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See also: Use Chondroitin sulfate has been studied for the treatment of arthritis; however, information on its effectiveness is conflicting. It is commonly given in combination with other agents, such as glucosamine sulfate or glucosamine hydrochloride. It has also been studied for use in drug delivery, antithrombotic and extravasation therapy, treatment of dry eyes, and cystitis.

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Dosing Chondroitin sulfate has been administered orally for treatment of arthritis at a dosage of 800 to 1,200 mg/day. Positive results often require several months to manifest, and a posttreatment effect has been observed.,,,,,,,, Animal studies have suggested that the bioavailability of chondroitin sulfate may be increased when given multiple times a day. Contraindications Contraindications have not been identified. Pregnancy/Lactation Information regarding safety and efficacy in pregnancy and lactation is lacking. Interactions See Drug Interactions section.

Adverse Reactions Potential adverse reactions associated with chondroitin sulfate include alopecia, constipation, diarrhea, epigastralgia, extrasystoles, eyelid edema, lower limb edema, and skin symptoms. Chondroitin sulfate may also exacerbate asthma., Toxicology There is little information regarding the long-term effects of chondroitin. Most reports conclude that it is safe. Source Chondroitin is a biological polymer that acts as the flexible connecting matrix between the protein filaments in cartilage.

Chondroitin can be isolated from natural sources, such as shark or bovine cartilage. Danaparoid sodium, a mixture of heparan sulfate, dermatan sulfate, and chondroitin sulfate (ratio, 21:3:1), is derived from porcine intestinal mucosa. History Chondroitin sulfates were first extracted and purified in 1960. Studies suggested that if enough chondroitin sulfate was available to cells manufacturing proteoglycan (one of the substances that form the cartilage matrix), stimulation of matrix synthesis could occur, resulting in an accelerated healing process. This idea of natural regeneration of cartilage was popularized with the publication of the book, The Arthritis Cure in 1997.

Chemistry Chondroitin sulfate is a high-viscosity, anionic mucopolysaccharide (glycosaminoglycan) with N-acetylchondrosine as a repeating unit and one sulfate group per disaccharide unit. Chondroitin 4-sulfate and chondroitin 6-sulfate are the most abundant mucopolysaccharides and occur in skeletal and soft connective tissue. Chondroitin's molecular weight is about 50,000, depending on product source or preparation. Sulfation of the sugar residues occurs to varying degrees, depending on tissue sources and conditions for formation. Danaparoid sodium (a heparin preparation containing chondroitin) has a lower molecular weight (5,500 to 6,000). Analytical determination, including high-pressure liquid chromatography, spectrophotometric analysis, chemical methods, ultraviolet spectrometry, and infrared spectroscopy, has been performed on chondroitin and related structures.,,,, A method for potentiometric titration of chondroitin sulfate has been reported.

Uses and Pharmacology The pharmacokinetics of chondroitin sulfate have been determined in rats and dogs. Another pharmacokinetic study involving rats and healthy human volunteers determined that the absolute bioavailability of chondroitin sulfate was 15% and 12%, respectively. When dissolved in water, there was rapid absorption in rats and humans. Another report concluded that oral chondroitin sulfate B (dermatan sulfate) reached plasma levels of 7% bioavailability. In 22 patients with renal failure, chondroitin sulfate half-life was prolonged, but it could be administered for clot prevention during hemodialysis in this population.

Glycosaminoglycans are found in urine as free molecules. The average adult metabolizes about 250 mg of glycosaminoglycans each day, with 10% of the metabolites excreted in urine. Chondroitin sulfate accounts for 60% of the glycosaminoglycans in human urine. Antiarthritic Chondroitin's role in treating arthritis has gained increasing popularity. Results of ongoing research have been controversial. Articular cartilage is found between joints (eg, finger, knee, hip), allowing for easy, painless movement. It contains 65% to 80% water, collagen, and proteoglycans.