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The list of modern drugs and medicines for joints

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NSAIDs: ambulance joints - pros and cons

Nonsteroidal anti-inflammatory drugs (NSAIDs) is the most common group of drugs, which is used in pain and inflammation of any organs.

The best-known representatives are:

  • aspirin
  • indomethacin
  • diclofenac
  • ibuprofen
  • nimesulide
  • diflunisal
  • lysinemonohydrochlorid
  • sulindac
  • aceclofenac
  • etodolac
  • lornoxicam
  • Ketoprofen
  • flurbiprofen
  • nabumeton

Mechanism of action

Wide popularity due to the rapid elimination of symptoms due to the triple effect of this group of medications:

  • anti-inflammatory;
  • analgesic;
  • motrin.

Anti-inflammatory effect due to other mechanisms than hormonal drugs, and emphasized in the title – non-steroidal tools. It is maximally expressed in indomethacin, and diclofenac flurbiprofen, and minimal anti-inflammatory effect can be expected from ibuprofen, aspirin and aminopyrine.

These medications block the prostaglandins – mediators of inflammation that are released when tissue damage. As a result, reduces the symptoms of inflammation: redness, swelling, pain, rise in temperature and impaired function.

Pain syndrome better eliminate Ketorolac, Ketoprofen, diclofenac and indomethacin. Less pain activity have aspirin, ibuprofen, and naproxen.

The strength of action of various drugs depends on the structure of the molecule. However, the possibility of individual sensitivity to different drugs.

Adverse reactions

Prolonged use of NSAIDs is essential in the treatment of osteoarthritis, is associated with developing dangerous adverse reactions, often from the digestive tract and kidneys.

As an anti-inflammatory effect is by blocking prostaglandins, a side effect is a decrease in protective factors of the stomach. The majority of the members of this group of medicines that acid, so they also irritate the stomach.

The result can be NSAIDs-gastropathies erosive or ulcerative mucosal defects of the gastrointestinal tract, the most severe manifestation of which is gastrointestinal bleeding.

It is believed that more aggressive in this respect have indomethacin, Ketoprofen, piroxicam. Rarely these complications occur while taking small doses of ibuprofen and diclofenac.

How to avoid side effects from the gastrointestinal tract:

  • If high stomach acidity, gastritis and ulcer in the anamnesis, severe comorbidity, in elderly, the likelihood of gastrointestinal bleeding increases. In such situations, the more justified the application of drugs selective (meloxicam, nimesulide, celecoxib) which does not reduce the protective factors of gastric mucus and can be used long-term.
  • It is possible to use drugs that reduce stomach acidity (proton pump inhibitors), but long-term therapy is assessed as uneconomical.

Side effects of NSAIDs are often seen in the development of cardiovascular complications such as strokes, heart attacks and thrombosis. Safer in that respect are naproxen and ibuprofen. The use of diclofenac substantially increases the risk of heart disease and blood vessels.

The development of hypertension, heart failure, acute renal failure may be a consequence of reduced blood flow in the renal vessels due to inhibition of prostaglandin synthesis.

Perhaps the development aspirinova bronchial asthma, Reye's syndrome (bleeding), and many other side effects.

These dangerous adverse reactions do not allow for self and dictate certain rules of application:

  • NSAIDs should not be taken long-term. They are used as a means of "emergency" quickly and effectively eliminate the symptoms of osteoarthritis of the knee.
  • Receiving anti-inflammatory drugs mask the picture of the disease without eliminating the cause, which often causes delayed access to a doctor.
  • The choice of drugs wide as the force of action and side effects. The doctor will be able to choose the optimal drug in a safe dosage, and will prescribe the necessary studies to prevent the development of complications.

Chondro: cartilage generation?

src="/all/images/1315-0.jpg">Since knee osteoarthritis is caused by damage to the cartilage of the articular surfaces, the ideal drug should have the ability to restore them. That hope appeared in the allocation of a group of chondroprotectors (CP), the most studied figures of which are glucosamine (HA) and chondroitin sulfate (CS).

The last 25 years a large number of studies have accumulated an extensive database supporting the effectiveness of HP and refute it. So mixed reviews on the use of drugs.

Do not expect a speedy recovery in patients receiving chondroprotectors: minimum the results should be assessed not earlier than 6 months of therapy. Reducing the dosage of NSAIDs in the treatment of osteoarthritis of the knee is the first symptomatic effect of the use of HP. The most effective these medications at 1 and 2 stages of osteoarthritis.

Glucosamine and chondroitin and non-steroidal drugs, anti-inflammatory effect by suppressing "cells inflammation" (prostaglandins and interleukins). However, unlike NSAIDs, chondroprotectors have excellent portability.

