Adequan or Legend, which is better? I get this question all the time. Even though both products have been around forever, rumors of their merit continue – including a misconception that one is just a cheaper version of the other. Let’s explore the differences, so you can decide if your horse is a candidate for either formulation, or both.
While both products are great options for treatment of moderate to severe arthritis, Adequan and Legend are completely different formulations, with entirely different applications. So much, in fact, that I sometimes use both products at the same time on the same horse. Even though both pharmaceuticals are effective for the management of arthritis, I cannot say which is better – it’s like comparing apples and oranges.
Adequan is polysulfated glycosaminoglycan, a substance that stimulates cartilage to repair itself. It can be administered intramuscularily (Adequan IM) or intra-articular (Adequan IA). Adequan IM treatment consists of a series of intramuscular injections every four days for a month, while Adequan IA treatment consists of a series of five weekly intra-articular injections. It may take as long as two months to see results.
Legend is hyaluronic sodium, a substance naturally found in synovial fluid. It comes available in intravenous (Legend IV) or intra-articular (Legend IA) formulations. Either route consists of three consecutive weekly treatments. Legend works quickly to reduce inflammation within the joint capsule, with improvement as early as two days.
The manufacturers of Adequan and Legend agree that intra-articular injection of their products is most effective, but it does pose greater risk of complications. However, intramuscular or intravenous administration sometimes offers better overall results because it acts systemically and can alleviate joint abnormalities throughout the body. There are pros and cons to both products: Adequan acts more slowly, but it has a more profound effect on joint repair; meanwhile Legend acts more quickly to improve lubrication and reduce pain, but it works for a shorter period.
These Adequan and Legend treatment protocols can be repeated at regular intervals, or the two products can be combined for optimal results. There are no metabolic or behavior changes associated with either product, and both are permitted in competition.
Tales from the Horse Doc 
Cheryl, I understand metabolic issues or behavior changes are not a concern with either treatment. However, what about a chronic arthritic joint? How long can you continue to use either or both of these drugs? Is there a point at which they will become ineffective due to frequency of use?
Since both polysulfated glycosaminoglycan (Adequan) and hyaluronate (Legend) are naturally-occuring substances in healthy joints, neither product becomes ineffective after prolonged use. However, arthritis is progressive – no matter what we do – so, one or both may appear less effective over time, especially in severe cases. The key to success with any arthritis protocol is, first, initiate treatment sooner than later, and secondly, adapt your regimen over time; oftentimes, continued success is achieved by changing the frequency and formulation. Thank you, Kim.
Thank you for posting on such informative topics. I found your blog through a web search, and ended up reading more articles than this one. I hope you continue to post!
Thank you, Emily!