Monovisc is a sterile and highly viscous gel-like substance known as hyaluronan. It is specifically designed to be injected into the knee joint to alleviate pain and improve mobility in individuals with osteoarthritis. Hyaluronan is a naturally occurring molecule found in the synovial fluid that surrounds the joints. It acts as a lubricant and shock absorber, allowing smooth movement of the joints.

Monovisc works by supplementing the natural hyaluronan in the knee joint, providing additional lubrication and cushioning. Osteoarthritis causes the synovial fluid to become thin and less effective in protecting the joint. The injection of Monovisc replenishes the hyaluronan levels, reducing friction between the bones and easing the pain associated with osteoarthritis.

Monovisc is typically prescribed to individuals who have been diagnosed with osteoarthritis in their knee joints. Osteoarthritis is a degenerative joint disease that commonly affects older adults. However, it can also occur in younger individuals due to factors such as joint injury, obesity, or genetic predisposition.

Patients with mild to moderate osteoarthritis who have not experienced sufficient relief from other conservative treatments, such as physical therapy or nonsteroidal anti-inflammatory drugs (NSAIDs), may be considered for Monovisc treatment. It is important to note that Monovisc is not suitable for individuals with severe osteoarthritis or those with infections in the knee joint.

Osteoarthritis

Osteoarthritis is a chronic condition that primarily affects the joints, causing pain, stiffness, and reduced mobility. It is the most common form of arthritis, typically occurring in older adults but can also affect younger individuals. The condition is characterized by the breakdown of cartilage, which cushions the ends of bones and allows smooth joint movement. As cartilage wears away, bones may rub against each other, leading to pain, inflammation, and joint damage.

Warnings and Precautions

Before considering Monovisc treatment, it is crucial to understand the potential risks involved and the precautions that should be discussed with your healthcare provider. While Monovisc is generally safe, there are certain factors that may increase the risk of complications. These include:

  • Allergies: If you are allergic to hyaluronic acid or any other ingredients in Monovisc, it is important to inform your healthcare provider. Allergic reactions can range from mild skin irritation to more severe symptoms such as difficulty breathing.
  • Infections: To minimize the risk of infection, it is essential to maintain proper hygiene during and after the treatment. Follow your healthcare provider’s instructions regarding wound care and any necessary precautions to prevent infections.
  • Medical History: Provide your healthcare provider with a complete medical history, including any previous knee surgeries, infections, or allergic reactions. This information will help them determine if Monovisc is suitable for you.
  • Medications: Inform your healthcare provider about any medications you are currently taking, including over-the-counter drugs and supplements. Some medications may interfere with the effectiveness of Monovisc or increase the risk of complications.

Side Effects

While Monovisc offers significant benefits in managing joint pain and improving mobility, it is essential to understand the potential side effects associated with this treatment.

Common Side Effects

When it comes to Monovisc treatment, some common side effects may occur. These side effects are usually mild and temporary, resolving on their own without any intervention. It is crucial to note that not everyone experiences these side effects, and their occurrence may vary from person to person.

  1. Localized Pain and Discomfort: It is common to experience mild pain and discomfort at the injection site after receiving Monovisc treatment. This can be managed with over-the-counter pain relievers and typically subsides within a few days.
  2. Swelling and Redness: Some individuals may notice localized swelling and redness around the injection site. This is a normal reaction to the treatment and generally resolves within a week.
  3. Joint Stiffness: Temporary joint stiffness may occur after Monovisc injection, especially during the initial phase of treatment. This stiffness usually improves over time as the joint adapts to the medication.
  4. Mild Headache: In rare cases, individuals may experience a mild headache following Monovisc treatment. This is typically short-lived and can be relieved with simple painkillers.

Rare Side Effects

While rare, certain side effects associated with Monovisc treatment may occur. These side effects require prompt medical attention if they develop, as they may indicate an adverse reaction to the medication. It is essential to contact your healthcare provider if you experience any of the following:

  1. Allergic Reactions: Although rare, some individuals may develop an allergic reaction to Monovisc. Symptoms may include hives, difficulty breathing, swelling of the face or throat, and dizziness. If you experience any of these symptoms, seek immediate medical attention.
  2. Infection: While infection is rare, there is a slight risk associated with any injection. If you notice increased pain, warmth, redness, swelling, or drainage at the injection site, contact your healthcare provider.
  3. Joint Effusion: In rare cases, excessive fluid accumulation in the joint, known as joint effusion, may occur after Monovisc treatment. This can cause increased swelling, pain, and limited mobility. If you experience these symptoms, consult your doctor for further evaluation.
  4. Bleeding: Though extremely rare, bleeding may occur at the injection site. If you notice persistent bleeding or bruising, it is essential to seek medical attention.

