Instructions for use of DONA® (DONA) solution for intramuscular administration

Don's drug belongs to the group of chondroprotectors and serves to protect articular cartilage from destruction. Dona also helps at the initial stage of arthrosis development, when cartilage loses its elasticity and there is a lack of basic elements in the connective tissues - glucosamine and chondroitin. Don's medicine is produced in Italy and Germany, so it has a fairly high price on the Russian market. In this regard, patients are looking for analogues of Don's drug, which help no less effectively, but cost an order of magnitude less.

Analogue drugs are drugs with the same active ingredient as Don's drug. At the same time, analogues may have other excipients that promote rapid absorption of the active component and have a positive effect on the patient’s health. Let's consider substitutes for Don, which can be used to replace this drug, since they have an equivalent effect and contribute to the restoration of cartilage.

pharmachologic effect

Manufacturer: MADAUS GMBH (Germany)
Release form: tablets, capsules, injection solution, powder in bags

Active ingredient: glucosamine

Analogs: Mukosat, Alflutop, Arthra

Dona belongs to the group of stimulators of bone and cartilage tissue repair, which has anti-inflammatory and anesthetic effects. The product stimulates the permeability of the joint capsule, increases the efficiency of enzymatic processes in the structures of cartilage and synovial membrane.

Under the influence of the drug, the process of normalizing calcium deposition in bone tissue, slowing down the progression of degenerative changes in joints, reducing pain and increasing the amplitude of active movements occurs.

Dona - instructions for use

According to the instructions for use of Dona, the medicine is prescribed 1 tablet 2 times a day, mainly during meals, which is washed down with a sufficient volume of water. The duration of the course of therapy can be up to 1.5 months. It is possible to adjust the dosage of the drug upward according to indications.

For intramuscular administration, the product solution is mixed with a solvent in 1 syringe and 3.0 ml is administered 3 times a week for 30–45 days. A packet of powder is dissolved in 200 ml of water and taken once a day for up to 3 months.

Tazan

The drug Tazan is available in tablet form. One tablet contains equal amounts of glucosamine and chondroitin sulfate (500 mg each). As additional substances, the tablets contain silicon dioxide, calcium stearate, potato starch, crospovidone and other agents.

The drug stimulates the regeneration of cartilage tissue, and glucosamine and chondroitin are actively involved in the process of cartilage restoration. When “third-party” glucosamine enters the body, cartilage tissue regulates the production of its own component. Chondroitin stimulates the production of hyaluron, collagen and proteoglycans.

The chondroprotective medicine Tazan is indicated for the treatment of osteoarthritis of the first to third degree. The product is not used for children and patients with problems of the urinary system or kidney diseases. Prescribed with caution for bronchial asthma, bleeding and diabetics.

ADVICE! Tazan is used in adults for three weeks, 1 tablet twice a day. Then the regimen is changed and the use is reduced to one tablet once a day. The therapeutic effect of the drug can be judged after no less than six months.

Tazan is usually well tolerated, but in some patients taking tablets may cause:

Arthra capsules

• tachycardia;
• stomach pain;
• allergic reaction;
• dizziness;
• insomnia;
• drowsiness.

Analogues of Dona

The pharmaceutical market is represented by a large number of analogues of the drug Don, which have a similar therapeutic effect, but may differ in some parameters. You can purchase Dona substitutes at the pharmacy in the form of:

• synonyms;
• generics;
• combined means.

The price category of these medications has a wide range. There are analogs of Dona that are cheaper and more expensive, but with an equivalent therapeutic result.

Table of Dona analogues with price and country of origin

A higher price for Dona analogues is observed among foreign manufacturers.

What else can replace Don, what effective analogues for the treatment of osteoarticular pathology? The list can be supplemented with the following medications:

• Glucosamine;
• Drastop;
• Sustagard arthro;
• Piaskledin;
• Artrocam;
• Injectran;
• Diaflex;
• Chondroitin;
• Flexamine;
• Sinagra.

A wide range of Dona analogs allows for effective treatment of diseases of the osteoarticular system not only for adults, but also for children.

Dona or Mukosat - which is better?