Preventing progress of the disease (on the x-rays – slowing the rate of narrowing of the joint space) is also an important effect in this group of medicines.

First, HA and CS were used in isolation and in the form of injectables that have restricted their application. Then was developed the oral release form. Give an example of several drugs with chondroprotective activity.

Preparations containing chondroitin sulfate

  • Hondrolon (the Russian company Microgen) is produced in ampoules of dry substance for intramuscular injection.
  • Chondroitin-AKOS (Sintez, Russia) – capsules for the oral administration of 250 mg and ointment for local application. In the night you need to take 4 capsules.
  • Structum ("Pierre Fabre", France) - capsules of 250 and 500 mg. Daily dosage is 1000 mg.

Products containing glucosamine

A study conducted in Belgium demonstrated the effectiveness of glucosamine in arthritis of the knee joint than XC.

  • Albona (JSC "Moscow pharmaceutical factory) is a drug for intramuscular administration of 400 mg of the active substance in the vial.
  • Don ("Rottapharm") is available in the form of powder and capsules for oral administration and solution for intramuscular injection. 1 sachet of powder contains 1500 mg of active substance in one capsule is 250 mg.

Drugs containing HA and CS

Thanks to numerous studies, there is evidence that the effectiveness of the two components to 60% improves the result of treatment as monotherapy 30.

Artra ("Unipharm", USA) and teraflex ("Bayer", Germany) – complex preparations containing both cartilage, several different dosages of incoming components: 500 mg of HA and HS in the first and 500 mg of HA and 400 KHS in the second.


Means for introducing into the cavity of the joints

When expressed pain syndrome, the doctor may recommend the introduction of medication directly into the joint cavity.

As drugs, quickly eliminating the symptoms of inflammation, corticosteroids are often used:

  • Hydrocortisone
  • Diprospan
  • Kenalog
  • Celeston

Optimally, the introduction of chondroprotectors, which is called "liquid helpers". Sodium hyaluronate in the formulations:

  • Duralan
  • Ostenil
  • Fermathron
  • Synvisc

They practically replace the joint fluid, improving the nutrition of the cartilage surfaces. However, these medications are not yet all available at cost.

Drugs local action

Drugs for local therapy are further methods of treatment of osteoarthritis of the knee. Usually the active substance – NSAIDs, such as drugs Voltaren-gel, Fastum-gel, Menovazin, ointments, diclofenac, indometacin and phenylbutazone. Therapeutic compresses with bischofite (a derivative of crude oil), security systems (anti-inflammatory drugs), medical bile expand the range of therapeutic interventions for gonarthrosis.

The absorption of the drug in the local treatment is not more than 7-8 %, so monotherapy is rarely effective.

Since the disease is accompanied by periods of exacerbation and remission, it is important to combine different methods of treatment to apply effective physiotherapy procedures, Spa treatment, perhaps a traditional medicines.

The doctor will help with recommendations at any stage of the disease!


Innovative Supplements for joints

Supplements are not medicines, biologically active substances (food additives), which are composed of natural ingredients andconsidered as a Supplement to the basic therapy.

For the treatment of diseases of the joints, all companies are world leaders in the manufacture of dietary Supplements (such as NSP, Vision, Vitaline Inc) and the Russian manufacturers offer a huge number of complexes.

In their structure can include components with different action:

  • herbs with anti-inflammatory activity;
  • vitamins and minerals activate metabolic processes;
  • calcium, vitamin D, collagen to strengthen bone tissue.

There are even components that improves blood circulation, and detoxicants (e.g. Deccox Vision).

Innovative medications for treating inflammatory-degenerative diseases of joints are chondro – means that protect against inflammation and restore cartilage tissue.

Prior to their appearance in diseases of the joints were possible to carry out only symptomatic treatment, that is, the elimination of the pain syndrome. The era of chondroprotectors marked the possible impact on the cause of the disease and cartilage tissue.

The first funds of this group were Glucosamine and Chondroitin. They are actively studied conventional medicine for more than 40 years. Recent years applications have accumulated considerable evidence of the effectiveness of chondroprotectors in the pathology of both large and small joints. For example, a study conducted in Belgium, showed that patients taking within 1-3 years chondroprotectors, 60% less likely to need joint replacement in osteoarthritis of the hip joints than those who took a placebo (a pill containing no substance).

In 2014, they entered into a mandatory treatment algorithm of osteoartroza recommended ESCEO the European society.

Most manufacturers of dietary Supplements have in their Arsenal of Chondroitin and Glucosamine in the form of a 100% natural product of high purity.

