A fixed-dose combination of four key nutraceutical agents designed for the symptomatic management and structural support of osteoarthritic joints. Chondroitin sulfate is a glycosaminoglycan that provides cartilage resilience and inhibits degradative enzymes. Collagen peptides (Type II) are hydrolyzed proteins that serve as building blocks for cartilage matrix. Sodium hyaluronate is a high molecular weight polysaccharide that provides viscoelasticity and lubrication to synovial fluid. Vitamin C (Ascorbic Acid) is a critical cofactor for collagen synthesis and a potent antioxidant that protects joint tissues from oxidative damage. This combination is classified as a Symptomatic Slow-Acting Drug for Osteoarthritis (SYSADOA) and is widely used in India as a dietary supplement and adjunct therapy.
Adult: One tablet/capsule, twice daily, after meals. Commonly prescribed for a minimum duration of 3-6 months.
Note: Administer orally with a full glass of water, preferably after meals to enhance tolerance and absorption. Do not crush or chew unless specified (some are chewable tablets). Maintain adequate hydration.
The combination works synergistically via multiple pathways: 1) Substrate Provision: Supplies raw materials (chondroitin, collagen peptides, hyaluronate precursors) for the synthesis and repair of cartilage extracellular matrix. 2) Enzyme Inhibition: Chondroitin sulfate inhibits matrix metalloproteinases (MMPs like collagenase, elastase) and aggrecanase, reducing cartilage breakdown. 3) Synovial Fluid Improvement: Sodium hyaluronate (or its absorbed fragments) stimulates endogenous hyaluronic acid production, improving synovial fluid viscosity and joint lubrication. 4) Biosynthesis Support: Vitamin C is an essential cofactor for lysyl and prolyl hydroxylase, enzymes critical for the cross-linking and stabilization of collagen fibrils. 5) Anti-inflammatory & Antioxidant: All components exhibit mild anti-inflammatory effects by modulating NF-ÎșB and cytokine production; Vitamin C scavenges free radicals generated in the inflamed joint.
Pregnancy: Category N (Not classified). Insufficient human data. Components are endogenous, but safety not proven. Use only if potential benefit justifies potential risk. Avoid high-dose Vitamin C (>100mg/day) during pregnancy unless prescribed.
Driving: Unlikely to affect driving ability. Drowsiness is a rare side effect.
| Warfarin, Acenocoumarol | Chondroitin sulfate may have mild anticoagulant properties; may potentiate INR increase. Risk is theoretical but monitor INR closely. | Moderate |
| Aspirin, NSAIDs (e.g., Diclofenac, Ibuprofen) | Additive gastro-protective and anti-inflammatory effects. No significant harmful interaction. | Minor |
| Chemotherapy (e.g., Doxorubicin, Etoposide) | Vitamin C as an antioxidant may theoretically interfere with pro-oxidant chemotherapy mechanisms. Avoid high doses. Discuss with oncologist. | Moderate |
| Aluminum-containing antacids | Vitamin C increases aluminum absorption; may increase toxicity. Separate administration by 2 hours. | Moderate |
| Estrogens, Oral Contraceptives | May increase serum Vitamin C levels. No dose adjustment needed. | Minor |
Same composition (Chondroitin (200mg) + Collagen Peptide (40mg) + Sodium Hyaluronate (30mg) + Vitamin C (35mg)), different brands: