What is the difference between Teraflex and Teraflex Advance?

What is better to use for degenerative-dystrophic pathologies - Teraflex or Teraflex Advance - depends on the degree of advanced disease. The difference between these drugs lies in the composition. Both medications are classified as chondroprotectors. However, Teraflex Advance has an enhanced formula, and is therefore recommended for use in a wider range of pathological conditions.

What is better to use for degenerative-dystrophic pathologies - Teraflex or Teraflex Advance - depends on the degree of advanced disease.

Characteristics of Teraflex

The drug is available in the form of capsules coated with a gelatin shell. 1 Teraflex capsule contains 500 mg of glucosamine hydrochloride and 400 mg of sodium chondroitin sulfate. These components promote the production of collagen and other substances necessary to restore damaged cartilage shells and maintain their health. Additional components present in the capsules include:

• magnesium stearate;
• gelatin;
• manganese sulfonate;
• stearic acid.

The use of this drug increases the production of hyaluronic acid, which is an essential component of joint fluid. In older people, thinning of the cartilaginous membranes and the development of diseases are observed against the background of a decrease in the production of synovial fluid, which leads to the appearance of microcracks in the membranes. Thus, the use of this drug is justified for the prevention of degenerative pathologies.

Theraflex not only improves metabolism, but also reduces swelling and restores the structure of cartilage.

The drug is most often used as part of the complex treatment of gout, osteoarthritis and osteochondrosis. The dose of the drug is selected individually. When treating diseases of the musculoskeletal system for at least 3 weeks, the medication is used 1 capsule 3 times a day. As the condition improves, the dose may be reduced. The recommended course duration is 3-6 months.

The drug is well tolerated by the patient's body, but it still has contraindications. The safety of using the medication during pregnancy and lactation has not been proven. In addition, this remedy can aggravate the course of chronic pathologies of the urinary system. The use of this medication in case of renal failure is extremely dangerous.

Teraflex should be used with caution when treating patients suffering from diseases such as bronchial asthma and diabetes mellitus. Special monitoring is required when treating people suffering from heart and liver failure.

A contraindication for taking Theraflex is intolerance to the active and auxiliary components included in the drug. Only if indicated, this drug can be used to treat children under 15 years of age. In addition, it is not recommended to use this medication in the treatment of people over 60 years of age. Adverse reactions when using Theraflex occur extremely rarely. On the part of the gastrointestinal tract, the following may occur:

• stool disorders;
• stomach ache;
• flatulence;
• nausea.

During Teraflex therapy, the likelihood of headaches, sleep disturbances and attacks of dizziness increases.

During Teraflex therapy, the likelihood of headaches, sleep disturbances and attacks of dizziness increases. Some patients complain of severe daytime sleepiness. Tachycardia and arrhythmia may occur. Allergic reactions cannot be ruled out. In extremely rare cases, Teraflex causes swelling of the legs.

Treatment of pain in patients with osteoarthritis of various localizations

Osteoarthritis (OA) is a chronic progressive disease, a characteristic feature of which is the presence of destructive changes in articular cartilage and subchondral bone with the development of marginal osteophytes.

OA is the most common joint disease, clinical symptoms of which are generally observed in more than 10–20% of the world's population [1]. During the International Decade of Bone and Joint Diseases (2000–2010), the following diseases were identified as having the most important medical and social significance for society: osteoarthritis (osteoarthrosis), osteoporosis, low back pain, rheumatoid arthritis, traumatic injuries. In terms of its impact on health, OA ranks 4th among all diseases in women and 8th in men. Major risk factors for the disease include age, obesity, and traumatic joint injury.

Knee joints are most often affected by OA (about 10% of the population over 55 years of age), while 25% of them develop severe impairments in functional activity [2]. The risk of disability in the group of patients with gonarthrosis is comparable to the group of elderly patients suffering from cardiovascular diseases, and higher than in other diseases in these patients. The high disability of patients with OA of the knee joints is the reason that the annual incidence of arthroplasty operations among patients over 65 years of age in Europe averages 0.5–0.7 per 1000 population [3]. The high prevalence of osteoarthritis (OA) and the disability problems associated with this disease are extremely relevant for Russia. In the population among people over 15 years of age, according to a large-scale domestic study that included examination of 41,348 people, clinical manifestations of OA were identified in 6.43% [4]. The number of patients with OA in our country is about 10–12% of the population, about a third of them have some degree of disability, and therefore timely and effective treatment of OA is of great social and economic importance.

