Alleviates symptoms of mild to moderate osteoarthritis of the knee.

One capsule should be taken once daily. The capsules should be swallowed whole with water.
Glucosamine sulfate capsules are not recommended for use in children and adolescents below the
age of 18, due to lack of data on safety and efficacy.
Elderly
No dosage adjustment is required when treating otherwise healthy elderly patients,

TAKE SPECIAL CARE with Glucosamine sulfate capsules if you
- Suffer from impaired glucose tolerance. More frequent controls of your blood glucose levels
may be necessary when starting treatment with Glucosamine sulfate capsules.
- Have kidney or liver dysfunction, since no studies have been performed in such patient’s dose
recommendations cannot be given.
- Have a known risk factor for heart (cardiovascular) disease, since high cholesterol
(hypercholesterolemia) has been observed in a few cases in patients treated with Glucosamine
sulfate.
- Suffer with asthma. When starting on Glucosamine sulfate capsules, you should be aware
of potential worsening of symptoms.

Diabetes: Ginkgo might interfere with the management of diabetes. If you have diabetes,
monitor your blood sugar closely.
Seizures: There is a concern that ginkgo might cause seizures. If you have ever had a seizure,
don't
use ginkgo.
Deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD): Ginkgo might cause
severe anemia in people have G6PD enzyme deficiency. Until more is known, use cautiously or
avoid using ginkgo if you have G6PD deficiency.
Surgery: Ginkgo might slow blood clotting. It might cause extra bleeding during and after
surgery. Stop using ginkgo at least 2 weeks before a scheduled surgery.

Pregnancy and Breast Feeding
Ginkgo is POSSIBLY UNSAFE when taken by mouth during pregnancy. It might cause early
labor or extra bleeding during delivery if used near that time. Not enough is known about the
safety of using ginkgo during breast-feeding. Do not use ginkgo if you are pregnant or breastfeeding.
Infants and children: Ginkgo leaf extract is POSSIBLY SAFE when taken by mouth for a
short time. Some research suggests that a specific combination of ginkgo leaf extract plus
American ginseng might be safe in children when used short-term.
Bleeding disorders: Ginkgo might make bleeding disorders worse. If you have a bleeding
disorder, don't use ginkgo.

No research has been performed with respect to the ability to drive and use machines. If
undesirable effects such as headache, drowsiness or fatigue occur then you are advised not to drive
or use machines.

The following side effects have been reported for glucosamine sulphate :
Common side-effects (in less than 1 in 10 patients but in more than 1 out of 100 patients):
Headache, Tiredness, Nausea, Abdominal pain , Indigestion , Diarrhea ,Constipation and
flatulence)
Uncommon side-effects (in less than 1 in 100 patients but more than 1 in 1000 patients): Rash ,
Itching and Flushing
Unknown frequency
Allergic reaction, Visual disturbance , Hair loss (alopecia) , Dizziness ,Swelling of the feet or
ankles ,Vomiting , Diabetes mellitus inadequate control , Asthma or aggravation of pre-existing asthma , Increased liver enzymes (hepatic enzyme elevation) and Yellow discoloration of the skin
(jaundice)
Ginkgo LEAF EXTRACT is LIKELY SAFE for most people when taken by mouth in
appropriate
doses. It can cause some minor side effects such as stomach upset, headache, dizziness,
constipation, forceful heartbeat, and allergic skin reactions.

Reporting of suspected adverse reactions
• Saudi Arabia:
The National Pharmacovigilance and Drug Safety Centre (NPC)
Fax: +966-11-205-7662
Call NPC at +966-11-2038222,
Ext: 2317-2356--2340.
Reporting hotline: 19999
E-mail: npc.drug@sfda.gov.sa
Website: www.sfda.gov.sa/npc
• Other GCC States:
− Please contact the relevant competent authority.

 Signs and symptoms of accidental or deliberate overdosing with Cartiflex can include: headache,
dizziness, disorientation, arthralgia, nausea, vomiting, diarrhoea or constipation. In the event of
overdosing, the treatment with Cartiflex must be suspended and the standard supportive measures
should be applied as required.

 Pharmacotherapeutic group: Non-steroidal anti-inflammatory and antirheumatic drug.
 ATC code: M01AX05 Glucosamine, N06DX02 Ginkgo folium
 Glucosamine is an endogenous substance, a common component of the polysaccharide chains in the
cartilaginous matrix and the glucosaminoglycanes in the synovial fluid. In in-vitro and in-vivo studies
have revealed that glucosamine stimulates the synthesis of physiological glucosaminoglycanes and
proteoglycanes by the chondrocytes from the hyaluronic acid by synoviocytes.
The mode of action in humans is not known. How long it takes before the treatment has effect cannot
be determined.

Glucosamine is a relatively small molecule (molecular weight 179) that dissolves easily in water and
hydrophilic organic solvents.
Glucosamine is the active substance, and is used for the synthesis of glycosaminoglycanes.
 Absorption: After oral intake, glucosamine sulphate salt is completely ionised in the acidic
environment of the stomach, as a result of which free glucosamine becomes available for absorption in
the small intestine. About 80% is absorbed, but as a consequence of the first-pass metabolism in the
liver the bioavailability is significantly lower; the exact percentage is not known.
 Distribution: After intravenous administration the distribution volume is about 5 litres, and the
elimination half life is about 2 hours.
 Metabolism: In the joint cartilage the cartilage cells use glucosamine for the production of
glycosaminoglycanes.
 Excretion: About 38% of an intravenous doses is excreted unchanged in the urine.

Glucosamine has a low acute toxicity. There are no known data from animal experiments concerning
the toxicity, reprotoxicity, mutagenity and carcinogenicity of glucosamine after repeated
administration. In vitro and in vivo studies in animals have shown that glucosamine reduces the insulin
secretion and causes insulin resistance, probably due to the inhibition of glucokinase in beta cells. The
clinical relevance of this is not known.

Microcrystalline Cellulose
Magnesium Stearate
Purified Water
Empty Hard Gelatin Capsule:

Not applicable

Do not store above 30° C.
Keep out the sight and reached of children

Cartiflex™ capsules are available in a pack containing 4 blisters of 10 capsules each.

Not applicable.