Synvisc, also known as hylan G-F 20, is a sterile, viscoelastic solution injected directly into the knee joint. It is composed of hyaluronan, a natural substance found in the synovial fluid of the joints. Hyaluronan acts as a lubricant and shock absorber, cushioning the joint and reducing friction during movement.

When injected into the knee joint affected by osteoarthritis, Synvisc supplements the depleted hyaluronan levels. This injection helps restore the joint’s natural lubricating properties and improves its overall function. Additionally, Synvisc enhances the cartilage’s ability to absorb shock, reducing pain and inflammation.

Synvisc is beneficial for individuals experiencing knee pain due to osteoarthritis. It is most effective for those who have not responded well to other conservative treatments such as pain medications, physical therapy, or corticosteroid injections. Generally, it is recommended for patients with mild to moderate osteoarthritis.


To start our journey into the world of osteoarthritis, let’s define the condition and its fundamental characteristics. Osteoarthritis is a degenerative joint disorder that primarily affects the cartilage in your joints, causing it to break down gradually. The process results in the bones rubbing against each other, leading to pain, swelling, and decreased mobility.

Recognizing the symptoms of osteoarthritis is crucial for early diagnosis and effective management. Common indicators include joint pain, tenderness, stiffness, a grating sensation during movement, and even the formation of bone spurs. It is essential to differentiate these symptoms from other joint conditions to receive proper medical attention.

While the exact cause of osteoarthritis remains elusive, several risk factors contribute to its development. Understanding these factors will shed light on the prevention and management of the condition.

When dealing with osteoarthritis, multiple treatment approaches can be adopted, depending on the severity of the condition. From lifestyle modifications and physical therapy to medications and surgical interventions, understanding the available treatments will help you make informed decisions for optimal joint health.

Warnings and Precautions

While it provides relief from pain and discomfort, it’s essential to understand its potential side effects, precautions, and contraindications before undergoing treatment.

  1. Medical History Evaluation: Consult with your healthcare provider and disclose your complete medical history, including any allergies, previous medical procedures, or medications you’re taking. Certain conditions may require caution or contraindicate the use of Synvisc.
  2. Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, avoid Synvisc treatment, as its effects on unborn babies and nursing infants are not yet fully understood.
  3. Infections and Skin Diseases: If you have a current infection or skin disease near the injection site, it’s advisable to postpone Synvisc treatment until the condition is resolved to minimize complications.
  4. Bleeding Disorders: Individuals with bleeding disorders or those taking blood-thinning medications should use caution with Synvisc, as it may increase the risk of bleeding.
  5. Joint Infections: If you have a joint infection, avoid Synvisc treatment, as it may exacerbate the condition.
  6. Allergic Reactions: If you’ve had allergic reactions to hyaluronic acid or other viscosupplements in the past, inform your healthcare provider to explore alternative treatment options.
  7. Joint Effusion: Synvisc is not suitable for individuals with joint effusion (excessive joint fluid accumulation).

Side Effects

While Synvisc is generally well-tolerated, it may cause various adverse reactions in some individuals.

Common Side Effects of Synvisc

  1. Pain and Swelling at the Injection Site: One of the most common side effects of Synvisc is mild pain and swelling at the site of injection. This reaction is usually temporary and resolves on its own.
  2. Joint Stiffness: Some individuals may experience temporary joint stiffness following a Synvisc injection. Gentle movement and over-the-counter pain relievers can help alleviate this discomfort.
  3. Skin Irritation: Occasionally, patients may notice mild skin irritation, such as redness or itching, near the injection site. This reaction typically subsides within a few days.
  4. Headache: In some cases, patients may experience mild headaches after receiving a Synvisc injection. Staying hydrated and getting sufficient rest can help manage this side effect.
  5. Nausea: A few individuals might experience mild nausea, which usually passes quickly. Drinking plenty of water and eating a light meal before the injection can help reduce the likelihood of this reaction.
  6. Fatigue: Some patients may report feeling slightly fatigued after receiving Synvisc. Taking it easy for the rest of the day can assist in recovering from this fatigue.