Treatment of OA is difficult for a number of reasons. The main goal of treating patients is rational pain relief and anti-inflammatory therapy, slowing the progression of the disease and maintaining the quality of life of patients. According to the modern classification of drugs used in the treatment of OA [5], they are divided into the following groups:

1. Symptomatic rapid-acting drugs (non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, opioid analgesics, corticosteroids, etc.) that affect the clinical symptoms of the disease (pain, inflammation, etc.).
2. Delayed-acting modifying agents (glucosamine, diaceriin, chondroitin, hyaluronic acid, avocado and soybean unsaponifiables), the effect of which appears more slowly than symptomatic agents and lasts after the end of their use. These pharmacological agents have a chondromodifying effect, preventing the degradation of articular cartilage.

Treatment of OA begins with symptomatic therapy. The doctor should strive to provide reliable pain relief to a patient with OA, which is difficult mainly due to the elderly age of this group of patients and the presence of a large number of concomitant diseases [6, 7]. Traditionally used NSAIDs have a symptomatic effect, reducing pain and inflammation in the joints. The main disadvantage of these drugs is the presence of severe adverse reactions, especially in relation to the gastrointestinal tract and cardiovascular system; Moreover, some of them negatively affect the metabolism of articular cartilage [8, 9].

The use of drugs that can potentially modify metabolic processes in cartilage has attracted attention primarily because of their safety in the treatment of OA. They are characterized, on the one hand, by an effect comparable to NSAIDs (although more slowly developing) on ​​pain and joint function, and on the other hand, by the ability to influence the course of the disease and its outcome, slowing down the progression of the disease. It was in the 2003 EULAR recommendations that glucosamine sulfate and chondroitin sulfate were identified as drugs with a “chondroprotective” effect. The final list of 10 recommendations of the EULAR special commission for the treatment of knee OA, based on evidence-based medicine and expert opinion, indicates the need to include symptomatic slow-acting drugs (glucosamine sulfate, chondroitin sulfate, avocado/soybean unsaponifiables, diacerein and hyaluronic acid), which have the ability to modify the structure of cartilage [5]. Numerous studies have shown that chondroitin and glucosamine have moderate to significant effects on pain and functional joint mobility in OA compared with placebo; these drugs are safe and characterized by a minimum of side effects [10–13]. The pharmacological effects of GA and cholesterol are presented in Table. 1.

According to a meta-analysis that included all available published studies on this problem, the severity of the therapeutic effect for chondroitin sulfate and glucosamine sulfate was 0.78 and 0.44, respectively [5].

Many studies have been conducted to study the effectiveness of glucosamine and chondroitin in the treatment of OA of the knee and hip joints. Research results have been summarized in reviews and meta-analyses [13–15]. In a meta-analysis by F. Richi et al. [15] showed that glucosamine has a structural-modifying (with three-year intake it slows down the degenerative process in articular cartilage) and symptomatic effect, chondroitin has a symptomatic effect (has a positive effect on the Lequesne index, visual analogue scale (VAS) indicators). However, safety during administration was excellent for both glucosamine and chondroitin.

