Artogistan 100 mg/ml solution for intramuscular and intra-articular injection 2 ml ampoules 10 pcs.

Degenerative-dystrophic diseases of the joints and spine: osteoarthritis and osteochondrosis of the spine.
To accelerate the formation of callus in fractures.

The drug is administered intramuscularly at a dose of 100 mg (1 ml) every other day. If well tolerated, the dose is increased to 200 mg starting from the fourth injection. The treatment course consists of 25-35 injections. If necessary, a repeat treatment course may be conducted after 6 months.

In cases of osteoarthritis of large joints, a combination of intra-articular and intramuscular administration is possible. Up to 5 intra-articular injections of 200 mg are performed with a 3-day interval between injections and 16 intramuscular injections of 200 mg with a 1-day interval between injections (every other day). Depending on the size of the joint, up to 2 ml of Artogistan can be injected into the joint cavity.

Intra-articular administration of the drug is performed under aseptic conditions by a specialist trained in the technique of intra-articular injection. After the intra-articular injection, the puncture site is treated with an alcohol swab and covered with a bactericidal plaster.

To form a bone callus, the treatment course lasts 3-4 weeks (10-14 intramuscular injections every other day).

1 ml of the preparation contains:
Active ingredient:
Sodium chondroitin sulfate 100 mg
Excipients:
Benzyl alcohol 9 mg
Sodium disulfite 1 mg
1 M sodium hydroxide solution to pH 6.0 – 7.5
Water for injections up to 1 ml

A clear or slightly opalescent, colorless or slightly colored liquid with a benzyl alcohol odor.

• hypersensitivity to the drug or its components;

• bleeding, tendency to bleed;

• thrombophlebitis;

• for intra-articular administration: presence of active inflammatory or infectious processes in the joint, presence of active skin disease or skin infection in the area of the intended injection;

• age under 18 years (efficacy and safety not established);

• pregnancy and breastfeeding period (due to lack of data).

With caution
Simultaneous use of the drug with direct-acting anticoagulants.

When used in conjunction with indirect anticoagulants, antiplatelet agents, and fibrinolytics, more frequent monitoring of blood coagulation parameters is required.
In the event of allergic reactions or the appearance of hemorrhages, treatment should be discontinued.
To achieve a stable clinical effect, at least 25 injections of the drug are necessary; however, the effect persists for several months after the end of the treatment course. To prevent exacerbations, repeated treatment courses are indicated.
Excipients
The product contains 9 mg of benzyl alcohol per 1 ml of solution. It is contraindicated in premature and newborn infants. It may cause toxic and anaphylactoid reactions in infants and children under 3 years of age.
The product contains sodium disulfite, which may occasionally cause severe hypersensitivity reactions and bronchospasm.
The product contains less than 1 mmol (23 mg) of sodium per 1 ml, meaning it is virtually sodium-free.
Pediatric use
Data on the efficacy and safety of chondroitin sulfate in children are currently unavailable.

When using the medication in individuals with increased sensitivity to the product, the following disturbances may occur:

• from the immune system: allergic reactions, angioedema;

• from the gastrointestinal tract: dyspeptic phenomena;

• from the skin and subcutaneous tissue: skin rash, itching, erythema, urticaria, dermatitis.
At the injection sites, redness, itching, and hemorrhages may occur.
The sodium disulfite included in the formulation can, in rare cases, cause severe hypersensitivity reactions and bronchospasm.

Currently, there have been no reported cases of overdose with the medication.
However, it can be assumed that exceeding the daily dose may lead to an increased manifestation of the medication's side effects. Symptomatic treatment is recommended.

Possible enhancement of the action of indirect anticoagulants, antiplatelet agents, fibrinolytics, which requires more frequent monitoring of blood coagulation parameters during simultaneous use. Exhibits synergistic action when used concurrently with glucosamine and other chondroprotectors.

Exhibits chondroprotective, regenerative, anti-inflammatory, and analgesic effects. Chondroitin sulfate is involved in the formation of the fundamental substance of cartilage and bone tissue. It possesses chondroprotective properties, enhances metabolic processes in hyaline and fibrous cartilage, and subchondral bone; inhibits enzymes that cause degeneration (destruction) of articular cartilage; stimulates the production of proteoglycans by chondrocytes. It contributes to the reduction of the release of inflammatory mediators and pain factors into the synovial fluid, suppresses the secretion of leukotrienes and prostaglandins. It slows down the resorption of bone tissue and reduces calcium loss, accelerates the processes of bone tissue recovery.

Chondroitin sulfate slows the progression of osteoarthritis and osteochondrosis. It aids in the restoration of the joint capsule and articular surfaces of the joints, prevents the collapse of connective tissue, and normalizes the production of synovial fluid.

When using the drug, tenderness decreases and mobility of the affected joints improves, with the therapeutic effect lasting for a long time after the end of the treatment course. In the treatment of degenerative changes in the joints accompanied by secondary synovitis, the effect is observed within 2-3 weeks from the start of the course.

Having structural similarity to heparin, it may potentially prevent the formation of fibrin clots in the synovial and subchondral microcirculatory pathways.

Absorption
After intramuscular administration, the maximum concentration of the drug in plasma (Cmax) is reached 1 hour after administration; then the concentration of the drug gradually decreases over 2 days.
With a single intra-articular administration of 200 mg, Cmax of chondroitin sulfate in plasma is observed after 1-2 hours and is 52.5-86.9 ng/ml.
Distribution
After intramuscular administration, chondroitin sulfate is rapidly distributed. Significant concentrations are detected in the blood as early as 30 minutes after injection. Sodium chondroitin sulfate accumulates primarily in the cartilage tissue of the joints. The synovial membrane does not pose a barrier to the penetration of the drug into the joint cavity. Experimental data show that 15 minutes after intramuscular injection, chondroitin sulfate is found in the synovial fluid, and then it penetrates into the articular cartilage, where its Cmax is reached after 48 hours.
With intra-articular administration, retention of chondroitin sulfate in the joint tissues is observed, along with its gradual release into the bloodstream.
Elimination
The half-life (T1/2) with intra-articular administration is 2.5 hours.