Arth-A Max

Uses

This is primarily used for conditions like Osteoarthritis, Rheumatoid arthritis, Bone & Joint injuries.

Arth-A Max is also used to associated treatment for these conditions: Osteoarthritis in the Hip Joint, Osteoarthritis of the Knee

How Arth-A Max works

Diacerein's active metabolite rhein Rhein reduces cartilage destruction by decreasing expression of matrix metalloproteinase (MMP)-1 and -3 as well as upregulating tissue inhibitor of matrix metalloproteinases which serve to reduce the activity of several MMPs . The anti-inflammatory action of rhein reduces the level of interleukin-1beta activity which plays a large role in reduction of extracellular matrix production, MMP activity, and continued inflammation . Rhein reduces abnormal osteoblast synthetic activity through an unknown mechanism .

Dosage

Arth-A Max dosage

Adult & Children above 12 years: One tablet (Diacerein50 mg & Glucosamine Sulphate750 mg) twice daily for 4-12 weeks, taken with food.

Creatinine Clearance(CrCl) < 30 ml/min: The dose of Diacerein to be reduced.

Side Effects

Diarrhea, constipation, epigastric pain, heart burn, nausea, vomiting, headache, skin rashes, drowsiness, intense yellow coloring of urine.

Toxicity

Rhein Rhein has an oral LD50 of >5000mg/kg in mice. This is equivalent to a diacerein dose of >6476mg/kg.

Precaution

Caution should be practiced when administering Glucosamine + Diacerein in those patients who are allergic to Glucosamine and/or Diacerein or to shellfish (e.g., shrimp, crab); who have diabetes, asthma, alcohol dependence or liver disease. Before taking Glucosamine + Diacerein complete blood count, liver function and urinalysis should be monitored regularly.

Interaction

There have been no reports of significant drug interactions of Glucosamine with antibiotics/ antidepressants/ antihypertensives/ nitrates/ antiarrythmics/ anxiolytic/ hypoglycemic agents/ antisecretives. But decreased absorption of Diacerein with aluminium and/ or magnesium hydroxide antacids. Increased risk of diarrhea with laxatives, antibiotics. Avoid co-administration with fibres and phytic acids.

Volume of Distribution

15-60L .

Elimination Route

Bioavailability of 50-60% . Entirely converted to the active metabolite rhein Rhein before reaching systemic circulation.

Half Life

4-10h .

Clearance

Total CL is 1.5L/h and renal CL is 0.1L/h .

Elimination Route

37% excreted in urine and 53% in feces as estimated in rats .

Pregnancy & Breastfeeding use

Diacerein is contraindicated in pregnancy and lactation. Glucosamine should not be taken by pregnant women and nursing mothers due to lack of scientific data regarding its effect on fetus and infants.

Contraindication

There are no known contraindications for Glucosamine. But proven hypersensitivity to Glucosamine is a contraindication. Diabetics are advised to monitor blood glucose levels regularly when taking Glucosamine. No special studies were formed in patients with renal and/or hepatic insufficiency. The toxicological and pharmacokinetic profile of Glucosamine does not indicate limitations for these patients. However, administration to patients with severe hepatic or renal insufficiency should be under appropriate medical supervision. Children should not be supplemented with Glucosamine. Diacerein or to shellfish (e.g., shrimp, crab); who have diabetes, asthma, alcohol dependence or liver disease. While taking the drug complete blood count, liver function and urinalysis should be monitored regularly. Diacerein is contraindicated in pregnancy, lactation and hypersensitivity to anthraquinone derivatives.

Acute Overdose

Diarrhea may occur.

Storage Condition

Store in a cool & dry place, protect from light & moisture.

Innovators Monograph

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