Chondroitin is a naturally occurring substance formed of sugar chains. Chondroitin is believed to help the body maintain fluid and flexibility in the joints.

Glucosamine is a naturally occurring substance that is believed to help develop and renew cartilage (the hard connective tissue mainly located on bones near joints in the body), and keep it lubricated for better joint movement and flexibility.

Methylsulfonylmethane (MSM) is a naturally occurring form of sulfur that helps support muscles and tendons in the body.

Chondroitin, glucosamine, and MSM is a combination medicine that has been used in alternative medicine as a possibly effective aid in treating osteoarthritis, muscle damage caused by exercise, and other inflammatory joint disorders.

It is not certain whether chondroitin, glucosamine, and MSM is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. This product should not be used in place of medication prescribed for you by your doctor.

Chondroitin, glucosamine, and MSM is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Chondroitin, glucosamine, and MSM may also be used for purposes not listed in this product guide.

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use chondroitin, glucosamine, and MSM, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

It may take up several weeks before your symptoms improve. Call your doctor if the condition you are treating with chondroitin, glucosamine, and MSM does not improve after a few weeks of treatment, or if your condition gets worse while using this product.

Glucosamine may increase the glucose (sugar) levels in your blood. If you have diabetes, you may need to check your blood sugar more often while taking this medication. You may also need to adjust your insulin dosage. If you need surgery, you may need to stop taking chondroitin, glucosamine, and MSM at least 2 weeks ahead of time. Do not change your dose or medication schedule without advice from your doctor.

Store at room temperature away from moisture, heat, and light.

You should not use this product if you are allergic to chondroitin, glucosamine, or methylsulfonylmethane.

Ask a doctor, pharmacist, herbalist, or other healthcare provider if it is safe for you to use this product if you have:

• diabetes;

• a bleeding or blood clotting disorder such as hemophilia;

• asthma or allergies;

• prostate cancer;

• high cholesterol; or

• high blood pressure.

It is not known whether chondroitin, glucosamine, and MSM will harm an unborn baby. Do not use this product without medical advice if you are pregnant.

It is not known whether chondroitin, glucosamine, and MSM passes into breast milk or if it could harm a nursing baby. Do not use this product without medical advice if you are breast-feeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid taking chitosan (usually marketed as a weight-loss product) while you are taking chondroitin, glucosamine, and MSM. Chitosan can make it harder for your body to absorb chondroitin.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Common side effects of Osteo Bi-Flex Plus may include:

• gas, bloating, heartburn, stomach cramps, nausea;

• headache, drowsiness;

• diarrhea, constipation;

• swelling in your ankles or feet;

• itching, skin irritation; or

• puffy eyelids.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Do not take this product without medical advice if you are using any of the following medications:

• a blood thinner--warfarin (Coumadin, Jantoven); or

• cancer medicine--doxorubicin, etoposide.

This list is not complete. Other drugs may interact with chondroitin, glucosamine, and MSM, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this product guide.