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.
Pain due to osteoarthritis (OA) of the knee
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.
Source: Prescribing Information
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.
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
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
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.
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.
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.
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: 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.
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.
Current infection or skin problems in area of injection
Known allergy to hyaluronate products
Allergies or allergic reactions
Conditions affecting certain hormones (e.g., low adrenal hormones)
Gut conditions (e.g., ulcerative colitis)
Conditions related to blood cells
Certain cancers (e.g., leukemia)
Nervous system conditions (e.g., multiple sclerosis)
Eye conditions
Kidney conditions
Lung conditions
Joint conditions (e.g., rheumatoid arthritis)
Pain due to osteoarthritis (OA) of the knee
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Bioventus LLC. (n.d.). Durolane® instructions for use.
De Lucia, O., et al. (2021). One-year efficacy and safety of single or one to three weekly injections of hylan G-F 20 for knee osteoarthritis: A systematic literature review and meta-analysis. Clinical Rheumatology.
Foran, J. R. H. (2021). Viscosupplementation treatment for knee arthritis. OrthoInfo.
Genzyme Corporation. (2023). Synvisc® Hylan G-F 20.
Genzyme Corporation. (2023). Synvisc-One® Hylan G-F 20.
McArthur, B. A., et al. (2012). Long term safety, efficacy, and patient acceptability of hyaluronic acid injection in patients with painful osteoarthritis of the knee. Patient Preference and Adherence.
Peck, J., et al. (2021). A comprehensive review of viscosupplementation in osteoarthritis of the knee. Orthopedic Reviews.
Wobig, M., et al. (1998). Viscosupplementation with hylan G-F 20: A 26-week controlled trial of efficacy and safety in the osteoarthritic knee. Clinical Therapeutics.
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