Severe Side Effects

While severe side effects are exceedingly rare, it is important to be aware of their possibility. If you experience any of the following severe side effects, contact your healthcare provider immediately:

  1. Severe Allergic Reaction: In extremely rare cases, individuals may develop a severe allergic reaction called anaphylaxis. Symptoms may include difficulty breathing, chest tightness, rapid heartbeat, dizziness, and fainting. Anaphylaxis is a medical emergency and requires immediate medical attention.
  2. Nerve Injury: Although highly uncommon, nerve injury may occur following Monovisc treatment. Symptoms may include numbness, tingling, weakness, or loss of sensation in the affected limb. If you experience any of these symptoms, seek medical attention promptly.
  3. Joint Infection: While the risk is minimal, there is a remote possibility of developing a joint infection after Monovisc treatment. Symptoms may include severe pain, swelling, redness, warmth, and fever. If you suspect a joint infection, contact your healthcare provider immediately.
  4. Blood Clots: Rarely, blood clots may form in the treated joint after Monovisc injection. Symptoms may include severe pain, swelling, tenderness, and discoloration of the affected limb. If you experience these symptoms, seek medical attention immediately.

Drug Interactions 

Monovisc is typically administered via injection into the knee joint, directly targeting the affected area. As such, the chances of significant systemic drug interactions are relatively low. However, it’s essential to consider potential interactions with other medications that an individual may be taking simultaneously. These interactions can occur at various levels, including pharmacodynamic and pharmacokinetic interactions.

  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs, such as Celebrex and Voltaren, are commonly used to relieve pain and inflammation. These medications can interact with Monovisc, potentially reducing its effectiveness. It is advisable to consult with a healthcare professional regarding the appropriate timing and dosing of NSAIDs when undergoing Monovisc treatment.
  • Corticosteroids: Corticosteroids, including prednisone and cortisone, are potent anti-inflammatory medications. When used concurrently with Monovisc, corticosteroids may diminish the therapeutic effects of Monovisc. A healthcare professional should be consulted to determine the best course of action.
  • Anticoagulants: Anticoagulants, such as Arixtra or Fragmin, are medications used to prevent blood clots. Combining these medications with Monovisc may increase the risk of bleeding at the injection site. It’s crucial to inform the healthcare provider about any anticoagulant therapy before undergoing Monovisc treatment.
  • Antiplatelet Drugs: Antiplatelet drugs, such as Plavix or Brilinta, are commonly used to prevent blood clotting. These medications can also increase the risk of bleeding when combined with Monovisc. A healthcare professional should be consulted to assess the potential risks and benefits.
  • Immunosuppressants: Immunosuppressants, like methotrexate or cyclosporine, are prescribed to individuals with autoimmune diseases or after organ transplantation. The use of Monovisc alongside immunosuppressants may affect the body’s immune response. It is important to discuss this interaction with a healthcare provider.
  • Antibiotics: Certain antibiotics, particularly aminoglycosides, may have potential interactions with Monovisc. These antibiotics are known to have adverse effects on connective tissues, which may interfere with the intended therapeutic effects of Monovisc. It’s crucial to consult with a healthcare professional regarding the use of antibiotics during Monovisc treatment.

Administration

If you require instruction on how to inject yourself with Monovisc, please reach out to your healthcare provider or reach out to our customer care team. We can set you with a consultation with one of our pharmacist.

Preparing for the Injection

Before starting the injection process, it’s crucial to ensure that you have a clean and sterile environment. Follow these steps to prepare for the injection:

  1. Gather all the necessary equipment, including Monovisc syringe, needles, antiseptic solution, gloves, and sterile drapes.
  2. Cleanse your hands thoroughly with soap and water, and then put on a pair of sterile gloves.
  3. Disinfect the injection site using an antiseptic solution and allow it to dry.

Administering the Injection

Once you have completed the preparation stage, you can move on to the injection process. Follow these steps to administer the injection:

  1. Locate the injection site, which is usually the area just above the patella (knee cap).
  2. Using aseptic technique, attach the needle to the syringe containing Monovisc.
  3. Hold the syringe at a 90-degree angle to the skin and insert the needle into the joint space.
  4. Slowly inject the entire contents of the syringe into the joint space.
  5. Once the injection is complete, withdraw the needle gently and dispose of it in a sharps container.
  6. Apply pressure to the injection site using a sterile gauze pad to minimize bleeding.

Post-Injection Care

After the injection, it’s essential to take proper care of the injected area to maximize the effectiveness of Monovisc and minimize the risk of complications. Follow these post-injection care guidelines:

  1. Avoid any strenuous activities or excessive weight-bearing for at least 48 hours following the injection.
  2. Apply ice packs to the injected area for 15-20 minutes several times a day to reduce swelling and discomfort.
  3. Take any prescribed pain medications or anti-inflammatory drugs as directed by your healthcare provider.
  4. Follow up with your healthcare provider as scheduled to evaluate the effectiveness of the injection and discuss any concerns or questions you may have.

Dosing

Your healthcare provider will determine the appropriate dose based on various factors, including the severity of your condition and your medical history. Generally, Monovisc is administered as a single injection into the affected joint.

