Monovisc

Monovisc is a high molecular weight hyaluronan injection used for treating osteoarthritis pain in the knee. It's a viscosupplement that supplements the hyaluronic acid naturally found in synovial fluid of healthy joints. ## Composition and Properties Monovisc consists of high molecular weight (1-2.9 million Daltons), ultra-pure, natural hyaluronan derived from bacterial fermentation (Streptococcus equi)[1][4]. It's cross-linked with a proprietary cross-linker and dissolved in physiologic saline[1][4]. Each pre-filled syringe contains 4 mL of Monovisc with 88 mg of hyaluronan (nominal), which is equivalent to three injections of Orthovisc[1][4]. ## Indications Monovisc is FDA-approved for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy or simple analgesics like acetaminophen[1][2][3]. In the European Economic Area, it's indicated as a viscoelastic supplement or replacement for synovial fluid in human knee joints[5]. Some regions have expanded indications to include hip, shoulder, and ankle joints[6]. ## Mechanism of Action Hyaluronic acid works by: - Providing lubrication and mechanical support in the joints - Acting as a shock absorber - Reducing nerve impulses and sensitivity of nociceptive nerve endings (analgesic effect) - Reducing joint inflammation - Protecting cartilage (chondroprotective effect)[6][8] ## Administration Monovisc is administered as a single intra-articular injection into the affected knee joint[9]. This single-injection approach differentiates it from some other viscosupplements that require multiple injections. The convenience of a single injection is one of its key benefits[5][9]. ## Effectiveness Pain relief from Monovisc can be felt as early as 2 weeks following the injection and may last up to 6 months[5][8]. Clinical studies have shown that a second injection six months after the first is safe[6]. ## Contraindications Monovisc should not be administered to patients with: - Known hypersensitivity to hyaluronate preparations - Known hypersensitivity to gram-positive bacterial proteins - Infections or skin diseases in the area of the injection site or joint - Known systemic bleeding disorders[7][9] ## Side Effects Common side effects may include transient pain, swelling, heat, rash, itching, bruising, and redness at the injection site. These reactions are typically mild and temporary[9].

Brand names

Monovisc

Other names

HyaluronanHigh molecular weight hyaluronan