Chondroitin

Chondroitin sulfate (CS) is a specific component of cartilage, is a natural mucopolysaccharide. In patients with diseases of the joints, its concentration in synovial fluid is reduced. Found in the cartilage, the ligaments of animals, fish.

Chondroitin sulfate has a regenerative (restorative) activity:

  • involved in the process of calcium residue in bones, preventing osteoporosis;
  • increases the synthesis of collagen, strengthening of ligaments, tendons, cartilage;
  • retains the cellular structure of the cartilage, thereby increasing the strength of the bones;
  • increases the production of synovial fluid, which prevents friction of the cartilage;
  • slows down the narrowing of the joint space withgonarthrosis;
  • reduces the destruction of chondrocytes (cartilaginous cells), making them resistant to the action of inflammatory enzymes.

In addition, Chondroitin sulfate has anti-inflammatory effects by suppressing the activity "cells inflammation" - enzymes and mediators involved in the cascade of inflammatory reactions. This reduces pain in joints, increases their mobility.

BAD Chondroitin sulfate is typically produced in capsule form by 250-350 mg (50-60 pieces). Often we recommend taking 1-2 capsules a day. Note that drugs have a much larger dosage: 500-1500 mg 3 times a day.

The cost for a month of treatment varies considerably, depending on the manufacturer, and is 300-2500 rubles.

Contraindications to the use are increased bleeding vessels and individual intolerance, pregnancy and lactation.

Glucosamine

Glucosamine (GA) is a component of chondroitin, a precursor of glycosaminoglycan, the main component of cartilage. It is isolated from chitin (a substance included in the shell of shellfish).

HA with Chondroitin has similar effects: symptomatic (reduction of pain during movement and improvement of joint function) and regenerative (the regeneration of cartilage tissue with prolonged use).

In addition, Glucosamine has some differences from Chondroitin:

  • has the best results and highest level of evidence in treatment of osteoarthritis of the knee (CG showed the best effect for arthritis of the hip joints);
  • is the preferred construction material for the formation of glycosaminoglycans in the human body (in particular, hyaluronic acid).

Often use an Association that Glucosamine in the structure of cartilage is a brick and Chondroitin – cement.

BAD Glucosamine is also available in the form of capsules, cost varies depending on the manufacturer approximately in the same range, and Chondroitin.

Contraindications are similar to those from the HS.

Both drugs are well-tolerated, side effects are not registered.

Due to the peculiarities of the action of Glucosamine and Chondroitin sulfate appeared complexes containing both drugs. In 1999, conducted a convincing study that showed that in the combined use of cartilage cells to produce steel in 2 times more glycosaminoglycans, and if treatment with one drug only one-third.

The combination of the two drugs is on average the same as one remedy. For example, Doppelgerts asset offers a range for a budget price –250-300 rubles per month of treatment. It contains 700 mg of Glucosamine and 100 mg Chondroitin sulfate per capsule.

Different manufacturers are trying to improve the complexes of the other components. So, Glucosamine Forte — BAD contains, in addition to HS and HA, the root of the herb "Devil's claw"and extant shark cartilage (Santegra, USA)."SOLGAR Glucosamine Chondroitin Plus" has additional components in the form of vitamin C and manganese.

Thanks to the latest research in medicine, we can say that the best Supplements for joints combines 4 components: Glucosamine, Chondroitin, MSM and Celadrin.

Methylsulfonylmethane

Methylsulfonylmethane (MSM, DMSO2, dimethylsulfone) – called "the third whale"in the treatment of diseases of the joints. This organic compound contains sulfur and is present in all tissues of the body. MSM improves the supply of nutrients through the cell membrane. When the deficit generated violations of the trophic tissue.

Sulfur is the fourth mineral in the human body by mass percentage, has many positive effects: antioxidant, antihistamine, analgesic and anti-inflammatory. The latter two effects are used in the treatment of inflammatory diseases of the joints. Sulfur is found in many foods: vegetables, fruits, grains, milk, meat, but is destroyed when cooked. With age, the need for it increases.

MSM promotes faster recovery of muscles after exercise, so long been used as a sports nutrition in complexes of Ice Power Plus, and Bone Boost from SAN, Animal Flex from Universal Nutrition and others.

The use of MSM with Chondroitin and Glucosamine was the next step in the treatment of diseases of the joints. It turned out that it enhances the effect of both drugs.

The French company"innovative manufacturing"has developed such an integrated drug and called it"Enjoy Enti"(Vision). Part of the Bada consists of Glucosamine, Chondroitin, MSM and bamboo Extract, rich in silicon.

