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Background  The widespread use of natural health products is also a problem, as they could interact with prescribed drugs in patients. One commonly used product is glucosamine for osteoarthritis and some reports have found increased values of cholesterol and other lipids in patients treated with simvastatin for hypercholesterolemia. The aim of this trial was to investigate the effects of glucosamine on s-cholesterol levels (total s-cholesterol, s-HDL, s-LDL) in primary care patients on treatment with simvastatin or atorvastatin.    Methods  Controlled, randomized, open, crossover pharmacodynamic study in two primary health care centres. Patients were treated with Artrox® (glucosamine) 625 mg twice daily and control (a commercially available multivitamin tablet Vitamineral®). The study started with a run-in period of four weeks followed by control or active treatment with randomization of sealed envelopes. Each treatment period was four weeks and the treatment with simvastatin or atorvastatin was unchanged during the study (12 weeks). 34 patients were treated with a stable dose of simvastatin (n=21) or atorvastatin (n=13) for at least three months. Assessments of total s-cholesterol, s-HDL, S-LDL and s-triglycerides were performed in the morning with the patients in a fasting condition. T-tests for paired samples were used for statistical analyses and a p-value <0.05 was considered significant. Endpoints were the differences in lipid values at week 8 and week 12.    Results  All patients completed the study. No significant changes were seen on any of lipid levels in the simvastatin group .Conclusion  The actual glucosamine product did not change lipid levels of patients treated with simvastatin. Atorvastatin group was too small for safe calculations but was also without changes .Trial registration  EUDRACT2006-001458-28

bmc pharmacology and toxicology

No changes of cholesterol levels with a commercially available glucosamine product in patients treated with lipid lowering drugs: a controlled, randomised, open cross-over trial