From basic things like food, clothes, to things that enrich our lives, like cars and gadgets - there is not one thing in this world that you cannot find an alternative to. Similar is the case with medicines. To give you an idea - the common pain-killer paracetamol is marketed under more than 50 brand names! Phew! In this clutter or 'me-too' drugs, how does one choose the right drug for him/her? One common dilemma is over the two forms of glucosamine available in the market which are glucosamine sulfate and glucosamine HCl (or glucosamine hydrochloride). Both the drugs are used to treat osteoarthritis. Osteoarthritis is a degenerative joint disorder characterized by degradation of joints, especially those in the limbs.
Treatment of osteoarthritis includes a number of rationales - from weight loss, to physiotherapy-related exercises and even medication. Common painkillers are also used to relieve pain. However, recently glucosamine derivatives have been marketed as an alternative medicine for the treatment of osteoarthritis. How does this drug work?
Glucosamine - An Alternative Medicine
Glucosamine is a precursor of glycosaminoglycan, one of the major components of the cartilage. It is hence believed that administration of glucosamine can retard, if not prevent, joint degeneration. Glucosamine is thus marketed as an alternative medicine to treat osteoarthritis. However, glucosamine cannot be manufactured and sold as it is, because glucosamine is hygroscopic, i.e., it absorbs moisture from the air. This leads to breakdown of the glucosamine molecule and a pure glucosamine tablet would not show therapeutic effect. Glucosamine is therefore manufactured as glucosamine sulfate or glucosamine hydrochloride (i.e. glucosamine HCl) tablets. Glucosamine sulfate and glucosamine hydrochloride are both salts of glucosamine.
It is important to know how a drug acts once it enters your body. Your body fluids - the saliva in your mouth, the sweat on your body, the sebum secreted by your scalp, your blood - all have a certain pH. The pH of a fluid is what makes it acidic, alkaline or neutral. The pH of a fluid is also what dictates whether a particular substance will dissolve in it or not. A tablet or pill taken orally reaches the stomach and is immediately exposed to an acidic environment.
It is here that the tablet needs to dissolve without the actual active drug molecule being hampered. The two different salts of glucosamine available in the market, viz. the sulfate salt and the hydrochloride salt, both equally dissolve in this acidic environment of the stomach. So where does the difference lie?
Glucosamine Sulfate Vs. Glucosamine HCl
Though chemically two different compounds, as a drug both glucosamine sulfate and glucosamine HCl have more or less the same properties. The main difference in the two drugs is explained below -
Glucosamine Sulfate: The main problem with glucosamine sulfate tablets is that they need to be additionally stabilized using either sodium chloride (NaCl) or potassium chloride (KCl) salt. Such tablets may hence contain almost 30% salt! In a daily glucosamine sulfate dose of 1500mg, this changes the actual intake of glucosamine sulfate from 1500mg to only 1050mg!
Glucosamine HCl: These tablets overcome the shortcomings of glucosamine sulfate tablets. They do not contain any stabilizing salts. Thus the daily glucosamine HCl dose remains a complete 1500mg of glucosamine.
However, apart from the above glitch, a comparison between the therapeutic effects of the above two forms of glucosamine reveals no significant difference. Both the forms of glucosamine have been shown to be equally effective. It does not matter to the body in what form it receives the glucosamine, because eventually the actual active ingredient of the tablet is the pure glucosamine. What makes a difference is the bioavailability of the drug in the body - and both the forms achieve the same levels in the body in terms of bioavailability. The relative purity of both the preparations is also comparable.
It could well be only in your head, if you think one of the forms gives you better relief! However, once in the body, they both achieve the same results.