Hyaluronic Acid (Injection)

Hyaluronic acid is useful for joint pain and stiffness when administered by a healthcare professional into the joints.

Overview

Hyaluronic acid is also sold under the following brand names:

  • Acide Hyaluronique
  • Ácido Hialurónico
  • Glycosaminoglycan
  • Glycoaminoglycane
  • Hyaluran
  • Hyaluronan
  • Hyaluronate de Sodium
  • Hyaluronate Sodium
  • Hylan
  • Sodium Hyaluronate

Hyaluronic acid is the same as a fluid that occurs naturally in our body. It's found in the highest concentration in fluids in the joints and eyes. The substance helps to cushion and lubricate your joints and ensures the joints are working smoothly. Therefore, when you are suffering from osteoarthritis, the hyaluronic acid found in the affected joints becomes thinned. Hyaluronic acid injections will give your body a natural supply hence easing pain and stiffness. The hyaluronic acid used as medicine is made by bacteria in the laboratory or is extracted from the rooster combs These injections are referred to a "viscosupplementation," since they help the fluid in your joints. The dose should only be administered under the doctor's immediate supervision.

The FDA has approved this treatment only for patients with osteoarthritis of the knee, but these injections have also been tried it in other joints as well. They have also been used by those who cannot have total knee replacement surgery or by those who can't take painkillers such as:

  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil or Motrin)
  • Naproxen sodium (Aleve)

It's injected into the eye during certain eye surgeries (corneal transplantation, cataract removal, and repair of the detached retina)to help replace natural fluids. It's injected directly into the bladder for women who have frequent tract infections. It can be taken orally for acid reflux or used as a lip filler in plastic surgery, and some people also use the medication for healing wounds, skin ulcers, burns and as a moisturiser. Also, hyaluronic acid can affect the way the body responds to injury.

Conditions Treated

  • Osteoarthritis
  • Cataracts

Type Of Medicine

  • Viscosupplements

Side Effects

Apart from the benefits of hyaluronic acid joint injections, the medicine can also cause some unwanted effects. Not all of the side effects may occur, but they need medical attention. Some people often have mild reactions that can cause temporary pain or swell in the joint; you may consider applying an ice pack to help ease them. It's however advisable not to strain the affected joint within 48 hours after receiving the injections. Avoid any strenuous activities such as jogging, standing for long periods, tennis, or heavy lifting.

Some of the most common short-term side effects include;

  • Difficulty with moving
  • Pain in the joints
  • Muscle pain or stiffness

The less common side effects are;

  • Redness in the joints
  • Bleeding
  • Blistering
  • Feeling of Pressure
  • Hives
  • Coldness
  • Burning
  • Infection
  • Ulceration
  • Tingling
  • Increased inflammation

Some of the side effects that could occur may not need medical attention since they may go away in the course of the treatment as the body adjusts to the medication. Also, your doctor will be able to inform you ways on how to reduce or prevent some of these side effects. If any of the mentioned side effects continue or are bothersome, check with your health care professional for directions. Also, ask your doctor any questions that you may have concerning the side effects.

These may not be a complete list of the side effects of Hyaluronic acid injection that may occur in patients. If you notice any different unwanted effects, seek medical advice from your healthcare professional. You may also report to the FDA at 1-800-FDA-1088.

Dosage

Hyaluronic acid is available in the following dosage forms:

  • Gel/Jelly
  • Solution

2 ML of Hyaluronic acid is injected into the knee once a week for about three to four weeks. During the procedure, if the joint effusion is present, it must be removed before performing the injection. A new syringe should, therefore, be used for the injection.

Some patients may not be helped by viscosupplementation, but those who report relief, say that it takes several weeks to notice an improvement after the procedure. Though the injections are effective, it has been noted that the lasting effect of the medication varies from one patient to the other. Most of them have reported pain-relieving results for several months. Some may have to repeat the injection after six months.

It is essential to take your medication seriously by attending to all the appointments with your doctor. Be quick to call your doctor If you miss an appointment to receive your injection or dose.

Interactions

Certain medicines should not be used together. But in some cases, the use of two different drugs can be encouraged even if an interaction may occur. In such cases, the doctor might want to change your dose or rather some precautions may be necessary. Inform your healthcare professional about any other prescriptions or non-prescriptions medicine that you are taking.

