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Hyalgun Intra-Articular Injection 20mg/2ml
Sodium hyaluronate is a high molecular weight solution derived from purified sodium hyaluronate in buffered physiological sodium phosphate with a pH of 6.8–7.5. Hyaluronic acid, naturally present in the body, plays a key role in the extracellular matrix, particularly in cartilage and synovial fluid. It contributes to the viscosity and elasticity of synovial fluid, essential for joint lubrication and shock absorption. In osteoarthritis, the quality and quantity of hyaluronic acid in the synovial fluid and cartilage diminish. Administering hyaluronic acid directly into the joint improves joint function by restoring these properties.
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✅ Description:
Hyalgun is indicated for managing pain associated with osteoarthritis (OA) of the knee in patients who have not responded adequately to nonpharmacologic therapies and basic pain relievers, such as acetaminophen. It may also serve as an adjunct in orthopedic surgery.
Use under the supervision of a registered physician.
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✔️ Dosage
Sodium hyaluronate is administered via intra-articular injection:
- A treatment cycle consists of five weekly injections (one per week).
- Some patients may benefit from three weekly injections instead.
- Administer the full 2 mL dose into one knee. For bilateral treatment, use separate injections for each knee.
- Treatment may be repeated after 6–12 months as needed.
Pediatric Use: The safety and effectiveness of sodium hyaluronate in children have not been established.
Use under the supervision of a registered physician.
✔️ Administration Instructions
Sodium hyaluronate is a single-use, pre-filled sterile solution for intra-articular injection:
Preparation:
- Do not dilute the solution.
- Ensure strict aseptic precautions.
- Use a sterile 20-gauge disposable needle.
- Clean the injection site thoroughly with an antiseptic.
Joint Effusion Management:
- If joint effusion is present, aspirate it using a 20-gauge needle before injecting the solution.
- Aspirate synovial fluid until the joint is nearly dry but not to the extent that it compromises the subsequent injection.
Injection:
- Attach the syringe containing sodium hyaluronate to the needle used for aspiration.
- Confirm needle placement by aspirating some synovial fluid before slowly injecting the solution.
- If the patient experiences pain during the injection, stop the procedure.
Post-Injection Care:
- Advise the patient to rest the treated knee for a few hours and avoid strenuous or prolonged weight-bearing activities (e.g., jogging, tennis) for 48 hours.
- Gradually return to normal activity afterward.
Dispose of any unused solution.
✔️ Local reactions may include:
- Pain, swelling, effusion, warmth, or redness at the injection site.
- These reactions are typically mild and resolve on their own with rest and cold compresses within a few days.
✔️ Drug Interactions
- Do not administer Hyalgun with other intra-articular products or mix with other medications.
- Avoid using disinfectants containing quaternary ammonium salts, as these may cause hyaluronic acid to precipitate.
✔️ Hyalgun is contraindicated in:
- Patients with known hypersensitivity to hyaluronate preparations.
- Cases of active or previous infections or skin conditions at the injection site to minimize the risk of septic arthritis.
✔️ Pregnancy & Lactation
- The safety of sodium hyaluronate in pregnant or breastfeeding women has not been established.
- It is unclear if sodium hyaluronate is excreted in human milk.
✔️ Precautions & Warnings
- Exercise caution in patients allergic to avian proteins, feathers, or egg products.
- Always follow strict aseptic techniques during administration.
- Remove joint effusion before injection.
- Advise patients to avoid strenuous activities or prolonged weight-bearing exercises for 48 hours after the injection.
✔️ Storage Conditions
- Store below 25°C in a cool, dry place, away from light.
- Protect from freezing.
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