Manufacturer: JSC SINTEZ (Russia)
Release form: capsules, solution for intramuscular and intraarticular administration

Active ingredient: chondroitin sulfate

Mucosat is an analogue of Dona tablets. Both products are chondroprotectors that improve the structure of cartilage tissue and slow down degenerative processes in it. But their mechanism of action is different due to the difference in active substances.

The best drug would be Mucosat, since the analogue is well tolerated, has minimal and rare side effects and broader indications. It can be used in fractures to stimulate callus formation. Patients often choose Mucosat, since this analogue is cheaper than Don tablets, which is an important point during a long course of treatment.

Dona or Alflutop - which is better and more effective

Manufacturer: K.O.
BIOTECHNOS S.A. (Romania) Release form: solution for injection and intra-articular administration

Active ingredient: bioactive concentrate from small marine fish

Dona and Alflutop have chondroprotective, anti-inflammatory and analgesic effects, and have a positive effect on local metabolism in cartilage and bone tissue. This analogue of Dona in injections will be better and more effective for acute pain syndrome accompanying diseases of the joints or spine.

The drug has a rapid effect, especially when injected into a joint, which leads to a decrease in pain and an increase in the range of motion of the limb. This effect of using the analogue is confirmed by reviews from doctors.

Dona or Teraflex - which is better or more effective?

Manufacturer: BAYER PHARMA A.G.
(Germany) Release form: capsules

Active ingredient: chondroitin sulfate, glucosamine

Both drugs are in the group of stimulators of bone and cartilage tissue repair, have the same active substance glucosamine and restore their structure.

The Teraflex composition is enriched with a second active component, which makes it more effective. This combined property of the drug gives an anti-inflammatory and analgesic effect. This is equivalent to the use of analgesics and non-steroidal anti-inflammatory drugs. Teraflex will be the best for osteoarthritis with moderate pain.

If pain in the joint is severe, Dona injections will be more effective, as they quickly relieve acute pain.

Dona powder for the preparation of a solution for oral administration 1500 mg in bags (sachets) No. 20

Name

Don.

Description

White crystalline powder, odorless.

Release form

Powder for the preparation of solution for oral administration.

Dosage

1.5 g.

Compound

One sachet contains: active ingredient: crystalline glucosamine sulfate 1884 mg (contains glucosamine sulfate 1500 mg and sodium chloride 384 mg). excipients: aspartame, anhydrous citric acid, macrogol 4000, sorbitol.

Pharmacotherapeutic group

Other nonsteroidal anti-inflammatory and antirheumatic drugs. ATX code: M01AX05.

Indications for use

Relief of symptoms (mild to moderate pain) of adequately diagnosed osteoarthritis of the knee.

Directions for use and doses

Adults and elderly patients: the contents of 1 sachet, equivalent to 1500 mg of glucosamine sulfate, dissolve in a glass of water and take 1 time per day, preferably with meals. Glucosamine is not intended for the treatment of acute painful symptoms. Symptom relief (especially pain relief) may take several weeks of use, and in some cases longer. If no relief of symptoms occurs after 2–3 months of use, treatment should be reconsidered. Patients should consult a doctor if pain worsens after starting glucosamine.

Contraindications

Hypersensitivity to glucosamine or any of the excipients. Powder for oral solution contains aspartame and is therefore contraindicated in patients with phenylketonuria. Powder for oral solution contains sorbitol. Patients with rare hereditary problems of fructose intolerance should not take this drug. The drug should not be used by patients with shellfish allergies, since the active substance is obtained from shellfish. Precautions Before using the drug, you should consult your doctor to rule out joint diseases for which other treatment methods are prescribed. Cases of exacerbation of bronchial asthma symptoms after starting glucosamine have been described. Patients suffering from bronchial asthma should be informed about the possible worsening of symptoms of the disease. This medicinal product contains 151 mg of sodium per daily dose, which should be taken into account by patients on a sodium-restricted diet. Patients with impaired glucose tolerance should use caution when taking glucosamine. For patients with diabetes mellitus, it is recommended to monitor glycemic levels and determine insulin requirements before and periodically during treatment. No specific studies have been conducted in patients with renal or hepatic impairment. The toxicological and pharmacokinetic profiles of glucosamine do not suggest any restrictions in these patients. However, the use of glucosamine in patients with severe hepatic or renal impairment should be carried out under medical supervision.

