Hylan Polymers A and B (Injection)

Overview

When patients develop osteoarthritis, they can experience increasing levels of pain, joint stiffness and loss of movement in the affected area. Although osteoarthritis can occur in any joint, it commonly affects the knee and can lead to immobility and problems walking.

In healthy patients, synovial fluid acts as a cushion around the joint and enables individuals to flex or bend their knee without any pain or discomfort. When osteoarthritis occurs, the synovial fluid degrades or breaks down and fails to cushion the knee joint effectively. As a result, the bones in the knee can rub against one another, causing pain and discomfort.

If untreated, osteoarthritis can also cause the bones in the joint to deform. As the bones are able to rub against each other without the presence of synovial fluid, they can develop bone spurs or areas of thickened growth. Whilst this can be painful in itself, inflammation may occur if the bone spurs become loose and move around of their own accord.

Although osteoarthritis can be caused by damage to a joint or excess weight, it can also occur as a patient ages. Due to this, a significant number of people are affected by the condition and the vast majority of them require treatment to ease their pain.

If pain medication and other alternatives have failed to provide satisfactory results, patients may be treated with Hylan polymers A and B. Administered via injection, Hylan polymers A and B act as a substitute for synovial fluid and mimics its effects. By using Hylan polymers A and B to replicate the effects of natural synovial fluid, the patient's symptoms can be greatly reduced.

Whilst Hylan polymers A and B injections are not a first-choice treatment for osteoarthritis of the knee joint, they can be effective in treating the patient's symptoms. If the patient has not obtained relief from drug therapy or conservative treatment, Hylan polymers A and B injections may be used to decrease muscle stiffness, provide pain relief and to enable the patient to regain their mobility.

Conditions Treated

  • Osteoarthritis of the knee joint

Type Of Medicine

  • Hyaluronan polymer

Side Effects

When using medication or undergoing treatment, it's not uncommon for patients to experience some side effects. Before receiving Hylan polymers A and B injections, patients should be told about the most common side effects associated with the medicine and given advice regarding the reduction of side effects.

In most cases, patients are more likely to experience side effects when they are first treated with Hylan polymers A and B but these should decrease over time. If the following side effects are fairly mild and short-lived, for example, patients may not need medical intervention:

  • Itching of the skin
  • Nausea
  • Rash on the skin
  • Sprain in the lower back
  • Dizziness
  • Pain at the injection site
  • Headache
  • Red, raised swellings on the tongue, lips, skin or in the throat

Although the above side effects do not necessarily require medical treatment, patients should always seek medical advice if they are concerned about the presence of any side effects. Furthermore, patients will need to seek immediate medical advice if they experience any of the following side effects after being given Hylan polymers A and B injections:

  • Difficulty with moving
  • Red, pinpoint spots on the skin
  • Fluid build-up around the knee
  • Muscle cramps
  • Feeling or warmth
  • Muscle stiffness and/or pain
  • General feeling of illness or discomfort
  • Stiffness and pain in the joints
  • Difficulty with breathing
  • Bleeding after defecation
  • Itching, crawling, burning, prickling, numbness, tingling or'œpins and needles' feelings
  • Bluish color
  • Blood in the stools or urine
  • Changes in skin color
  • Swelling or bloating of the arms, lower legs, hands, feet or face
  • Fainting
  • Bleeding gums
  • Irregular, pounding or fast pulse or heartbeat
  • Chills
  • Aching or pain in the lower legs
  • Tarry, black stools
  • Swelling of the feet, legs or ankles
  • Rapid weight gain
  • Uncomfortable swelling around the anus
  • Tenderness
  • Swelling or warmth in the joints
  • Trouble with walking
  • Redness in the joints
  • Unusual bruising or bleeding
  • Redness of the arms, neck face and occasionally, upper chest
  • Unusual weakness or tiredness
  • Shortness of breath
  • Unusual weight gain or loss
  • Tingling of the feet or hands

Patients should also seek medical assistance if they experience any side effects which are not listed above after being treated with Hylan polymers A and B injections.

In addition to this, patients can report the presence of any additional symptoms to the Food and Drug Administration on 1-800-FDA-1088.

Dosage

As Hylan polymers A and B are administered via injection, patients will be given their medication by a trained healthcare professional, usually in a clinical setting. In most cases, patients will be given three injections of Hylan polymers A and B, with each injection being one week apart. A typical dose of Hylan polymers A and B of is 2mL per injection. In rare, cases, however, patients may be given one injection with 6mL of Hylan polymers A and B.

Whilst most patients are treated with a course of three injections, this regime can be implemented twice in a six month period, if it is necessary. If a second course of injections is prescribed, however, at least four weeks should be left between the first and second set of treatments.

Although this is a standard dosing regime for treatment with Hylan polymers A and B injections, every patient will be assessed individually. It is possible, therefore, that their treatment will differ, depending on their condition and their response to the medicine.

As Hylan polymers A and B are given as a single injection, it may take more than one treatment before the patient begins to feel the effects of the medication. If symptoms persist after three injections have been administered, patients should contact their physician for advice.

Potential Drug Interactions

When more than one medication is taken or used, it is possible that an interaction may occur. In some cases, an interaction between medicines can be dangerous or harmful to the patient. Due to this, patients should tell their doctor if they are using any other medicine before they are treated with Hylan polymers A and B injections. This includes prescription medicines and over-the-counter medications, as well as vitamins and/or supplements.

In addition to this, patients should obtain medical advice before using any new medicines, vitamins or supplements once they have started receiving Hylan polymers A and B injections.