When studying the mechanism of action of glucosamine and chondroitin sulfate, it turned out that in addition to common mechanisms, there are also differences in the effect of these substances on joint tissue. Glucosamine (GA), produced in the body as glucosamine 6-phosphate (GK6-P), is a fundamental building block required for the biosynthesis of compounds such as glycolipids, glycoproteins, glycosaminoglycans, hyaluronate and proteoglycans. Chondroitin sulfate (CS) is an important class of glycosaminoglycans required for the formation of proteoglycans found in articular cartilage [16]. The primary biological role of GA in stopping or preventing joint degeneration is directly due to its ability to act as an essential substrate for stimulating the biosynthesis of glycosaminoglycans and hyaluronic acid, necessary for the formation of proteoglycans found in the structural matrix of the joint. CS, whether absorbed intact or in the form of components, provides an additional substrate for the formation of a healthy joint matrix, since cholesterol is a component of proteoglycans (macromolecules containing many glycosaminoglycan molecules) attached to a long chain of hyaluronic acid (hyaluronate). Both GA and cholesterol are able to increase the synthesis of proteoglycans and collagen, reduce the activity of leukocyte elastase, collagenase and aggrekenase, and suppress IL-1-stimulated synthesis of prostaglandins by fibroblasts [17–19]. At the same time, there are some fundamental differences regarding, first of all, the effect on the subchondral bone and synovial membrane. It is believed that the ability to normalize bone turnover is characteristic of cholesterol, as well as the ability to mobilize fibrin, lipids and cholesterol deposits in the synovium and subchondral blood vessels, as well as reduce chondrocyte apoptosis [20]. This fact served as a prerequisite for the creation of combination drugs with the aim of potentiating the complementary effects of cholesterol and G, as well as implementing the entire spectrum of their mechanisms of action [21].

Available evidence of the symptom-modifying (reduction of pain and, accordingly, the need for anti-inflammatory drugs, improvement of the functional state of patients) and chondroprotective effects of GA sulfate and cholesterol also contributed to the creation of drugs based on their combination in order to obtain a possible overall greater effect compared to monotherapy with these drugs. According to L. Lippielo et al. (1999), the combined use of cholesterol and GA hydrochloride in an experiment increased the production of glycosaminoglycans by chondrocytes by 96.6% compared to 32% with monotherapy [22]. The use of another substance, GA hydrochloride, instead of GA sulfate in combination preparations is associated with its higher stability and bioavailability [23] (Table 2).

The drug Theraflex is also a combination of two salts - chondroitin sulfate (400 mg) and glucosamine hydrochloride (500 mg) in one capsule. There is another form of release of the drug for oral administration: Teraflex Advance, which contains chondroitin sulfate 200 mg, glucosamine sulfate 250 mg and ibuprofen 100 mg.

A preclinical study of the effect of Teraflex on cartilage structures and cells was carried out at the Department of Traumatology and Orthopedics of the Rostov State Medical University (Professor V. D. Sikilind, A. V. Alabud). Experimental studies were performed on dogs and rabbits with modeling of various fractures. After modeling intra-articular fractures, metal osteosynthesis of fractures was performed using various extraosseous and transosseous fixators with joint unloading and pharmacological protection of cartilage (structure-modifying therapy with Theraflex). The experiment studied the features and dynamics of cartilage regeneration without and with the use of drug protection during various treatment methods (Fig. 1). A total of 120 surgical interventions were performed in 6 series of experiments on chinchilla dogs and rabbits. Under the influence of drug therapy with a combination of cholesterol and GA, the number and size of chondrocytes per unit area of ​​articular cartilage objectively increases. The most effective recovery occurred in the group of animals where fractures with a small area of ​​damage to the articular cartilage were modeled. The greatest degenerative changes in cartilage were observed after modeling fractures with a significant area of ​​damage to articular cartilage without additional stimulation of reparative regeneration of glycosaminoglycans.

L. I. Alekseeva et al. (Institute of Rheumatology, Russian Academy of Medical Sciences) [24], when assessing the effectiveness and tolerability of the drug Teraflex in 50 patients with significant gonarthrosis, obtained results that served as the basis for modifying the dose of Teraflex. For 4 months, patients received Theraflex (2 capsules per day for the first 3 weeks, then 1 capsule per day) and ibuprofen (400 mg 3 times a day with the possibility of subsequent dose reduction) and were observed for 2 months without treatment. A decrease in pain, stiffness and degree of functional impairment according to the WOMAC index was noted by the end of drug use in 37%, 42% and 24% of patients, respectively. At the same time, in 26 patients it was possible to reduce the dose of ibuprofen from 1200 to 800 mg per day, and in 3 patients, NSAIDs were discontinued. However, in 11 patients, when the Teraflex dose was reduced from 2 capsules/day to 1 capsule/day, an increase in joint pain was noted, so the Teraflex dose was again increased to 2 capsules per day, which allowed them to achieve an effect. 47 patients completed the full 6-month course of treatment.