Interaction with other drugs and other forms of interaction

No specific studies have been conducted on the interaction of glucosamine with other drugs. However, the physicochemical and pharmacokinetic properties of glucosamine sulfate indicate a low potential for such interactions. One study found that glucosamine is not an inhibitor of the activity of the following cytochrome P450 enzymes: CYP1A2, CYP2E1, CYP2C19, CYP2C9, CYP2D6, CYP3A4, as assessed by metabolite formation from selective substrates for each of the CYP enzymes studied. In fact, the compound does not compete for absorption mechanisms or bind to plasma proteins after absorption, and its metabolism as an endogenous compound that is incorporated into proteoglycans or degraded independently of the cytochrome enzyme system is unlikely to result in interactions with other drugs. There are reports of an enhanced effect of coumarin anticoagulants, so more careful monitoring of coagulation parameters is necessary in patients concomitantly taking coumarin anticoagulants (for example, warfarin or acenocoumarol). Oral administration of glucosamine sulfate may increase the absorption of tetracyclines from the gastrointestinal tract, but the clinical significance of this interaction is small. It is acceptable to take steroidal or non-steroidal anti-inflammatory drugs simultaneously with glucosamine.

Use during pregnancy and breastfeeding

Due to the lack of sufficient clinical data on the use of glucosamine in pregnant women or excretion in breast milk, the use of the drug during pregnancy and breastfeeding is not recommended.

Impact on the ability to drive a car and operate machinery

Studies regarding the effect of the drug on the ability to drive a car and other mechanisms have not been conducted. You should be careful when driving vehicles and performing work that requires attention. In case of drowsiness, fatigue, dizziness or visual impairment, driving a vehicle or operating other machinery is prohibited.

Features of application

Use in children and adolescents Do not use in children under 18 years of age, since the safety and effectiveness of the drug for such patients have not been established. Use in the Elderly No specific pharmacokinetic studies have been conducted, but according to clinical experience, dosage adjustment is not required when treating the elderly. Patients with impaired renal and/or hepatic function In patients with impaired renal and/or hepatic function, no recommendations for dose adjustment exist, since appropriate studies have not been conducted.

Side effect

To determine the frequency of adverse events, the following categories of their occurrence in patients were used: Very often (≥ 1/10) Often (≥ 1/100 to

Overdose

There are no known cases of accidental or intentional overdose. Based on acute and chronic toxicity studies in animals, toxic symptoms are unlikely to occur even at doses up to 200 times the therapeutic dose. In case of overdose, glucosamine should be discontinued and treatment should be symptomatic, aimed at restoring water and electrolyte balance.

Pharmacological properties

Pharmacodynamics

Mechanism of action Glucosamine sulfate is a salt of the amino monosaccharide glucosamine, which is an endogenous component and preferred substrate for the synthesis of glycosaminoglycans and proteoglycans in articular cartilage and synovial fluid. In earlier in vitro studies, glucosamine sulfate was shown to stimulate the synthesis of glycosaminoglycans and, accordingly, joint proteoglycans. However, glucosamine sulfate has been shown to inhibit the activity of interleukin-1 beta intracellular signaling pathway through blockade of intracellular activation and nuclear translocation of nuclear factor kappa B in cartilage chondrocytes and other similar cells. Clinical efficacy and tolerability The safety and effectiveness of glucosamine sulfate has been confirmed in clinical trials with treatment durations of up to three years. Short- and medium-term clinical studies have shown that the effectiveness of glucosamine sulfate in relation to the symptoms of osteoarthritis is observed after 2-3 weeks of its use. However, unlike NSAIDs, glucosamine sulfate has a long-lasting effect, lasting from 6 months to 3 years. Clinical studies with daily administration of glucosamine sulfate for up to 3 years have shown gradual improvement in disease symptoms and slower structural changes in the joint, as demonstrated by plain radiography. Glucosamine sulfate demonstrated good tolerability during short-term and long-term courses of treatment.

