1 What is Orthovisc?

Brand: Orthovisc, Synvisc

Generic: Hyaluronan

Orthovisc is a pain reliever or analgesic drug, used to treat pain in the knees related to osteoarthritis or joint swelling. Orthovisc is a prescription medicine and it is available in the form of an injection. This medication is similar in constitution to the synovial fluid, a substance that lubricates the knee joint. This allows the knee to move with ease and smoothly, which eventually decreases joint pain.

Orthovisc is known to be mostly given post trying out the other arthritis medications and if they have failed to show any success. Hyaluronan, also known as hyaluronate, is a natural chemical in the body, whose concentration is more in the joint tissues and in the fluid that fills the joints. It acts as a lubricant as well as a shock absorber in the joint regions, thereby helping the knees to move smoothly and also reducing the pain.

Orthovisc is known to be a viscous thick sterile mixture which is mostly made up of highly purified hyaluronan which are from the rooster combs. In people suffering from osteoarthritis, the joints do not have the required amount of the natural hyaluronan and even if it is present, then the quality of the same would be quite poor than the normal one.

2 Instructions

Read your medication guide and follow your doctor’s prescription at all times.

  • Inject Orthovisc into the affected joint, once a week as per doctor’s prescription. This must be given only by health care professionals in a clinic or hospital setting.
  • Avoid using skin disinfectants which contain ammonium salt, for example benzalkonium chloride, for preparation at the injection site. The doctor would need to remove any kind of extra fluid from the joints before he/she begins to inject the medicine.
  • Hyaluronan should be not injected into the arteries or the veins since it can lead to an increase in the side effects.
  • The dosage depends on your medical condition or treatment response.
  • Do not reuse or recycle disposable needles, IV tubing and other medical supplies used in administering this medication.
  • Discard needles safely in a puncture-proof container.
  • Avoid engaging in activities that may cause strain to the knees for 48 hours (i.e. weight lifting, jogging, and prolonged standing).
  • Continue using Orthovisc on a regular schedule. Do not stop using this medication abruptly without consulting your doctor.
  • The individual may need up to three injections to get the full benefit of the medication. Hence, it becomes important to get the medication on schedule without any miss or delay.

Inform your doctor immediately if your condition aggravates or does not improve.

Have your health care provider inject your missed dose as soon as possible. Otherwise, contact your doctor immediately.

3 Usage

As mentioned earlier, Orthovisc is available in the form of an injection and it is mostly injected in the knees by a known doctor. For 48 hours after the patient receives the injection, there are certain things which should be avoided:

  • Carrying out any kind of strenuous activities and also any high impact activities, for example running or tennis.
  • Avoid doing heavy lifting.
  • Do not stand on your feet for longer duration which should be not more than an hour.

The knee region where one has received the injection should be iced by wrapping an ice pack in a towel in case you have any kind of mild pain or mild form of swelling near the injection region. Ensure to follow the schedule about all the follow-up appointments so as to receive all the injections in a timely manner and in a proper series.

Post the first or the second injection, you may experience some relief from the pain, but ensure to get all the remaining three to four injections on time for gaining the maximum benefit and at the same time, continue to apply the ice pack to the affected injection site on the knee.

4 Interactions and Side Effects

Some drugs may either lessen the beneficial effects or worsen the side effects of Orthovisc. Likewise, Orthovisc may make some drugs less efficient or intensify their side effects.

Make sure to inform your doctor about all other drugs you are currently taking or using (prescribed and non-prescribed medications including vitamins, minerals, and herbal products) to check for possible drug interaction with Orthovisc.

Never alter the doses of other medications while on Orthovisc, neither stop nor start any medicine without the doctor’s recommendation.

There are no drug interactions which have been evaluated yet, however it is important to inform the doctor about all types of medications whether prescribed or over-the-counter, vitamins, herbal and dietary supplements. Not all kind of drug interactions are mostly known or reported and many new kinds of drug interactions are always reported on a continuous basis. Hence before starting any new medicine during the course of the treatment, it is advisable to let the doctor know of the same. Also, do not suddenly start or stop any of the medicines without consulting the doctor. Medicines are also known to cause interactions with certain food items. In certain cases, it can turn out to be harmful and hence the doctor can advise you on the food items that should be avoided. As of now, there are no specific types of foods which need to be excluded from the diet during the course of the Orthovisc medication.

Side Effects

There are no side effects known aside from a possible allergic reaction in people who have previous or unknown hypersensitivity to the drug.

Watch out for signs of allergic reactions such as:

  • Rash
  • Itching
  • Swelling

Inform the doctor immediately if you face any of the medicine’s side effects such as increase in the knee pain, bleeding issues, certain signs of infections such as swelling, redness and warmth felt around the knee region.
Some common side effects of orthovisc are pain in the joints, headache, itching, tingling sensation, swelling in the joints, pain in the back, stiffness, feeling of numbness, dizziness. Also, there can be few common side effects at the site of the injection and those are swelling, mild form of discomfort and redness where the injection was given.

5 Warnings

Before taking Orthovisc, tell your health care provider if you have/are:

  • Any allergies to any substance, food (i.e. egg products) or medication, particularly to hyaluronan (Orthovisc).
  • Medical history or a present condition such as:
    • Knee joint infection
    • Skin infection
    • Problem around the injection site
    • Poor circulation in the legs
    • Bleeding disorder or blood clotting
  • Pregnant, planning to get pregnant or currently breastfeeding a baby (It is not known if Orthovisc can harm the unborn child or if it can pass through breast milk that may harm the nursing child. The risks and benefits of using this medication during pregnancy must be discussed well with your doctor.)
  • An individual who is suffering from bleeding related issues or any kind of allergies towards the drugs or its ingredients should not take this medicine.
  • Any individual who is suffering from infection present in the knee or in the skin which is around the knee.
  • Avoid the intake of the medicine if the individual has an allergy to the gram positive bacteria proteins. You can always check with the doctor if you are unsure about this kind of allergy.
  • This medicine is not approved for anyone who is younger than 21 years of age.

6 Dosage

The doctor would be the best person to decide on how many of the courses or injections would be required. This would be based upon various factors such as age of the individual, medical condition, its severity, the improvement of symptoms, how the body responds to the medicine. In most of the cases, one course of Orthovisc is said to provide relief from pain for almost five to six months.

The usual form of adult dose for osteoarthritis can be 2 ml intraarticularly to be injected into the knee once a week for a period of three to four weeks. If there is presence of joint effusion, then it should be removed prior to the injection. Ensure to use a new syringe for the injection, since orthovisc is mostly provided as one single dose and it also does not have any daily dosing schedule. If you would need more than one injection, then it is better to inform the doctor for instructions on the same. Also since this medication is mostly provided by the doctor, hence it is very unlikely that an overdose can occur.

There are certain things one should avoid for 48 hours after taking the injection. Those activities would include any kind of strenuous activity, excessive jogging, and any kind of high impact sports, for example tennis. Also, one should avoid weight bearing activities or standing for long durations, which is more than an hour at a time.

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