Currently, the Teraflex dose is 3 capsules per day for the first 3 weeks, then 2 capsules per day for 3 months or more.

According to the Department of Clinical Geriatrics and Organization of Gerontological Care (RMAPO) [25], in postmenopausal women with an average age of 54.2 ± 7.6 years, the use of Teraflex for 6 months allowed a significant reduction in the main manifestations of OA (Table 3) with a decrease in the need in NSAIDs in 21% of patients and refusal to take NSAIDs in another 14% of patients. The authors also assessed the possibility of combining Theraflex with hormone replacement therapy for surgical menopause and showed that this combination does not reduce the effectiveness of therapy and does not affect the incidence of adverse events.

The possibility of using Teraflex in a continuous and intermittent course was studied [26]: 50 patients received Teraflex according to the usual regimen for 9 months and 50 patients received Teraflex for 3 months, then a 3-month break in treatment was taken, then again patients in this group received Teraflex. In general, by 9 months of the study, no significant differences were found between the effectiveness of the drug in both groups, although the severity of the effect was higher with continuous use of the drug (Fig. 2). In both groups, 34% of patients stopped taking NSAIDs. Ultrasound examination showed improvement (reduction in the synovium, area of ​​the suprapatellar volvulus, size of the popliteal cyst and severity of periarticular changes) in 83% of patients who received Teraflex continuously, and in 81.2% of patients who received Teraflex intermittently.

The effect of Teraflex Advance was studied at the Institute of Rheumatology of the Russian Academy of Medical Sciences (L. I. Alekseeva et al.) in comparable groups of 20 people with gonarthrosis, whose average age was about 58 years [27]. Patients received ibuprofen (600–1200 mg/day) for 3 months in combination with Teraflex Advance 6 capsules/day (group 1), Teraflex 2 capsules daily (group 2) or ibuprofen alone 600–1200 mg/day (3rd group). The researchers noted equal effectiveness of both forms of the drug, clearly superior to the effectiveness of ibuprofen in relation to pain, stiffness and functional impairment (WOMAC index). A significant reduction in pain was noted in all three groups, but in patients receiving only ibuprofen, the reduction in pain was significantly less than in the other two groups. In the groups of patients receiving Teraflex and Teraflex Advance, stiffness scores decreased significantly after 2 months of therapy, while when taking ibuprofen alone, the reduction in stiffness did not reach statistical significance throughout the entire course of therapy. At the same time, indicators of functional impairment and the total WOMAC index when taking Theraflex Advance significantly decreased after 1 month of treatment, when taking Theraflex - after 2 months and were significantly lower than when using only ibuprofen. According to V.V. Povoroznyuk [28], taking Teraflex Advance 2 capsules 2 times a day made it possible to achieve an analgesic effect after 2 weeks of administration, and when taking the usual form of Teraflex (1 capsule 2 times a day) - after 2 months. Both forms of the drug are well tolerated. It is believed that GA and ibuprofen have a synergistic antinociceptive effect, which explains the choice of ibuprofen for combination with Theraflex. It is proposed to begin therapy for patients with OA by taking Teraflex Advance for the first 2–3 weeks to more quickly achieve an analgesic effect, followed by taking the usual form of Teraflex for another 4–6 months.

Treatment of OA, like other chronic diseases, is most effective in the early stages. According to M. S. Svetlova [29], long-term use of Teraflex in patients with OA with a disease duration of no more than 36 months (on average 11.5 months) can significantly improve the quality of life, which manifests itself after 1–2 years of therapy, which the author conducted according to the following scheme: the first month 3 capsules/day, from the 2nd to the 6th month — 2 capsules/day and repeated courses for 2 months with an interval of 1 month, 2 capsules/day. In the control group, which received only NSAIDs, the effect was maximal in the first 6 months, and then gradually lost, and after 3 years of therapy, the severity of all indicators approached the original level. After 2 and 3 years of treatment with Theraflex, all clinical indicators, with the exception of pain severity according to VAS at rest, were significantly lower than in the control group. At the same time, among patients receiving Theraflex, the need for taking NSAIDs significantly decreased, so that after 6 months 22% of patients stopped taking them, after a year - 26.4%, after 2 years - 27.5% and after 3 years - 27 .7% of patients. These data indicate that the administration of basic therapy for OA should not be delayed and should be carried out for a sufficiently long time.

