Hyalgan (Sodium Hyaluronate)

Hyalgan is indicated for symptomatic treatment of osteoarthritis in joints where intra‑articular injection is appropriate.

• Knee osteoarthritis when conservative therapy has not provided adequate relief.
• Hip osteoarthritis in patients who are candidates for intra‑articular injection.
• Osteoarthritis of other joints (e.g., ankle, shoulder) where injection is feasible.
• As an adjunct to physical therapy or rehabilitation programs to enhance joint function.
• For patients who cannot tolerate long‑term NSAIDs or systemic analgesics.

• Sodium hyaluronate injected into the joint space integrates with the existing synovial fluid, restoring its viscoelastic properties. The increased molecular weight and concentration improve lubrication, reduce friction, and may modulate inflammatory pathways by inhibiting cytokine activity and decreasing cartilage degradation, thereby supporting joint mechanics and potentially alleviating pain.

Adverse reactions to Hyalgan are generally related to the injection procedure and the product itself.

Common

• Mild pain or tenderness at the injection site.
• Local swelling or effusion within the joint.
• Warmth or transient redness around the injection area.
• Temporary stiffness or limited range of motion.
• Mild bruising or hematoma at the puncture site.

Serious

• Joint infection (septic arthritis) requiring medical intervention.
• Severe allergic reaction, including anaphylaxis.
• Acute inflammatory synovitis with intense pain and swelling.
• Hemarthrosis (bleeding into the joint space).
• Systemic hypersensitivity manifesting as rash, fever, or urticaria.

Before using Hyalgan, consider the following safety points.

• Do not inject into a joint with active infection, septic arthritis, or skin lesions overlying the injection site.
• Contraindicated in patients with known hypersensitivity to sodium hyaluronate or any formulation components.
• Use caution in individuals with bleeding disorders or those receiving anticoagulant therapy due to increased bleeding risk.
• The safety of Hyalgan during pregnancy and lactation has not been established; avoid use unless clearly needed.
• Monitor for signs of infection or severe inflammation after each injection.
• Evaluate renal function in patients with severe kidney disease, as hyaluronate is cleared renally.

Hyalgan may interact with other medications or treatments administered around the same time.

Avoid

• Concurrent intra‑articular corticosteroid injections within the same joint, which may increase infection risk.
• Use of systemic anticoagulants (e.g., warfarin, direct oral anticoagulants) without appropriate monitoring.
• Administration of hyaluronidase enzymes, which can degrade the hyaluronic acid matrix.

Use with caution

• Systemic steroids or disease‑modifying antirheumatic drugs (DMARDs) that may alter immune response.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) that could mask early signs of joint infection.
• Repeated intra‑articular injections of different viscosupplements, which may increase cumulative joint irritation.