Here are some key dosing guidelines to keep in mind:

  • Pre-treatment Considerations: Before receiving Monovisc, inform your doctor about any allergies, especially to hyaluronic acid or avian proteins. It is important to disclose all current medications and medical conditions to ensure there are no contraindications.
  • Single Injection Protocol: Monovisc is typically administered as a single injection, directly into the affected joint. This approach simplifies the treatment process and provides long-lasting relief from osteoarthritis symptoms.
  • Post-treatment Care: After receiving the Monovisc injection, it is crucial to follow your healthcare provider’s instructions for post-treatment care. This may include avoiding strenuous activities for a certain period, applying ice packs to the injected joint, and taking any prescribed pain medications.

Overdose

While it is important to follow the recommended dosing guidelines, an overdose of Monovisc is unlikely due to its localized administration. The risk of systemic side effects is minimal since the injection is confined to the knee joint. However, if you experience any unusual or severe symptoms after receiving a Monovisc injection, it is crucial to seek immediate medical attention.

Missed Dose

If you miss a scheduled Monovisc injection, it is important to contact your healthcare provider to reschedule the appointment. To ensure the optimal benefits of Monovisc, it is vital to complete the full course of treatment as recommended by your healthcare provider.

By strictly following the dosing guidelines and receiving appropriate medical supervision, you can effectively manage your joint pain and improve your overall quality of life. Remember to consult with your healthcare provider for personalized advice and treatment recommendations.

Storage

Monovisc is a delicate medical product that requires proper storage to maintain its quality and efficacy. By following these guidelines, you can ensure that your Monovisc remains safe and effective for use.

Storage Temperature

One of the critical factors in storing Monovisc is maintaining the proper storage temperature. Monovisc should be stored at a temperature between 2°C and 25°C (36°F and 77°F). It is important to avoid exposing the product to extreme temperatures, as this can compromise its integrity. Ensure that the storage area remains within the recommended temperature range to preserve the quality of Monovisc.

Protect from Light

Monovisc should be protected from direct light exposure. Exposure to light, especially sunlight or artificial light sources, can degrade the product over time. It is recommended to store Monovisc in its original packaging, which is designed to shield it from light. If you need to transport the product, ensure it is stored in a light-protected container.

Avoid Freezing

Freezing Monovisc can lead to irreversible damage and render it unusable. It is crucial to prevent Monovisc from freezing at all costs. Therefore, you should store Monovisc away from freezing temperatures, such as in a refrigerator, and ensure it is kept at the appropriate storage temperature mentioned earlier.

Keep in Original Packaging

To maintain the integrity of Monovisc, it is best to store it in its original packaging until you are ready to use it. The original packaging provides an additional layer of protection against external factors that may compromise the product. Avoid transferring Monovisc to other containers or packaging unless explicitly instructed to do so by a healthcare professional.

When storing Monovisc, it is important to handle the product with care. Rough handling or excessive shaking can damage the product and affect its quality. Store Monovisc in a secure location where it will not be subject to physical stress or potential accidents. This will help preserve its effectiveness and ensure the safety of its use.

Disposing

If you have recently undergone a Monovisc injection and are wondering how to dispose of the product safely, it is essential to follow proper guidelines to ensure the well-being of both yourself and the environment.

  1. Check with your healthcare provider: The first step is to consult your healthcare provider or the medical facility where the injection was administered. They can provide specific instructions and guidelines on how to dispose of Monovisc safely. Different clinics or healthcare providers may have their own protocols or guidelines for disposal.
  2. Do not attempt to reuse or recycle: Monovisc is a single-use medical product, and it should never be reused or recycled. Once the syringe has been used for the injection, it should be properly disposed of.
  3. Secure the used syringe: After the injection, carefully place the used syringe in a puncture-proof container such as a sharps container. These containers are designed specifically for the safe disposal of medical sharps and can usually be obtained from pharmacies or healthcare facilities. If you don’t have access to a sharps container, you can use a hard plastic or metal container with a tight-fitting lid.
  4. Seal and label the container: Once the syringe is inside the puncture-proof container, ensure that the lid is tightly sealed to prevent any leakage. Additionally, it is crucial to label the container clearly as “Used Medical Sharps” to indicate its contents and minimize the risk of accidental injury.
  5. Contact your local waste management authority: Reach out to your local waste management authority, municipal office, or health department to inquire about the specific regulations for disposing of medical sharps in your area. They can provide you with the necessary information regarding the collection or drop-off points for sharps disposal. Some areas have designated drop-off locations or community programs to ensure the safe disposal of medical waste.
  6. Transport the container to the designated collection point: Follow the guidelines provided by your local waste management authority regarding the transport of the container. This may involve using designated collection boxes or arranging for a special pickup service. Do not dispose of the container in regular household trash or recycling bins, as this can pose risks to sanitation workers and the environment.

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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