Neovastat

Shark cartilage/Drug Interactions:

  • AnalgesicsAnalgesics: In animal research, shark cartilage has been shown to inhibit nitric oxide synthesis (54; 55).
  • AnestheticsAnesthetics: In animal research, shark cartilage has been shown to inhibit nitric oxide synthesis (54; 55).
  • AntiangiogenicsAntiangiogenics: In human, animal, and in vitro research, shark cartilage or its constituents have shown evidence of antiangiogenic effects (56; 57; 58; 59; 28; 29; 60; 61; 62; 50; 63; 64; 5; 7; 65; 50). Based on this information, authors have suggested that patients in treatment protocols involving other antiangiogenic agents should avoid shark cartilage, due to theoretical additive or synergistic activity (34).
  • AntiarthriticsAntiarthritics: In vitro and animal research shows that shark cartilage possesses anti-inflammatory properties (13; 14; 15; 66) and improves affected joints (67).
  • AntidiabeticsAntidiabetics: In a phase I/II study using shark cartilage, a patient with type 2 diabetes mellitus and renal carcinoma was noted to develop hypoglycemia (31). Hyperglycemia was reported in one of 60 patients in an open-label study (32).
  • AntihypertensivesAntihypertensives: Transient hypotension was noted in one of 60 patients in an open-label study (32).
  • Anti inflammatoriesAnti inflammatories: In vitro and in animal research, shark cartilage possessed anti-inflammatory properties (42; 13; 14; 15). In animals, shark cartilage was less effective as an anti-inflammatory agent than nitrones (68).
  • AntineoplasticsAntineoplastics: In animal research, shark cartilage demonstrated antitumor effects (64), which has been noted from other animal research in a review (50). In clinical trials of AE-941 and Benefin? shark cartilage, a demonstration of anticancer effect was lacking (44; 37).
  • Cardiovascular agentsCardiovascular agents: Transient hypotension was noted in one of 60 patients in an open-label study (32). According to secondary sources, there is a small risk of arrhythmia in patients with known arrhythmias, due to the calcium in shark cartilage. Patients with coronary artery disease and peripheral vascular disease may depend on blood vessel collateralization, which theoretically could be inhibited by the antiangiogenic properties of shark cartilage (27; 28; 29).
  • CisplatinCisplatin: In animal research, shark cartilage demonstrated antitumor effects (69).
  • Diuretics, thiazideDiuretics, thiazide: Shark cartilage products contain calcium (up to 25%) (33).
  • Gastrointestinal agentsGastrointestinal agents: In clinical research, subjects taking shark cartilage developed gastrointestinal distress (nausea, vomiting, constipation, dyspepsia) (32; 33; 38; 39). Diarrhea was reported in a clinical trial (37).
  • Heart rate regulating agentsHeart rate regulating agents: According to secondary sources, there is a small risk of arrhythmia in patients with known arrhythmias, due to the calcium in shark cartilage.
  • HematologicsHematologics: Neutropenia (N=5) and leucopenia (N=2) were reported only in those receiving shark cartilage in a clinical trial of subjects on chemotherapy for advanced cancer (37).
  • HepatotoxinsHepatotoxins: A case report documented hepatitis (transaminitis, low-grade fever, right upper-quadrant abdominal tenderness, jaundice) in an elderly male patient using shark cartilage, which resolved six weeks after the supplement was discontinued (the product in question was never checked for adulterants or impurities) (30).
  • ImmunomodulatorsImmunomodulators: In vitro research showed that the immune response of natural killer cells is stimulated by AR10 fraction proteins of about 14.5 kDa from shark cartilage (70).
  • Interferons (? and ?)Interferons (? and ?): Based on study, both interferon ? and ? possess antiangiogenic properties and according to an expert, may act synergistically with shark cartilage to inhibit blood vessel growth, slow wound healing, reduce inflammation, or cause birth defects (34).
  • Renal agentsRenal agents: Shark cartilage products contain calcium (up to 25%) (33). According to secondary sources, there is a risk of hypercalcemia in patients with renal disease, due to the high calcium content in some shark cartilage preparations.
  • ThalidomideThalidomide: According to preliminary reports, thalidomide may act synergistically with shark cartilage to inhibit blood vessel growth, slow wound healing, reduce inflammation, or cause birth defects (71; 34).

    • Shark cartilage/Herb/Supplement Interactions:

