F, Champagne P, et al. Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 2002;13:1259-63..
  6. Merly, L., Simjee, S., and Smith, S. L. Induction of inflammatory cytokines by cartilage extracts. Int Immunopharmacol. 2007;7(3):383-391. PubMed
  7. Bargahi, A., Hassan, Z. M., Rabbani, A., Langroudi, L., Noori, S. H., and Safari, E. Effect of shark cartilage derived protein on the NK cells activity. Immunopharmacol.Immunotoxicol. 2011;33(3):403-409. PubMed
  8. Leitner SP, Rothkopf MM, Haverstick DD, and et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients with either metastatic breast or prostate cancer refractory to standard treatment. Amer Soc Clin Oncol 1998;17:A240.
  9. Milner M. A guide to the use of shark cartilage in the treatment of arthritis and other inflammatory joint diseases. Amer Chiropractor 1999;21:40-42.
  10. Rosenbluth, RJ, Jennis, AA, Cantwell, S, and et al. Oral shark cartilage in the treatment of patients with advanced primary brain tumors. A phase II pilot study (meeting abstract). Proc Annu Meet Am Soc Clin Oncol 1999;18:A554.
  11. Saad F, Klotz L, Babaian R, Lacombe L, Champagne P, and Dupont E. Phase I/II trial on AE-941 (Neovastat) in patients with metastatic refractory prostate cancer (abstract presentation). Canadian Urological Association Annual Meeting (June 24-27, 2001).
  12. Merly L, Smith SL. Pro-inflammatory properties of shark cartilage supplement. Immunopharmacol Immunotoxicol. 2015;37(2):140-7. PubMed

See these in context on the Shark Cartilage monograph →

Hyaluronic Acid 4 references
  1. Park Y, Song JS, Choi CY, Yoon KC, Lee HK, Kim HS. A randomized multicenter study comparing 0.1%, 0.15%, and 0.3% sodium hyaluronate with 0.05% cyclosporine in the treatment of dry eye. J Ocul Pharmacol Ther. 2017;33(2):66-72. PubMed
  2. U.S. Food and Drug Administration. Do Not Use Needle-Free Devices for Injection of Dermal Fillers - FDA Safety Communication. October 8, 2021. Available at: https://www.fda.gov/medical-devices/safety-communications/do-not-use-needle-free-devices-injection
  3. Disphanurat W, Srisantithum B. Efficacy and safety of 0.15% isobutylamido thiazolyl resorcinol combined with hyaluronic acid vs 0.15% isobutylamido thiazolyl resorcinol or hyaluronic acid alone in melasma treatment: A randomized evaluator-blind trial. J C PubMed
  4. Humbert P, Mikosinki J, Benchikhi H, Allaert FA. Efficacy and safety of a gauze pad containing hyaluronic acid in treatment of leg ulcers of venous or mixed origin: a double-blind, randomised, controlled trial. Int Wound J 2013;10(2):159-66. PubMed

See these in context on the Hyaluronic Acid monograph →

Glucosamine 58 references
  1. Adams ME. Hype about glucosamine. Lancet 1999;354:353-4. PubMed
  2. 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
  3. 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
  4. 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
  5. 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.
  6. Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother 1998;32:574-9.
  7. 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.
  8. 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.
  9. 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.
  10. Does glucosamine increase serum lipid levels and blood pressure? Pharmacist's Letter/Prescriber's Letter 2001;17(11):171115.
  11. 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.
  12. 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
  13. 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
  14. 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.
  15. 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
  16. Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4..
  17. 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
  18. Hoffer LJ, Kaplan LN, Hamadeh MJ, et al. Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism 2001;50:767-70.. PubMed
  19. 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
  20. Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. PubMed
  21. 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
  22. Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. PubMed
  23. 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
  24. 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.
  25. Stumpf JL, Lin SW. Effect of glucosamine on glucose control. Ann Pharmacother 2006;40:694-8. PubMed
  26. 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
  27. 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
  28. 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
  29. Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine potentiates the effect of warfarin. Jan 2006. Drug Safety 29(10):911-1010. DOI
  30. 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
  31. 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
  32. 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
  33. 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
  34. 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
  35. 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
  36. 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
  37. 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
  38. 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
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