Pharmacokinetics

Absorption Following oral administration of 14C-labeled glucosamine, it is rapidly and almost completely absorbed, and approximately 90% of the radiolabel is detected in the systemic circulation. The absolute bioavailability of glucosamine in humans after oral administration was 44%, including the first pass effect. Following daily oral administration of 1500 mg glucosamine sulfate to healthy volunteers under fasted conditions, maximum steady-state plasma concentrations (Cmax, cc) averaged at 3 hours (Tmax) of approximately 1602 ± 426 ng/mL between 1.5–4 hours ( median: 3 h, tmax). At steady state, AUC was 14564 ± 4138 ng∙h/ml. It is unknown whether food intake has a significant effect on oral bioavailability. The pharmacokinetics of glucosamine are linear in the dose range of 750–1500 mg, with deviation from linearity at a dose of 3000 mg due to lower bioavailability. There are no gender differences in the absorption and bioavailability of glucosamine. The pharmacokinetics of glucosamine were similar in healthy volunteers and patients with knee osteoarthritis. Distribution Following oral absorption, glucosamine is distributed into various vascular compartments, including synovial fluid, with an apparent volume of distribution 37 times greater than total fluid volume in humans. Glucosamine does not bind to plasma proteins. Therefore, it is extremely unlikely that glucosamine is capable of drug interactions when taken together with other drugs that are highly bound to plasma proteins. Metabolism The metabolic profile of glucosamine has not been studied, since it is an endogenous substance; it is used as a “building material” for the biosynthesis of articular cartilage components. Glucosamine is primarily metabolized by conversion to hexosamine, independent of the cytochrome system. Crystalline glucosamine sulfate does not act as either an inhibitor or inducer of human CYP450 isoenzymes, including CYP3A4, 1A2, 2E1, 2C9 and 2D6.00, even when tested at glucosamine concentrations 300 times the peak plasma concentration observed in the patient after therapeutic doses crystalline glucosamine sulfate. There are no clinically significant interactions between glucosamine and other drugs that could occur through inhibition and/or induction of human CYP450 isoforms. Excretion In humans, the half-life of glucosamine from plasma is 15 hours. After oral administration of 14C-labeled glucosamine, excretion in urine was 10 ± 9%, and in feces - 11.3 ± 0.1% of the administered dose. The average excretion of unchanged glucosamine after oral administration in humans is approximately 1% of the administered dose, suggesting that the kidney and liver do not play a significant role in the elimination of glucosamine, its metabolites and/or its degradation products.

Pharmacokinetics in various categories of patients

In patients with renal or hepatic insufficiency Studies of the pharmacokinetics of glucosamine in patients with renal or hepatic insufficiency have not been conducted. These studies were considered inappropriate due to the insignificant contribution of the liver and kidneys in the processes of metabolism, degradation and excretion of glucosamine. Therefore, given the favorable safety profile and good tolerability of glucosamine, dosage adjustment of the drug is not required in patients with renal or hepatic impairment. Children and adolescents No studies have been conducted on the pharmacokinetics of glucosamine in children and adolescents. Elderly patients Pharmacokinetic studies have not been conducted in elderly patients, however, clinical trials of the effectiveness and safety of glucosamine included mainly elderly patients. It has been shown that there is no need for dose adjustment in this category of patients.

Release form

The sachet is made of a three-layer material, which consists of paper/aluminum/polyethylene fused together by heating on four sides. 20 or 30 sachets along with instructions for use are placed in a cardboard box.

Best before date

3 years Do not use after the expiration date indicated on the package.

Storage conditions

Store at a temperature not exceeding 25 °C. Keep out of the reach of children.

Release from pharmacies

Dispensed by prescription.

Applicant

MEDA Pharma GmbH & Co. KG, Benzstrasse 1, 61352 Bad Homburg, Germany

Manufacturer

ROTTAFARM Ltd., Damastown Industrial Park, Mulhaddart, Dublin 15, Ireland

Buy Dona powder for the preparation of a solution for oral administration 1500 mg in bags (sachets) No. 20 in a pharmacy

Price for Dona powder for the preparation of a solution for oral administration 1500 mg in bags (sachet) No. 20

Instructions for use for Don powder for the preparation of a solution for oral administration 1500 mg in bags (sachets) No. 20

Dona or Arthra - which is better?

Manufacturer: UNIFARM INC. (USA)
Release form: tablets

Active ingredient: glucosamine, chondroitin sulfate

Dona and Artra are used to treat joint diseases accompanied by a violation of the structure of cartilage tissue. Dona's analogue in tablets contains, in addition to glucosamine, chondroitin sulfate. The best drug for joints would be Artra, since the medication has more indications and fewer contraindications.