Some medicines should not be used around or at the time of eating since it could cause an interaction. Eating certain types of food or the use of tobacco products and alcohol with other medicines is not advise since an interaction may occur. Therefore, consider discussing with your doctor the use of medication with either food, tobacco or alcohol.

Certain medical conditions or problems can affect the use of hyaluronic acid, and therefore such patients should not receive the medication. Open up to your healthcare professional about any medical issues such as;

  • Allergy to bacterial proteins
  • Hypersensitivity to hyaluronate preparations
  • Gram-positive
  • Skin or knee joint infections or
  • Other problems at the joint where the injection is to be administered.

Hyaluronic acid can also increase the risk of bleeding when it's taken with the drugs that increase the risk of bleeding. Drugs which increase the risk of bleeding must be discontinued a week before a hyaluronic acid injection is given. The examples of these medicines include;

  • Aspirin
  • Anticoagulants like warfarin or heparin
  • Antiplatelets like clopidogrel
  • Nonsteroidal anti-inflammatory drugs like ibuprofen
  • Naproxen

Hyaluronic acid may also interact with dietary supplements and herbs. Herbs and supplements that can increase the risk of bleeding when taken with hyaluronic acid should be discontinued one week before the medication. Patients have reported cases of bleeding with the use of garlic, Ginkgo biloba, and saw palmetto. Herbs such as St.John's Wort or Pycnogenol® can also increase the risk of bleeding.

Hyaluronic acid may interact with disinfectants containing quaternary ammonium salts. Use these disinfectants with caution when using hyaluronic acid since it may interfere with the medicine.

Warning:

Joint effusion is a situation where there is too much fluid in the knees. Patients suffering from this condition should be treated first before they receive this medicine.

Avoid using this medication if you are pregnant or breastfeeding. Although it's safe to use to receive the drug as an injection, it may not be safe when either it's applied directly to the skin or taken orally. It may not be scientifically proven but to be on the safe side, avoid using it.

Individuals who are sensitive to hyaluronic acid or have a known allergy should avoid using this medication. If you are allergic to avian (bird) protein such as eggs or feathers should not use these products since commercial hyaluronic acid can contain proteins from birds.

Avoid straining your knee joint within two days of receiving the medication. You should not get involved in activities such as tennis, jogging, soccer, heavy lifting or even standing on your feet for long.

A patient can experience temporary swelling in the knee joint or pain after receiving a hyaluronic acid injection. If the swelling or the pain does not stop after receiving this medicine, contact your doctor.

Injectable preparations should be used cautiously in patients who are prone to easy bleeding or bruising. Just like any other injection, a hyaluronic acid injection can cause bruising, redness, infection or even hematoma formation. The injection into the joints could cause joint symptoms or arthritis.

Hyaluronic acid can increase the risk of bleeding. Patients with bleeding disorders or those using drugs that can increase the risk of bleeding should take caution. Your healthcare provider may want to adjust your dose.

If taken orally, hyaluronic acid can cause a rash around the mouth. When injected into the eye, hyaluronic acid can increase eye pressure. Usually, it stops within 48 to 72 hours.

Avoid using this medication in breast augmentation, or for the implantation of ligament, bone, tendon, or muscle.

Also, avoid injecting into your blood vessels.

Your doctor will have to monitor your progress carefully when you're on this medication. It will allow the doctor to judge if the medicine is working as intended or if you should discontinue the medication.

Storage

According to research, the storage of partially used hyaluronic acid could carry some contamination risk. Therefore safe storage is paramount, and it's the responsibility of your doctor to store the medication under specified storage in the medical guide.

Summary

Hyaluronic acid posses the benefits of treating osteoarthritis of the knee. It aids in relieving pain and stiffness in the joint. But patients using this medication may also experience side effects. It's, therefore, a decision for you and your doctor to make before considering the use of this injection. To get the best results of the medication as it is intended, you should follow your doctor's instructions on how to prevent or deal with any possible side effects. Interactions may occur between this medicine and other drugs or dietary supplements. Open up about your medications and allergies to your healthcare provider for him/her access and give you the best advice.