Rare Side Effects of Synvisc

  1. Allergic Reactions: While rare, some individuals may be allergic to the components of Synvisc. Signs of an allergic reaction include hives, difficulty breathing, swelling of the face or throat, and rapid heartbeat. If any of these symptoms occur, seek immediate medical attention.
  2. Joint Infection: There is a minimal risk of developing a joint infection after a Synvisc injection. Watch out for signs of infection, such as increased pain, warmth, redness, or fever, and contact your healthcare provider if you suspect an infection.
  3. Bleeding: In rare cases, some patients may experience bleeding at the injection site. If you notice excessive bleeding or the formation of a bruise, consult your doctor.
  4. Blood Clots: Although extremely uncommon, Synvisc injections have been associated with the formation of blood clots. Inform your healthcare provider immediately if you experience swelling or pain in the legs, which may indicate a blood clot.
  5. Joint Effusion: Some individuals might experience increased joint swelling or effusion following a Synvisc injection. This side effect should be monitored and reported to your doctor if it persists.
  6. Flushing: Rarely, patients may experience facial flushing or warmth after receiving Synvisc. This reaction is usually mild and transient.

Severe Side Effects of Synvisc

  1. Anaphylaxis: Although exceptionally rare, anaphylactic reactions to Synvisc can occur. Anaphylaxis is a severe allergic response that requires immediate emergency medical attention. Symptoms include difficulty breathing, rapid drop in blood pressure, and loss of consciousness.
  2. Vision Changes: Severe side effects might include visual disturbances or changes in vision. If you experience any issues with your eyesight after receiving Synvisc, contact your eye doctor promptly.
  3. Nerve Damage: In very rare cases, patients may experience nerve damage near the injection site, leading to symptoms such as weakness, numbness, or tingling. If you notice any neurological changes, inform your doctor immediately.
  4. Severe Joint Pain: While uncommon, some patients may experience a sudden increase in joint pain following a Synvisc injection. If the pain is persistent and severe, seek medical attention.
  5. Breathing Difficulties: Severe respiratory problems, such as shortness of breath or wheezing, may rarely occur after receiving Synvisc. If you encounter any breathing difficulties, seek immediate medical help.
  6. Dizziness or Fainting: Severe dizziness or fainting spells are uncommon but should be reported to your doctor if they occur.


Living with osteoarthritis can be challenging, but with medical advancements like Synvisc, patients find relief and improved joint mobility. However, understanding the interactions between Synvisc and other substances is crucial for safe and effective treatment.

Drug Interactions

  1. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Combining Synvisc with NSAIDs may increase the risk of bleeding or bruising. It’s crucial to inform your healthcare provider about any NSAIDs you are taking.
  2. Anticoagulants: If you are on blood-thinning medications like warfarin or heparin, using Synvisc could potentially lead to increased bleeding. Your doctor should closely monitor you if these medications are used together.
  3. Corticosteroids: Concurrent use of Synvisc and corticosteroids might diminish the effectiveness of the treatment. Your healthcare provider may adjust the dosages accordingly.
  4. Immunomodulators: Interactions between Synvisc and immunomodulatory drugs may affect the immune response and interfere with the treatment’s efficacy.
  5. Antibiotics: Some antibiotics may interact with Synvisc, influencing the way the drug works. Make sure to disclose all medications, including antibiotics, to your healthcare provider.

Herbal Interactions

  1. Garlic Supplements: Garlic may have antiplatelet effects, which can increase bleeding risk when combined with Synvisc. Inform your doctor if you are taking garlic supplements.
  2. Ginger and Ginkgo Biloba: These herbs possess anti-inflammatory properties and could potentially interfere with the action of Synvisc. Consult your healthcare provider before using them alongside Synvisc.
  3. Echinacea: Echinacea may have immunostimulatory effects, which can interact with Synvisc’s therapeutic action.