There is data [30] on the effectiveness of Theraflex in patients with osteochondrosis (OC). The drug Teraflex was used in the complex treatment of 40 patients with degenerative diseases of the cervical, thoracic and lumbar spine with acute and chronic pain of varying intensity. Three patients had widespread AC with damage to several parts of the spine. The average age of the patients was 48.5 years. Teraflex was administered orally, regardless of food intake according to the standard regimen. The symptoms that patients had with damage to the cervical spine are presented in Table. 4 and for lesions of the lumbar region in table. 5. X-ray examination of all patients in the affected area revealed a decrease in the height of the intervertebral discs, subchondral sclerosis of the vertebrae, narrowing of the joint space, incongruity of the articular surfaces, and the formation of osteophytes. Controlled limitation of spinal function was observed in 100% of patients.

Treatment results were assessed by changes in symptoms and the Oswester Disability Questionnaire for back pain [31], before drug use, on the 7th, 14th and 21st days of the study and monthly until the end of the 4-month course of therapy.

The results of the study showed that a significant improvement in the condition with relief of pain and positive dynamics of neurological symptoms was observed in 75% of patients (Fig. 3), mostly young. In 20% of patients, the intensity of the pain syndrome decreased; the effect was absent in only 5% of patients. The dynamics of restoration of range of motion corresponded to a decrease in pain. The drug was well tolerated in all patients; only 2 patients had a single bowel disorder, which was not the reason for discontinuation of Teraflex therapy. No allergic manifestations were noted.

Thus, the use of the drug Teraflex in the treatment of degenerative-dystrophic diseases of the spine [30] is rational, especially in young patients, both in combination with NSAIDs and as monotherapy. In combination with NSAIDs, the analgesic effect occurred 2 times faster, and the need for therapeutic doses of NSAIDs progressively decreased.

Conclusion

1. Theraflex drug is a drug that has a reliable symptom-modifying effect (reducing pain, reducing stiffness, improving motor activity) in patients with OA of large joints and the spine.
2. The effectiveness of Theraflex is equivalent with continuous use for more than 6 months and with intermittent use for 3 months with a three-month break.
3. Consecutive use of Teraflex Advance with a transition to Teraflex allows you to achieve a faster analgesic effect and thereby improve patient adherence to the course of treatment.
4. The use of Theraflex can reduce the need for NSAIDs.
5. Long-term (2–3 years) repeated courses of Theraflex can achieve a long-term symptom-modifying effect.
6. There is evidence of pain relief, with positive dynamics of neurological symptoms in patients with osteochondrosis while taking Theraflex.
7. Theraflex drug is well tolerated with long-term use.

