Synvisc, Synvisc-One
Synvisc (hylan G-F 20) is a viscosupplement used to treat knee pain due to osteoarthritis (OA) in adults. It's an option for people who still have pain despite having tried certain treatments, like exercise and acetaminophen (Tylenol). Synvisc (hylan G-F 20) is a type of knee joint gel that's injected directly into the knee by a healthcare professional (HCP) to lubricate the joint. Synvisc is given as 3 weekly injections, whereas Synvisc-One is given as a single injection. Side effects include injection site reactions, such as redness, pain, and swelling around the knee.
What is Synvisc (hylan G-F 20)?
What is Synvisc (hylan G-F 20) used for?
- Pain due to osteoarthritis (OA) of the knee
How Synvisc (hylan G-F 20) works
Synvisc (hylan G-F 20) is a viscosupplement. It's similar to hyaluronic acid, a substance that's naturally found in the connective tissues in your body. When Synvisc (hylan G-F 20) is injected into the knee, it helps lubricate the knee joint so that you can move it smoothly. This can ease pain from osteoarthritis in the knee.
Drug facts
Side effects of Synvisc (hylan G-F 20)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Less Common Side Effects
- Rash
- Itching
- Muscle cramps or pain
- Injection site pain
- Trouble walking
- Headache
- Back pain
Synvisc (hylan G-F 20) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: hives, swelling in the face or throat, trouble breathing
The following Synvisc (hylan G-F 20) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Difficulty with moving
fluid build up around the knee
muscle pain or stiffness
pain and stiffness in the joints
Less common
Bleeding after defecation
bluish color
changes in skin color
fainting
fast, pounding, or irregular heartbeat or pulse
pain or aching in the lower legs
swelling of the ankles, feet, or legs
tenderness
uncomfortable swelling around the anus
warmth or swelling of the joints
Rare
Redness in the joints
Incidence not known
Black, tarry stools
bleeding gums
bloating or swelling of the face, arms, hands, lower legs, or feet
blood in the urine or stools
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
feeling of warmth
general feeling of discomfort or illness
muscle cramps
pinpoint red spots on the skin
rapid weight gain
redness of the face, neck, arms, and occasionally, upper chest
tingling of the hands or feet
trouble breathing
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain or loss
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare
Pain at the injection site
Incidence not known
Dizziness
headache
raised red swellings on the skin, lips, tongue, or in the throat
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Synvisc (hylan G-F 20)
Pros
- Only need 1 or 3 injections, depending on the brand name
- Effects might last up to 1 year
- Might delay time for total knee replacement surgery
- Good option if other treatments for OA pain didn't work well
Cons
- Must be given by a healthcare professional
- Might not be the best option for people with an allergy to egg products
- Can cause temporary pain at the injection site
- Not studied in people age 21 years old or younger
Pharmacist tips for Synvisc (hylan G-F 20)
- If you're getting Synvisc (hylan G-F 20), mark your appointments to get your injection(s) on your calendar. This will help you avoid missing a dose.
- Your prescriber might have you avoid physical activity after receiving Synvisc (hylan G-F 20). In general, take things easy for the first 48 hours right after your injection. You should avoid strenuous activities such as running, jumping, swimming, biking or standing on your feet for more than 1 hour at a time. Ask your prescriber when you can resume major physical activities again.
- You can expect to experience temporary pain and swelling in the knee where Synvisc (hylan G-F 20) was injected. This should go away, but if it doesn't, contact your prescriber.
- If you're pregnant or breastfeeding, talk to your prescriber about the risks and benefits of receiving Synvisc (hylan G-F 20). There isn't enough information to know if it's safe for you or your baby.
Common questions about Synvisc (hylan G-F 20)
If you received Synvisc, you might have some improvement in your pain symptoms as soon as a week after your injection. But people typically feel a more noticeable difference about 2 to 3 months after the start of treatment. If you received Synvisc One, you might start to feel pain relief a month after your injection. Not everyone responds to treatment the same way. Talk with your healthcare team if you have more questions about what to expect with Synvisc (hylan G-F 20).
How long your pain relief lasts might differ depending on your condition and how your body responds to Synvisc (hylan G-F 20). Clinical studies show that people who received Synvisc and Synvisc One can experience pain relief up to 6 months after treatment. Some long-term studies showed that the benefits of Synvisc (hylan G-F 20) might last up to a year or longer. Each person responds differently to the treatment, so results can vary among individuals.
In studies, up to 56% of people with OA who got three Synvisc (hylan G-F 20) injections were free or nearly free of pain when they put weight on their knee 10-24 weeks after the last shot. This was compared to less than 13% of people who got a shot of saline (no medication).
Yes. Some knee injections that contain hyaluronic acid, like Synvisc (hylan G-F 20), are made using rooster combs. These are the red comb-like structure on top of a rooster's head. They contain the same gel-like substance that's in our knee joints.
Durolane (sodium hyaluronate) and Synvisc (hylan G-F 20) are both knee injections that are used to relieve knee pain in adults with osteoarthritis who don't get enough relief from other treatments. Both Durolane and Synvisc-One are injected into the knee once, while Synvisc is given as three weekly injections. Another difference between Synvisc (hylan G-F 20) and Durolane is that Durolane is made from bacteria, while Synvisc (hylan G-F 20) is made from chicken combs.
Both Synvisc and Synvisc-One contain hylan polymers as the active ingredient. The main difference between them is that Synvisc has a lower dose and is given as one injection a week for three weeks. Synvisc-One has a higher dose, and it's given as one injection. Follow up with your healthcare professional to see which formulation is best for you.
Weight gain wasn't a side effect reported by people taking Synvisc (hylan G-F 20) during clinical studies. If you have concerns about your weight, contact your primary care provider.
No, Synvisc (hylan G-F 20) isn't a steroid. It contains sodium hyaluronate, which is a gel-like substance that helps lubricate the joints and helps absorb shock from movements. There are other knee injections used to treat osteoarthritis that do contain a steroid.
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Risks and warnings for Synvisc (hylan G-F 20)
Synvisc (hylan G-F 20) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reaction
- Risk factors: Allergy to sodium hyaluronate, avian (bird) proteins, feathers, or egg products
Synvisc (hylan G-F 20) can cause life-threatening allergic reactions (e.g., anaphylaxis). If you have a history of an allergic reaction to hyaluronate products, bird products, feathers, or egg products, you're at a higher risk of having a reaction to Synvisc (hylan G-F 20). Make sure to tell your prescriber all of your allergies. If you experience rash, trouble breathing, or swelling in your lips, tongue, or throat, get medical help right away.
Serious skin damage
Some people have reported serious skin damage after getting Synvisc (hylan G-F 20). Contact your prescriber if you notice changes in skin color or open sores.
Synvisc (hylan G-F 20) dosage
Typical dosage for Synvisc (hylan G-F 20)
- Synvisc: Each Synvisc injection contains 16 mg of hylan polymers (hylan A + hylan B). The typical dose is one injection given into the knee joint by a healthcare professional once a week for 3 weeks.
- Synvisc-One: Each Synvisc One injection contains 48 mg of hylan polymers (hylan A + hylan B). The typical dose is one injection given into the knee joint by a healthcare professional once.
Interactions between Synvisc (hylan G-F 20) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Synvisc (hylan G-F 20) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Synvisc (hylan G-F 20) will not be safe for you to take.
- Current infection or skin problems in area of injection
- Known allergy to hyaluronate products
What are alternatives to Synvisc (hylan G-F 20)?
This medication is used for many different conditions. Generally, it's used for autoimmune problems, conditions related to swelling, or cancer. Some examples include:
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