Hyaluronic Acid Sodium Salt (Sodium hyaluronate)
Indications
Hyaluronic Acid Sodium Salt (Sodium hyaluronate) is used for:
Osteoarthritis
Adult Dose
Intra-articular
Osteoarthritis of the knee
Adult: 20-25 mg once wkly for 5 wk or up to 30 mg once wkly for 3-4 wk.
Not to repeat treatment course within 6 mth for any individual joint.
Child Dose
Renal Dose
Administration
Contra Indications
Hypersensitivity to sodium hyaluronate or avian proteins.
Precautions
Do not concomitantly use disinfectants containing quaternary ammonium salts for skin preparation because hyaluronic acid can precipitate in their presence.
Inject subcutaneous lidocaine or similar local anesthetic prior to injection of hyaluronate.
Remove joint effusion, if present, before injection. Do not use the same syringe for removing joint effusion and for injecting hyaluronate.The vial/syringe is intended for single use.
Lactation: Unknown whether distributed in breast milk, caution advised
Pregnancy-Lactation
Interactions
The safety and effectiveness of the use of sodium hyaluronate concomitantly with other intra-articular injection has not yet been established.
As sodium hyaluronate is precipitated by quaternary amine bactericides or disinfectants eg, benzalkonium chloride and chlorhexidine, etc, adequate attention should be given.
Adverse Effects
Side effects of Hyaluronic Acid Sodium Salt (Sodium hyaluronate) :
>10%
Arthralgia (25%),Tenderness (61-92%),Swelling (81-91%),Firmness (88-89%),Bruising (52-87%),Pruritus (25-36%),Skin discoloration (33-78%),Firmness (86-89%),Lumps/bumps (56-83%)
1-10%
Increased blood pressure (4%),Fatigue (1%),Nausea (<2%),Injection site pain (3%),Paresthesia (1%),Tendonitis (2%),Limb pain (1%),Tendonitis (2%),Joint effusion (2%)
<1%
Angioedema,Arthritis,Herpetic eruptions,Thrombocytopenia,Peripheral edema,Vasovagal reaction,Hives,Gait disturbances
Mechanism of Action
Sodium hyaluronate is a polysaccharide which functions as a tissue lubricant. It is widely used in ophthalmic surgery because it forms a viscoelastic solution in water which makes it a suitable substitute for aqueous and vitreous humour.