Literature

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12. Mazieres B., Combe B., Phan Van V. et al. Chondroitin sulfate in osteoarthritis of the knee: a prospective, double blind, placebo controlled multicenter clinical study // J Rheum. 2001; 28: 173–181.
13. McAlindon TE, LaValley MP, Gulin JP, Felson DT Glucosamine and chondroitin for the treatment of osteoarthritis: a systematic quality assessment and meta-analysis // JAMA. 2000; 283:1469–1475.
14. Leeb BF, Schweitzer H., Montag K., Smolen JS A meta-analysis of chondroitin sulfate in the treatment of osteoarthritis // J Rheumatol. 2000; 27:205–211.
15. Richy F., Bruyere O., Ethgen O. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis // Arch Intern Med. 2003; 163:1514–1522.
16. Povoroznyuk V.V. Glucosamine and chondroitin in the treatment of osteoarthritis: literature data and results of our own research // RMZh. 2006; vol. 14, no. 4: 1–5.
17. Baici A., Bradamante P. Interaction between human leukocyte elastase and chondroitin sulfate // Chem Biol Interaction. 1984; 51:1–11.
18. Lippielo L., Grande D. In vitro chondroprotection of glucosamine and chondroitin sulfate in a rabbit model of a OA and demonstration of metabolic synergy on chondrocyte in vitro // Ann Rheum Dis. 2000; 59 (Suppl. 1): 266.
19. Yaron I., Shirasi R., Judovich R., Yaron M. Chondroitin sulfate inhibits prostaglandin E2 production in synovial cell cultures and reverses IL-1 inhibition of cartilage synthesis // Ann Rheum Dis. 2000; 59 (Suppl. 1): 265.
20. Reveliere D., Mentz F., Merie-Beral H. et al. Protective effect of chondroitin 4,6-sulfate on apoptpsis of rabbit articular chondrocytes - preliminary results. In: Mautone G., Tajana E., Rovati S., Vacher D. editors. New appoaches in OA. Zurich: Litera Rheumatologica 24, EULAR; 1999: 15–20.
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25. Malichenko S. B., Kolesova I. R. Study of the clinical effectiveness and tolerability of the drug Teraflex (glucosamine hydrochloride - 500 mg and sodium chondroitin sulfate - 400 mg) for articular syndrome in women in physiological and surgical menopause (report). M., 2005.
26. Alekseeva L. I. Results of an open comparative randomized study of the effectiveness and safety of 2 treatment regimens with Theraflex in patients with osteoarthritis of the knee joint. Clinical study // Breast cancer. 2008, vol. 16, no. 5: 316–319.
27. Alekseeva L. I. An open randomized comparative study of the effectiveness and safety of the drug Teraflex Advance compared with the drugs Teraflex and ibuprofen in patients with osteoarthritis of the knee joints. Scientific report. 2008.
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N. V. Chichasova, Doctor of Medical Sciences, Professor

GBOU VPO First Moscow State Medical University named after. I. M. Sechenova Ministry of Health of the Russian Federation, Moscow

Contact Information

Characteristics of Teraflex Advance

Teraflex Advance has a strengthened formula. It contains 3 active ingredients. The content of glucosamine hydrochloride in one capsule, depending on the dosage, is 250 or 500 mg, and chondroitin sulfonate is 200 or 400 mg. Another active component of this drug is the NSAID – Ibuprofen at a dose of 100 mg. The excipients present in this medication include:

• magnesium stearate;
• stearic acid;
• starch;
• microcrystalline cellulose;
• silica;
• crospovidone;
• povidone.

Thanks to this composition, the drug helps improve the nutrition of cartilage, protects connective tissue from damage and restores its structure, and also relieves inflammation and reduces pain.

Ibuprofen, present in the drug, blocks the transformation of arachidonic acid into prostaglandins, and also normalizes body temperature.

The use of Teraflex Advance helps to quickly restore joint mobility, increases the production of synovial fluid and reduces the rate of destruction of cartilage tissue.

This medication can be used not only in the treatment of osteochondrosis and gout, but also in the treatment of spinal hernia. In addition, the following pathological conditions are indications for the use of this medication:

• polyarthrosis;
• heel spur;
• gonarthrosis;
• coxarthrosis;
• joint pain.

This medicine has many contraindications. The drug should not be used to treat patients with renal failure. A contraindication for the use of the drug is hypersensitivity to the active components. It is not recommended to use the product for the treatment of children under 18 years of age and women during pregnancy and lactation.

Theraflex Advance should not be used to treat patients with renal failure.

Teraflex Advance should not be used for exacerbation of gastritis, stomach ulcers and erosive diseases of the digestive system. It is not recommended to use the medication for patients with bronchial asthma and hemophilia. Contraindications for the use of Teraflex Advance are liver and heart failure. The medication should be taken with caution in patients suffering from hypertension, diabetes mellitus, atherosclerosis, and coronary artery disease. There is a high likelihood of allergic reactions in people with seafood intolerance.

There is a possibility of side effects when using this drug. Abdominal pain, as well as stool disorders, flatulence and heartburn may occur.

Some patients experience decreased appetite, bloating, and dry mouth while taking the medication. The drug can cause headaches, sleep disturbances and attacks of dizziness. Possible loss of hearing and vision. In some patients, while taking the drug, the following manifestations of an allergic reaction of the body are observed:

• swelling of the legs;
• skin itching;
• rhinitis;
• hives;
• rash.

