Inosine

Snapshot

Indications	Contraindications
Serum urate elevation^1–4 Parkinson disease (investigational)^{1, 5} Amyotrophic lateral sclerosis³ Multiple sclerosis (investigational)^6–8 Immune checkpoint inhibitor adjunct⁹	Pregnancy or nursing¹⁰ Diabetes or hyperglycemia¹⁰

Inosine is a purine nucleoside the body makes and converts to urate, and oral supplementation raises serum urate^{1, 2}. That effect drives its research use in neurodegenerative disease, where higher urate was proposed as protective: early Parkinson disease, amyotrophic lateral sclerosis, and multiple sclerosis¹. Trial participants were typically adults with early disease and low baseline urate. Inosine is also sold to athletes as an ergogenic aid, but trials in cyclists and runners found no performance benefit.

Urate elevation is reliably achieved, but clinical benefit has not followed.² A phase 3 trial in early Parkinson disease found no difference in progression², and a trial in amyotrophic lateral sclerosis showed no functional benefit¹¹. Multiple sclerosis studies were small and inconsistent. In advanced solid tumors, a 2024 randomized open-label phase 2 study found that adding inosine to immune checkpoint inhibitors lengthened progression-free survival, with no overall survival difference. Products listing inosine number 92 in United States (US) supplement labeling, mostly capsules plus tablets and powders; see Form comparison.

The most consequential caution follows from the mechanism: raised urate brought kidney stones in inosine trials in amyotrophic lateral sclerosis and multiple sclerosis^{7, 11}. US product labels ask people with kidney disease or gout to consult a healthcare provider before use¹⁰.

Last updated October 17, 2026. Read how we make monographs.

In the full monograph

34 sources, 25 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources