Monovisc is a drug in the viscosupplementation agents class. It is used to treat osteoarthritis-induced knee pain if other medications fail.

Monovisc is made of ultra-pure hyaluronic acid. This substance would be found within the synovial fluid inside a healthy knee. It works by injecting the gel-like substance into the knee. The injection lubricates the joints, mimicking the synovial fluid and acting as a shock absorber.

Precautions and Warnings of Monovisc

Monovisc should not be taken if the patient has a bleeding disorder, specific medication allergies, or skin or knee infections. Avoid Monovisc if you are allergic to it or have gram-positive bacteria proteins, hemophilia, or a knee or skin infection.

Talk to a doctor first if you have glaucoma, a skin condition, or skin sensitivity. Additionally, individuals should notify their doctor if they have an uncommon allergic response to sodium hyaluronate and other medications, foods, colorants, or preservatives. Note that other brands of sodium hyaluronate may also include eggs or different allergens.

The impact of Monovisc on unborn babies is unknown. Notify your physician if you are pregnant or intend to become pregnant. It is uncertain if hyaluronan passes into breast milk or poses a risk to nursing babies. Please let your doctor know if you are breastfeeding.

Monovisc is not for individuals under 21 years old.

Monovisc Side Effects

Many side effects can result from taking Monovisc. These symptoms could indicate an allergic reaction if you notice the emergence of hives, experience breathing difficulties, or encounter swelling in your face, lips, tongue, or throat.

Common Side Effects

Common side effects experienced by those taking Monovisc include:

  • Stiffness, swelling, or pain in the joints
  • Itchiness
  • Numbness
  • Tingling sensations
  • Headaches or dizziness
  • Back pain
  • Nausea
  • Rash
  • Muscle cramps
  • Swelling, pain, redness, or mild discomfort at the site of the injection

Serious Side Effects

Call a doctor immediately if you experience more severe side effects such as:

  • Bleeding
  • Increased pain in the knee
  • Hives
  • Swelling in the face
  • Loss of vision, eye discomfort, or perceiving halos around lights
  • Abnormal or rapid heartbeats
  • Breathlessness
  • Unexpected episodes of dizziness, feeling faint, or fainting
  • Intense headaches, confusion, or difficulty speaking
  • Weakness in limbs, difficulty walking, loss of coordination, or feelings of instability
  • High muscle stiffness
  • Tremors
  • High fever
  • Excessive sweating
  • Warmth, swelling, or redness in the knee

Drug Interactions With Monovisc

Only a few moderate drug interactions are known for Monovisc. These include:

Benzalkonium chloride topicalOnly skin disinfectants that contain iodine or alcohol skin preparations are safe and recommended for use.
Cetylpyridinium topicalOnly skin disinfectants that contain iodine or alcohol skin preparations are safe and recommended for use.
mRNA COVID-19 vaccines (all variations)These may contain hyaluronic acid.

Strengths and Dosages of Monovisc

Monovisc comes in 5.0 mL syringes which contain 4.0 mL of the drug. This is not a drug for daily use. Most users are given the drug in one dose, offering them pain relief for several months. Some doctors may prescribe additional Monovisc injections in less frequent cases if the pain persists. These injections are typically administered at least one week following the initial injection.

Monovisc injections are administered by a healthcare professional, not at home. Qualified medical practitioners who may administer the medication include orthopedic specialists, sports medicine specialists, or rheumatologists.

Each injection contains:

  • Hyaluronan (88 mg)
  • Sodium Chloride (36 mg)
  • Potassium Chloride (0.8 mg)
  • Sodium Phosphate, Dibasic (4.6 mg)
  • Potassium Phosphate, Monobasic (0.8 mg)
  • USP water for injection (until 4 mL is reached)

Monovisc Alternatives

Monovisc is most often used to reduce knee pain caused by osteoarthritis. Some medications that may be prescribed as an alternative include Meloxicam and Celebrex.

Meloxicam is a non-steroidal anti-inflammatory drug used for short-term pain relief. It is typically used for those with arthritis but is also used to treat other inflammatory conditions, such as osteoarthritis, fibromyalgia, juvenile rheumatoid, rheumatoid arthritis, pain, and tendonitis.

Celebrex is a COX-2-specific non-steroidal anti-inflammatory drug used for ankylosing spondylitis, osteoarthritis, familial adenomatous polyposis, juvenile rheumatoid arthritis, pain, period pain, rheumatoid arthritis, and spondyloarthritis.

Some other non-steroidal anti-inflammatory drug alternatives that may be used are diclofenac, mobic, celecoxib, naproxen, ibuprofen, and voltaren. Each of these is also used to reduce pain.

Frequently Asked Questions of Monovisc

How do you take Monovisc?

A physician delivers Monovisc through a single intra-articular injection directly into the knee. This procedure is known as viscosupplementation and it aims to alleviate osteoarthritis knee pain by restoring the viscoelastic characteristics of the hyaluronic acid present in the knee.

How long does Monovisc last?

One Monovisc injection can last up to six months.

Is Monovisc a steroid?

Monovisc is not a steroid. It is a type of “viscosupplement.” This is a substance injected into the joint to provide lubrication and cushioning for individuals suffering from osteoarthritis. Monovisc contains ultra-pure hyaluronic acid, a naturally occurring substance in the body that helps lubricate and cushion joints.

Is Monovisc a one-time injection?

Monovisc injections work for up to six months. While they are designed for single doses, a doctor may prescribe more than one Monovisc injection. If this is the case, the additional injections are usually given at least one week after the initial injection. Doses are not taken daily.

How long does it take for the Monovisc injection to work?

The Monovisc injection usually begins providing pain relief between two and four weeks after it is administered. It should continue to work for up to six months after that period of time.

What is the difference between Monovisc and Synvisc?

Both Monovisc and Synvisc contain hyaluronic acid found in synovial fluid so they can mimic its physiology. However, the hyaluronic acid in Monovisc is taken from rooster combs. This is the fleshy crest on top of a rooster’s head. Synvisc contains hyaluronic acid that is manufactured from bacterial fermentation. Synvisc is also made to have a much higher molecular weight that more closely mimics synovial fluid in healthy young adults.

While Monovisc is administered through a single dose, Synvisc can be taken as a single injection or it can be taken weekly for three weeks for the same result. Monovisc primarily targets osteoarthritis in the knee, whereas Synvisc is a versatile option suitable for various synovial joints such as knees, hips, ankles, and shoulders. Dosage varies depending on the treated joint.

What is the cost of Monovisc in America?

The estimated national average for the cost of the Monovisc injection is $3,091. Other insurance, coupon, and savings options may be available to lower the price of the injection.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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