Food Interactions

  1. Alcohol: Drinking alcohol during Synvisc treatment may increase the risk of stomach bleeding. It’s best to avoid alcohol consumption while on this medication.
  2. Grapefruit: Grapefruit and its juice may influence the metabolism of Synvisc in the body, affecting its potency.
  3. High-Fat Foods: Consuming high-fat meals before or after Synvisc injection could potentially interfere with its absorption.

How to Use

Administrating Synvisc properly is crucial for an optimal, safe, and effective treatment.

  1. Sanitization and Cleanliness: Ensure the injection area is clean and sanitized. Both you and the healthcare provider must follow proper hygiene practices.
  2. Positioning: Find a comfortable position for the injection. Usually, patients sit or lie down with their knee exposed and relaxed.
  3. Numbing the Area: To minimize discomfort during the injection, the healthcare provider may apply a local anesthetic to numb the knee area.
  4. Injecting Synvisc: Once the knee area is numbed, the healthcare provider will carefully inject Synvisc into the affected joint space.
  5. Bandaging: After the injection, the provider will apply a bandage to the injection site. You may be asked to rest for a short while.
  6. Post-Injection Care: Your doctor will give you specific instructions on post-injection care. Follow them diligently to optimize the treatment’s effectiveness.


Understanding the dosing guidelines for Synvisc is essential for both medical professionals and patients.

Initial Dosing Guidelines

The initial dose of Synvisc is typically administered as a series of injections. The usual course consists of three injections, spaced one week apart. The injections are directly administered into the affected joint. The initial dosage aims to alleviate pain and improve joint function, providing relief for the patient.

Maintenance Injections

After the initial dosing, some patients may require maintenance injections to sustain the benefits of Synvisc. The frequency of maintenance injections may vary from patient to patient and depends on the individual’s response to the treatment. Generally, maintenance injections are given every six months, but your healthcare provider will determine the appropriate interval based on your specific condition.

Missed Dose

If you miss a scheduled Synvisc injection, it is essential to contact your healthcare provider promptly. Missing a dose can impact the overall effectiveness of the treatment. Your doctor will advise you on the best course of action and whether it’s necessary to reschedule the missed injection.


While Synvisc is generally safe when administered correctly, an overdose can lead to adverse effects. It is crucial to recognize the signs and symptoms of an overdose, which may include severe joint pain, swelling, redness, or other unusual reactions. If you suspect an overdose, seek immediate medical attention.

To avoid an overdose, always follow your healthcare provider’s dosing instructions diligently. Never try to administer more Synvisc injections than prescribed, thinking it will provide faster relief. Overdosing can lead to complications and negate the benefits of the treatment.


Proper storage of Synvisc is essential to ensure its effectiveness and safety in treating joint pain. Remember to keep in mind that Synvisc typically has a shelf life of up to two years when stored properly. However, it is crucial to check the specific expiration date on the product packaging and never use it beyond that date.

  • Keep in the Original Packaging: Always store Synvisc in its original packaging to protect it from external contaminants and environmental factors.
  • Store in a Refrigerator: Synvisc must be refrigerated at a temperature between 2°C and 8°C (36°F and 46°F). A dedicated medical refrigerator is ideal to prevent temperature fluctuations.
  • Avoid Freezing: Do not freeze Synvisc, as freezing can alter its composition and render it ineffective.
  • Protect from Light: Keep Synvisc away from direct light exposure, as UV rays can degrade the product.
  • Check Expiry Date: Before use, verify the expiration date on the packaging. Expired Synvisc should never be used.
  • Follow Manufacturer’s Instructions: Adhere to the manufacturer’s storage instructions to maintain the product’s quality.


As with any medical product, it is essential to dispose of Synvisc properly to prevent potential harm to both humans and the environment.

  • Remove the medication from its packaging, but keep it in the original vial.
  • Mix the medication with an undesirable substance like used coffee grounds or kitty litter.
  • Seal the mixture in a sturdy container, ensuring it is leak-proof.
  • Dispose of the container with your regular household waste.

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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