To avoid allergic reactions associated with the release of the drug from the protein bovine animals, Glucosamine and Chondroitin are of marine origin. For maximum preservation of useful properties of the components in the production process technology is used cladrabine.

The drug is available in capsules of 30 PCs in package, need to take 1 capsule per day. Month of treatment"Enjoy Enti"will cost 2300-2500 RUB.

BAD"Glucosamine Chondroitin Super Formula" is characterized by a high content of 3 of these components than their counterparts. Also included in the formula, Selenium, Magnesium and vitamin E.

"Glucosaminechondroitin MSM" (Doctor's Best) contains additional sodium and potassium.

The latest effective compound for the treatment of diseases of the joints is Celadrin.

Celadrin

Celadrin ® is a special blend of fatty acids (FA) isolated from bovine fat. The LCD included in the lipid composition of cell membranes responsible for transport of nutrients into the cell and degradation products.

Celadrin has a whole set of unique effects:

  • Under the influence of negative factors, including mediators of inflammation, the cell membrane quickly recovers its integrity.
  • Inhibits the production "cells inflammation" in the development of autoimmune and inflammatory pathological processes.
  • Improves the joint fluid, thereby increasing the amplitude of movements in joints is not allowed the development of friction of cartilage.

Thanks to these properties, Celadrin ® improves the flexibility of ligaments, reduces pain, restores range of motion in the joint.

Celadrin 525 from the company Solgar (USA) is available as capsules (60 PCs pack), the day we recommend taking 1-2 pieces. The cost of treatment will average 2100-2300 RUB for 1-2 months.

New Celadrin & MSM from Now contains Celadrin and MSM. It is recommended to apply a daily dose of 3 capsules, 20-day course of treatment will cost around 600-700 rubles.

To a group of medicines that contain four essential to restore joint function component, is BAD Agel FLX (Agel Enterprises, USA).

It comes in the form of gel with fruit flavor (21G) and contains active components in increased amounts of: Chondroitin sulfate 1200 mg, Glucosamine sulfate 1500 mg, MSM 400 mg, and 750 mg. of Celadrin Month course of treatment with an innovative drug is about 3000 rubles.

There is no information on large meta-analyses confirming the effectiveness of Agel FLX, however, the drug is considered to be very promising. A three-year study conducted at the Department of traumatology and orthopedics, St. Petersburg state medical University im. I. P. Pavlova, which was attended by 134 patients, showed a significant reduction of pain and increase range of motion.

On topic: the List of effective SUPPLEMENTS for joints containing all 4 active substances


What is important to remember the patient when using nutritional Supplements?

  • The doctor will help?

    The doctor may prescribe Supplements officially, as they do not belong to the group of medicines. However, he can advise theman additional method of prevention and treatment. The doctor may have experience of the use of dietary Supplements other patients with similar pathology and long-term observations of disease dynamics.

  • Can you relate to Adam, as a waste of money?

    You can, if you do not believe that 35% of the global consumption of BAD falls on US, where take into account the economic feasibility of spending every dollar. In second place is Europe (32% market share), the third – Japan (a country of longevity). Important the right choice of manufacturer and complete possession of information that Supplements do not act quickly!

  • When to expect result?

    Taking dietary SUPPLEMENTS, it is important to follow the rules of admission (multiplicity and time of application), but do not treat them as drugs that should help immediately (for example, NSAIDs). A group of chondroprotectors are drugs with delayed effect (the minimum is 3 months). Dietary supplements operate more smoothly, the result often have to wait longer than with medication.

  • How to evaluate the result?

    The result can be evaluated objectively on the reduction of NSAIDs not earlier than six months after the start of the use of dietary Supplements. This suggests reducing pain, stiffness and improvement of joint function. Dietary supplements for diseases of the joints used for life, treatment rates.

  • Side effects and contraindications

    Tolerability of dietary Supplements are usually good, side effects not described. This is due to the fact that the basis is a 100% natural substance without preservatives, additives and dyes. Rarely can be an individual intolerance. Contraindications the dietary Supplements usually very small: pregnancy and lactation. There is no danger of addiction and overdose.

    • There are comments about the ineffectiveness of the use of dietary Supplements, and chondroprotectors. Reason for them often is a mismatch between expectations and reality: patients believe that after 1-3 months the cartilage should be restored, and pain to leave forever.

    In fact, the correct approach to receive the nutritional Supplements is to use them as an additional therapy for a long time. Dietary supplements, like chondro, will be more effective in the early stages of the disease. The first result can be considered as a reduction in the dose of NSAIDs, indicating that reduction of pain syndrome. Other effects in respect to the cartilage tissue it is possible to speak not earlier than through 1,5-2 years after administration. To suspend the course of the disease is a hugeresult!