Polysulfated Glycosaminoglycan

What is polysulfated glycosaminoglycan (PSGAG)?

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

PSGAG is used off label (extra label) in cats and small mammals. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is PSGAG given?

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

PSGAG accumulates in the joint within two hours, but 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 as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

Side effects from PSGAG 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). PSGAG may cause the following side effects:

• Transient pain at the injection site
• Vomiting or diarrhea for a short time
• Abnormal bleeding

Serious adverse reactions may occur. If any of the following signs develop, stop giving PSGAG and contact your veterinarian immediately:

• Appetite loss
• Lethargy
• Continued vomiting or diarrhea

Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment (e.g., irregular breathing, rash, fever, puffiness and swelling around the face) and notify your veterinarian if you have any concerns.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This long-acting medication should stop working within a few days to a few weeks, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE PSGAG in:

• Pets with a known hypersensitivity to it
• Pets with known or suspected bleeding disorders
• Pets with septic (infectious) arthritis

USE WITH CAUTION in:

• Pets with renal or liver disorders
• Pets that are breeding, pregnant, or lactating (safety has not been evaluated)

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

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with PSGAG, including:

• Antiplatelet medications (aspirin, clopidogrel)
• Glucocorticoids (dexamethasone, triamcinolone, prednisone)

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• If the medication is administered into the joint, monitor your pet at home for joint swelling or signs of infection.
• Monitor your pet for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store PSGAG?

• Store at room temperature between 68°F and 77°F (20°C and 25°C) and away from direct sunlight.
• Keep the container out of reach of children and pets.

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. Be prepared to provide information about the product and your pet's weight and symptoms.