In order to prevent potential interactions occurring, Hylan polymers A and B injections may not be prescribed if patients are already taking one of the following medicines:

  • Benzalkonium chloride
  • Lidocaine (topical)
  • Pramoxine
  • Benzocaine
  • Cetylpyridinium
  • Zinc chloride
  • Menthol (topical)

Warnings

If patients have other, existing health conditions, it may affect their treatment with Hylan polymers A and B injections. Similarly, the patient's medical history may have a bearing on their current treatment. Patients should, therefore, disclose their full medical history to their physician before beginning a cycle of Hylan polymers A and B injections. The following conditions may be particularly relevant to treatment with this medicine:

  • Too much fluid in the knees (Joint effusion)
  • Allergy to bird products, such as eggs, feathers and/or poultry
  • Allergy to products containing hyaluronan and/or sodium hyaluronate
  • Venous or lymphatic stasis (Blood clots or severe swelling)
  • Knee joint, skin infections or other problems at the site of the intended injection

As osteoarthritis generally affects older people, studies of Hylan polymers A and B injections on patients under the age of 21 years have not been performed. Due to this, the safety of this treatment for patients under this age has not been verified. As a result, patients under the age of 21 years are not usually prescribed Hylan polymers A and B injections.

Both during and after treatment, patients will need to have regular consultations with their physician. This will enable their doctor to assess their condition and determine whether the Hylan polymers A and B injections are having a positive effect on their symptoms. In addition to this, the patient's physician can rule out the possibility of the treatment having a harmful effect on the patient.

After a Hylan polymers A and B injection has been administered, patients may experience temporary swelling or pain in the knee joint. If the swelling or pain persists or is made worse by the injection, patients should contact their physician for medical advice.

After receiving a Hylan polymers A and B injection, it is important that patients do not over-exercise or strain their knee, even if they are noticing a reduction in their symptoms. Patients should, therefore, avoid standing for long periods of time, heavy lifting and playing sports.

Hylan polymers A and B injections should not be used alongside disinfectants containing quaternary ammonium salts as these substances can prevent Hylan polymers A and B from working effectively.

Currently, it is not known whether Hylan polymers A and B injections could cause harm to an unborn baby if the treatment is administered to the expectant mother. As a result, the Food and Drug Administration has not assigned this medicine a pregnancy category. Due to this, it is not known whether Hylan polymers A and B injections are safe for use in pregnant patients. Unless the benefits greatly outweigh the possible risks, pregnant patients should not be treated with Hylan polymers A and B injections until further studies have been conducted.

If patients become pregnant whilst undergoing treatment with Hylan polymers A and B injections, they should inform their physician immediately.

As some medicines can be passed to an infant via breastfeeding, it is not recommended that patients breastfeed whilst being treated with Hylan polymers A and B injections. It is not known whether this medicine could be transferred to an infant via breastfeeding and, if so, what type of risk it could present to the child. Patients should, therefore, obtain medical advice before breastfeeding whilst receiving treatment with Hylan polymers A and B injections or before resuming breastfeeding after they have been treated with Hylan polymers A and B injections.

Before beginning treatment, patients should tell their doctor if they have any known allergies or have ever experienced an allergic reaction. This includes allergies to medicines, animals, foods, preservatives and/or dyes.

In rare cases, patients may exhibit an allergic reaction after being treated with Hylan polymers A and B injections. If so, patients will require emergency medical treatment. An allergic reaction may include the following symptoms:

  • Difficulty swallowing
  • Rash on the skin
  • Itching
  • Hoarseness
  • Hives
  • Wheezing
  • Difficulty breathing
  • Swelling of the throat, lips, mouth, tongue, face and/or hands

Storage

Normally supplied in a glass syringe, Hylan polymers A and B should be kept in a controlled environment until they are ready for use. As each syringe is intended for a single use, it should be disposed of once the solution has been administered.

When storing Hylan polymers A and B, the manufacturer's guidelines should be followed. However, Hylan polymers A and B glass syringes can normally be kept between temperatures of 2?-30?C. The product should not be frozen and should be kept out direct light and away from heat and moisture.

As this medicine is administered by a qualified healthcare professional, patients should not have to store Hylan polymers A and B. Instead, the medication should be kept in a safe environment and administered in a clinical setting.

Summary

When patients are diagnosed with osteoarthritis, they are generally treated with pain medication and anti-inflammatories. Although these are effective for many patients, a significant number of individuals do not obtain adequate relief from this type of treatment.

If attempts to treat the patient's condition with oral medication have failed, Hylan polymers A and B injections may be prescribed. By mimicking the effects of synovial fluid, Hylan polymers A and B can replace the lost cartilage in the knee and, therefore, reduce the patient's symptoms.

Once Hylan polymers A and B have been injected into the knee joint, the bones of the knee should no longer run against one another. As well as reducing the patient's pain and discomfort, this should help to minimize stiffness of the knee joint. In many cases, patients are able to increase their mobility after being treated with Hylan polymers A and B injections.

Although the effects of Hylan polymers A and B injections vary, some patients have reported beneficial effects for a period of up to 50 weeks. Whilst the average period of symptom relief from Hylan polymers A and B injections is 26 weeks, this still ensures an adequate period of symptom relief and highlights the effectiveness of the treatment.

Despite being beneficial to patients with osteoarthritis of the knee joint, Hylan polymers A and B injections are not currently used on any other joints. Injections will not, therefore, have a systemic effect and will only provide relief from pain and discomfort affecting the knee joint.

If patients are only experiencing symptoms of osteoarthritis in the knee joint or if the pain in other joints is well-managed by oral pain relief, Hylan polymers A and B injections can be used to successfully reduce the patient's symptoms and to enable them to increase the flexibility of the knee joint.