Polysulfated Glycosaminoglycan

By Krista Williams, BSc, DVM, CCRP; Rania Gollakner, BS, DVM, MPH

What is polysulfated glycosaminoglycan?

Polysulfated glycosaminoglycan (Adequan®) is a disease-modifying osteoarthritis (DMOAD) used to treat non-infectious and traumatic arthritis in dogs.   

Polysulfated glycosaminoglycan (PG) use in cats and small mammals is considered’off-label'. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully, as their directions may differ significantly from those on the label.  

How is polysulfated glycosaminoglycan given?

Polysulfated glycosaminoglycan is given by injection twice weekly for up to four weeks. It can be given into the muscle or directly into the affected joint.

Although PG accumulates in the joint within two hours, it may take up to four weeks to see beneficial effects.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects from PG are rare in dogs and cats, provided it is given according to label recommendations and at the prescribed interval (or for off-label use, according to the directions given by your veterinarian). Side effects can include transient pain at the injection site, short-lived vomiting or diarrhea, and abnormal bleeding.

Contact your veterinarian if you observe any abnormal signs, such as appetite loss, lethargy, or continued vomiting or diarrhea. At that time, ensure your veterinarian is aware of any other medications/natural remedies you give to your pet.

Are there any risk factors for this medication?

PG should not be used in pets with a known hypersensitive to it or in pets with known or suspected bleeding disorders. PG should be used with caution in pets with renal or liver disorders. PG has not been evaluated in breeding, pregnant, or lactating dogs or cats. This medication should not be used in pets with septic (infectious) arthritis.

Your veterinarian will advise you on the safety of PG use in your pet.

Are there any drug interactions I should be aware of?

There are no known definitive contraindications; however, this medication should be used with caution with anticoagulants (warfarin, heparin) and antiplatelet medications (aspirin, clopidogrel) as it may increase the risk of abnormal bleeding. Its use with glucocorticoids (dexamethasone, triamcinolone, prednisone) can also mask the signs of joint infection, so it is best to avoid this combination.

Is there any monitoring that needs to be done with this medication?

Your veterinarian may monitor your pet to ensure the medication is working. If the medication is administered into the joint, monitor your pet at home for joint swelling or signs of infection. Monitor your pet for serious side effects.

How do I store polysulfated glycosaminoglycan?

Store at room temperature between 68°F and 77°F (20°C and 25°C) and away from direct sunlight.

What should I do in case of an emergency?

Call your veterinary office immediately if you suspect an overdose or an adverse reaction to the medication. If they are unavailable, follow their directions in contacting an emergency facility.

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