Both active ingredients enhance the action of each other, which leads to stimulation of the production of joint fluid and restoration of the damaged structure of synovial cartilage. The effectiveness of the analogue for osteoarthritis is confirmed by reviews from doctors who often prescribe Arthra for treatment.

Sinarta

The drug Sinarta contains glucosamine sulfate. One sachet contains 1.5 pure substances; the drug package contains 10 or 30 sachets. As excipients aspartame, polyethylene glycol and sorbitol. Produced in powder form for preparing a solution.

Despite the contraindications, Sinarta is one of the most effective analogues of Dona.

Glucosamine sulfate stimulates the action of glycosaminoglycans, has an anti-inflammatory effect, and slows down the process of degradation of cartilage tissue. The effectiveness of the drug can be assessed within three weeks after use.

Glucosamine is usually well tolerated and does not have a negative effect on systems and organs. About 90% of the drug is absorbed from the gastrointestinal tract, and the bioavailability of the drug is 26%. Sinarta is indicated in the treatment of osteoarthritis.

Use the product one sachet per day, dissolving the powder in a glass of water. It is advisable to drink the medicine with meals. Treatment time is from one to two months. On the recommendation of a doctor, when positive dynamics are achieved, treatment can be carried out in courses 2-3 times a year.

Contraindications to the drug are quite general - these are intolerance to glucosamine, pathologies of the liver and kidneys, and a tendency to bleeding. Due to the fact that the product contains aspartame, it is not recommended for use in patients with phenylketonuria.

IMPORTANT! The medicine is not recommended for patients with seafood allergies; the drug is prescribed to asthmatics with caution, and diabetics need to monitor their blood sugar levels when treated with Sustart.

Adverse reactions from the medication are flatulence, epigastric pain, constipation, diarrhea, nausea, dyspepsia, allergic reaction, skin rash, itching, dizziness and drowsiness.

Dona or Sustilak - which is better?

Manufacturer: CELEBRITY BIOPHARMA LTD (India)
Release form: tablets

Active ingredient: glucosamine

Both products have the same active substance and mechanism of action on the cartilage tissue of the joints. Dona is a medicine that quickly relieves acute pain; it will be best for more pronounced destructive changes in the joint, preventing the patient from becoming disabled.

The therapeutic effect of using the Sustilak analogue manifests itself after a longer period of time. The drug can be used as a prophylaxis at the very initial manifestations of pathology and at any stage of development of joint destruction. In this case, Sustilak will be more effective in practical use.

Dona or Structum - which is better?

Manufacturer: PIERRE FABRE MEDICINE PRODUCTION (France)
Release form: capsules

Active ingredient: chondroitin sulfate

Dona and Structum are in the same pharmacological group, but act differently due to different active ingredients. Both drugs stimulate metabolism in cartilage tissue, slow down the progression of degenerative processes, and reduce joint pain.

Structum capsules will be more effective for osteoarthrosis and osteochondrosis of the intervertebral discs, as well as in the treatment of osteoarticular pathology. The drug is safer, can be prescribed to children over 15 years of age and has a minimum of contraindications. The results from its use last for a long time after the course of therapy.

Artradol

Another effective representative of chondroprotectors is Artradol. Artradol contains proteoglycans, which are involved in the construction of cartilage tissue. The distinctive ability of the drug Artradol is that it not only protects the joint from destruction, but is also capable of restoring muscle tissue cells.

And Artradol is also able to relieve inflammation and inhibit the process of decay in cartilage tissue. Thanks to the chondroprotector components, it has an antithrombotic effect and activates synovial and subchondral microcirculation. Thanks to this, the production of synovial fluid is stimulated.

Artradol is available in tablet form. Highly porous pills are actively dissolved in a special liquid and injected intramuscularly. The package contains 10 ampoules. The medicine is intended for the treatment of degenerative-dystrophic diseases of the joints.

Artradol is usually well tolerated by patients, but some patients may experience allergic reactions, and bleeding from small vessels at the injection site. Injections are contraindicated for pregnant women, women during lactation and children. Use with caution in patients with gastrointestinal pathologies and a tendency to bleeding.

