Synvisc-One

Indications

Hylan G-F 20 is a gel made from hyaluronan (hyaluronic acid) that is injected into a joint to relieve pain caused by osteoarthritis, most often of the knee, when simple pain relievers, exercise and physiotherapy have not given enough relief. It is sometimes used in other joints such as the hip, ankle or shoulder.

How It Works

Healthy joints contain a thick fluid rich in hyaluronan that cushions and lubricates the joint. In osteoarthritis this fluid becomes thinner. Hylan G-F 20 is a cross-linked, more elastic form of hyaluronan that temporarily restores the cushioning and lubricating properties of the joint fluid (viscosupplementation), which can reduce pain and stiffness for several months.

Dosage and Administration

It is injected directly into the affected joint by a doctor, using a sterile technique, sometimes after removing excess joint fluid. Depending on the product, it is given as a single injection or a short course of weekly injections, as prescribed. Avoid strenuous activity or prolonged weight-bearing on the joint for about 48 hours afterwards.

Interactions

• Should not be mixed with disinfectants containing quaternary ammonium salts (such as Benzalkonium Chloride), as the gel can form a precipitate.
• Tell the doctor about blood thinners, as there may be a higher risk of bleeding into the joint.
• No other important interactions are known.

Contraindications

• Known allergy to hyaluronan products or to bird proteins, feathers or eggs (it is made from rooster combs).
• Infection in or near the joint, or skin disease at the injection site.
• Severe swelling or fluid build-up in the joint, or poor circulation in the leg (venous or lymphatic problems).

Side Effects

The most common effects are pain, swelling, warmth, stiffness or fluid build-up in the injected joint, usually mild and settling within a few days. Rarely, a severe inflammatory flare of the joint, allergic reactions, rash or itching can occur.

Get urgent medical help if the joint becomes very hot, red, swollen and painful with fever (possible infection), or if there is swelling of the face, difficulty breathing or a widespread rash.

Pregnancy and Lactation

Safety in pregnancy and breastfeeding has not been established. It is not usually given during this time unless the doctor considers it necessary.

Precautions and Warnings

• Not for injection into blood vessels or outside the joint.
• Not studied in children.
• Relief is temporary; repeat treatment may be considered by the doctor.
• Remove excess fluid from a swollen joint before injecting, as the doctor advises.

Overdose

Overdose is unlikely as it is given by a doctor in measured amounts. Excess volume could increase joint pain and swelling, which are treated as needed.

Therapeutic Class

Viscosupplement (intra-articular hyaluronan, medical device for osteoarthritis).

Storage

Store below 30°C; do not freeze. Protect from light and keep in the original package. Keep out of the reach of children.