  • AnalgesicsAnalgesics: In animal research, shark cartilage has been shown to inhibit nitric oxide synthesis (54; 55).
  • AnestheticsAnesthetics: In animal research, shark cartilage has been shown to inhibit nitric oxide synthesis (54; 55).
  • AntiangiogenicsAntiangiogenics: In human, animal, and in vitro research, shark cartilage or its constituents have shown evidence of antiangiogenic effects (56; 57; 58; 59; 28; 29; 60; 61; 62; 50; 63; 64; 5; 7; 65; 50). Based on this information, authors have suggested that patients in treatment protocols involving other antiangiogenic agents should avoid shark cartilage, due to theoretical additive or synergistic activity (34).
  • AntiarthriticsAntiarthritics: In vitro and animal research shows that shark cartilage possesses anti-inflammatory properties (13; 14; 15; 66) and improves affected joints (67).
  • Anti inflammatoriesAnti inflammatories: In vitro and in animal research, shark cartilage possessed anti-inflammatory properties (42; 13; 14; 15). In animals, shark cartilage was less effective as an anti-inflammatory agent than nitrones (68).
  • AntineoplasticsAntineoplastics: In animal research, shark cartilage demonstrated antitumor effects (64), which has been noted from other animal research in a review (50). In clinical trials of AE-941 and Benefin? shark cartilage, a demonstration of anticancer effect was lacking (44; 37).
  • AntioxidantsAntioxidants: Ongoing in vitro research has reported that shark cartilage acts as a scavenger for reactive oxygen species (72; 73).
  • Calcium supplementsCalcium supplements: Shark cartilage products contain calcium (up to 25%) (33).
  • Cardiovascular agentsCardiovascular agents: Transient hypotension was noted in one of 60 patients in an open-label study (32). According to secondary sources, there is a small risk of arrhythmia in patients with known arrhythmias, due to the calcium in shark cartilage. Patients with coronary artery disease and peripheral vascular disease may depend on blood vessel collateralization, which theoretically could be inhibited by the antiangiogenic properties of shark cartilage (27; 28; 29).
  • Chondroitin sulfateChondroitin sulfate: According to secondary sources, chondroitin is a popular therapy for osteoarthritis and is a constituent of shark cartilage.
  • DiureticsDiuretics: Shark cartilage products contain calcium (up to 25%) (33).
  • Gastrointestinal agentsGastrointestinal agents: In clinical research, subjects taking shark cartilage developed gastrointestinal distress (nausea, vomiting, constipation, dyspepsia) (32; 33; 38; 39). Diarrhea was reported in a clinical trial (37).
  • Glucosamine sulfateGlucosamine sulfate: According to secondary sources, glucosamine is a constituent of shark cartilage and is a popular therapy for osteoarthritis.
  • Heart rate regulating agentsHeart rate regulating agents: According to secondary sources, there is a small risk of arrhythmia in patients with known arrhythmias, due to the calcium in shark cartilage.
  • HematologicsHematologics: Neutropenia (N=5) and leucopenia (N=2) were reported only in those receiving shark cartilage in a clinical trial of subjects on chemotherapy for advanced cancer (37).
  • HepatotoxinsHepatotoxins: A case report documented hepatitis (transaminitis, low-grade fever, right upper-quadrant abdominal tenderness, jaundice) in an elderly male patient using shark cartilage, which resolved six weeks after the supplement was discontinued (the product in question was never checked for adulterants or impurities) (30).
  • HypoglycemicsHypoglycemics: In a phase I/II study using shark cartilage, a patient with type 2 diabetes mellitus and renal carcinoma was noted to develop hypoglycemia (31). Hyperglycemia was reported in one of 60 patients in an open-label study (32).
  • HypotensivesHypotensives: Transient hypotension was noted in one of 60 patients in an open-label study (32).
  • ImmunomodulatorsImmunomodulators: In vitro research showed that the immune response of natural killer cells is stimulated by AR10 fraction proteins of about 14.5 kDa from shark cartilage (70).
  • MineralsMinerals: According to secondary sources, trace elements, such as iron, zinc, selenium, copper, manganese, molybdenum, titanium, and strontium, are found in high levels in shark cartilage.
  • Renal agentsRenal agents: Shark cartilage products contain calcium (up to 25%) (33). According to secondary sources, there is a risk of hypercalcemia in patients with renal disease, due to the high calcium content in some shark cartilage preparations.

    • Shark cartilage/Food Interactions:

  • Acidic fruit juices (apple, grape, orange, tomato, cranberry)Acidic fruit juices (apple, grape, orange, tomato, cranberry): In clinical research, acidic fruit juices reduced the absorption of shark cartilage (45; 42).

    • Shark cartilage/Lab interactions:

  • Blood pressureBlood pressure: Transient hypotension was noted in one of 60 patients in an open-label study (32).
  • Blood sugarBlood sugar: In a phase I/II study using shark cartilage, a patient with type 2 diabetes mellitus and renal carcinoma was noted to develop hypoglycemia (31). Hyperglycemia was reported in one of 60 patients in an open-label study (32).
  • Calcium levelsCalcium levels: Shark cartilage products contain calcium (up to 25%) (33). According to secondary sources, there is a risk of hypercalcemia in patients with renal disease, due to the high calcium content in some shark cartilage preparations.
  • Heart rateHeart rate: According to secondary sources, there is a small risk of arrhythmia in patients with known arrhythmias, due to the calcium in shark cartilage.
  • Keratan sulfateKeratan sulfate: Keratan is a protein measured in basic science research and experimentally as a marker of cartilage metabolism. A protein in shark cartilage reacts with the same antibodies as the keratan sulfate ELISA assay (74). Expert opinion suggests that this may lead to erroneous results.
  • Troponin-ITroponin-I: Expert opinion suggests that the troponin-I in shark cartilage can cause a false-positive result in human serum troponin-I assays, a test commonly used to evaluate cardiac ischemia (35). It is unclear, however, if the troponin-I is digested by proteolytic enzymes prior to absorption.