The tablets should be taken every other day, 1 ml. From the fourth injection, you can double the volume of the drug if it is well tolerated by the patient. The course of therapy is at least 25 injections. If positive results from treatment are obtained, the course is repeated after six months. The medication is available by prescription.

Dona or Rumalon injections - which is better?

Manufacturer: ROBAPHARM EOOD (Bulgaria)
Release form: solution for injection

Active ingredient: glycosaminoglycan-peptide complex

Rumalon, an analogue of Dona in ampoules, is a combined product of animal origin that stimulates the synthesis of collagen and mucopolysaccharides, slows down the destruction of cartilage and restores it. Both medications are chondroprotectors, but act through different mechanisms.

When comparing drugs for the treatment of osteoarticular pathology, the best remedy would be Rumalon, which has broader indications and fewer side effects. The medication is well tolerated and effective, as confirmed by patient reviews.

Elbona

Manufacturer: NPO FARMVILAR (Russia)
Release form: solution for injection, powder for the preparation of solution for oral administration

Active ingredient: glucosamine

Elbona belongs to the group of correctors that regulate the metabolism of bone and cartilage tissue. This analogue of Dona has an anti-inflammatory and analgesic effect, prevents the destruction of cartilage tissue and promotes its restoration. Acting on the joint capsule, the drug increases its permeability and increases the range of motion in the joint.

Chondroglucide

Chondroglucide is produced by domestic companies. The release form is a gel for external use, packaged in tubes of 30 g. Chondroglucide contains 250 mg of glucosamine and 500 mg of chondroitin. Externally, the medicine is a thick gel-like substance, odorless, and the color ranges from white to yellowish. Excipients of the drug are sodium disulfide, lavender oil, propylene glycol, ethanol and other substances.

Chondroglucide belongs to the group of chondroprotectors and serves to stimulate cartilage tissue. It also has an analgesic and anti-inflammatory effect. Helps slow down destructive processes. Chondroitin sulfate in the drug is obtained from cattle cartilage; it suppresses the action of hyaluronidase and elastase, which affect the breakdown of cartilage tissue. Glucosamine also has protective agents, inhibiting phospholipase and collagenase, which destroy cartilage.

The drug is recommended for osteoarthritis. The gel is applied two to three times a day to the damaged joint with a strip 4 cm long, which corresponds to 2 g of the drug. Treatment must be continued for at least one month, after which the course is interrupted and, on the doctor’s recommendation, repeated again after a couple of weeks. Usually the drug is well tolerated, but an allergic reaction may occur on the surface of the skin.

The chondroprotector is contraindicated for use in children, pregnant women and during lactation, as well as in case of individual intolerance to the drug. Do not apply the medicine to damaged areas of the skin.

Chondrogard

Manufacturer: SOTEX CJSC (Russia)
Release form: solution for intramuscular and intraarticular administration

Active ingredient: chondroitin sulfate

Chondrogard is an analogue of Dona in injections. This is a high molecular weight mucopolysaccharide that has the properties to inhibit and reduce degenerative changes in cartilage tissue.

Under the influence of the medication, the inflammatory process of the synovial membrane of the joint is reduced, and phosphorus-calcium metabolism is restored. This process leads to a decrease in pain, relief of swelling and an increase in the range of active movements in the joint.

Teraflex

Teraflex is one of the most effective and relatively cheap chondroprotective agents. The drug contains chondroitin and glucosamine. It helps relieve pain, improve the mobility of articular joints, and stimulates regenerative processes in cartilage tissue. Thanks to these properties, Theraflex significantly reduces the need for non-steroidal anti-inflammatory drugs.

The drug is indicated for osteochondrosis, osteoarthrosis and other degenerative pathologies of the spine. The drug is not recommended for hypersensitivity, in patients with renal failure, during pregnancy and lactation, as well as for children.

Take the capsules with a whole glass of water; the drug does not depend on the time of meal. In the first three weeks of treatment, one capsule is prescribed three times a day, then two capsules. Duration of therapy is from three to six months, treatment is repeated if necessary.

Teraflex is usually well tolerated by patients, but negative reactions may also occur: insomnia, abdominal pain, heaviness in the legs, tachycardia, allergic reactions. If abdominal pain occurs, the drug is discontinued.