It is extremely rare for patients undergoing medication treatment to experience complaints of shortness of breath and increased sweating. Heart rate may increase.

Structure of cartilage tissue

Cartilage is a type of connective tissue, and there are three types of it in the body:

• Hyaline (vitreous) - has a bluish color, with a high content of fine collagen fibers, covers the articular surfaces of bones;
• Elastic (mesh) - characterized by increased elasticity and flexibility, it is dominated by elastin fibers, it forms small bronchi and auricles;
• Fibrous - connects tendons and ligaments to the hyaline cartilage of the articular surface.

Like any tissue, cartilage consists of cells and intercellular substance (matrix), the proportion of the latter significantly predominates in it. The matrix contains a lot of water, which does not compress or stretch, but circulates freely in the intercellular space. It is water that provides high elasticity to cartilage tissue, distributing loads and cushioning. Another important component of the matrix is ​​protein fibers: collagen and elastic. The hyaline cartilage of articular surfaces is dominated by collagen, which provides high strength. Its large molecules, twisted into a triple helix, are resistant to any deformation and quickly return to their original state. The matrix also contains glycosaminoglycans, proteoglycans, and hyaluronic acid, which retain water and participate in metabolic processes.

Cartilage cells - chondrocytes and their young forms, chondroblasts - play an equally important role: they synthesize all the components of the matrix and joint fluid. There are very few chondrocytes, only 1-5%, but they are responsible for the renewal and restoration of cartilage.

One of the main differences between cartilage tissue is the absence of blood vessels. As a consequence, cartilage must receive nutrition in an alternative way. Synovial, or joint, fluid reduces friction between articular surfaces and provides nutrition to cartilage tissue. Therefore, the delivery of nutrients and the removal of breakdown products is ensured by synovial fluid.

Comparison of Teraflex or Teraflex Advance

The drugs are combined chondroprotectors belonging to the third generation. The medications have a similar composition and mechanism of action.

Similarities

These medications contain active ingredients such as chondroitin and glucosamine. They contribute to the activation of regeneration processes in cartilage tissue. In addition, the drugs are available in capsule form. They are packaged in 30, 60 or 120 pieces. into the package.

What is the difference

The main difference between these drugs is the presence of Ibuprofen in Teraflex Advance. This NVPS gives the chondroprotector additional positive properties. At the same time, the medication has a greater number of contraindications and side effects compared to Teraflex.

Which is cheaper?

The price of Teraflex is 1400-3200 rubles. depending on the number of tablets. The cost of Teraflex Advance ranges from 800 to 2200 rubles.

Comparison of ease of use of Teraflex Advance and Teraflex

This includes dose selection taking into account various conditions and frequency of doses. At the same time, it is important not to forget about the release form of the drug; it is also important to take it into account when making an assessment.

The ease of use of Teraflex Advance is approximately the same as Teraflex. However, they are not convenient enough to use.

The drug ratings were compiled by experienced pharmacists who studied international research. The report is generated automatically.

Last update date: 2020-12-04 13:44:20

Reviews from patients

Irina, 42 years old, Orel

As a child, I did gymnastics and got injured. For a long time there were no consequences, but starting at the age of 35, the damaged knee began to bother me. Pain and aches appeared. On the recommendation of a doctor, I started using Teraflex. The drug is good, quickly eliminated the existing symptoms. Now I take this remedy in courses of 1 month every six months. I did not observe any deterioration.

Svetlana 49 years old, Novosibirsk

In winter, I fell on the ice and bruised my hip joint. First there was pain, and after a few days there was also stiffness. The doctor recommended Teraflex Advance. The condition of the joint improved within a day. The pain went away, the swelling disappeared. After about 2 weeks of taking this medication, joint mobility was restored.

Vladimir, 38 years old, Samara

I have been suffering from osteochondrosis for a long time. There was constant pain and crunching in the lower back. I started using Teraflex as prescribed by the doctor. The product quickly eliminated the discomfort. After 3 weeks of taking it, I noticed that the spine became more mobile, even physical activity did not cause pain, the crunching disappeared.