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Euflexxa vs Synvisc

Euflexxa vs Synvisc:


Arthritis is a general term that describes inflammation of the joints. Osteoarthritis is the most common type of arthritis.

This degenerative joint condition affects over 27 million Americans, according to the CDC. Women are 3 times more likely than men to develop OA.

Symptoms typically start after the age of 40 years, however, they can affect younger people after a traumatic injury. The main symptoms of OA are joint pain and stiffness.


Many factors can increase your risk of this degenerative joint condition. It is commonly a mixture of the following, which leads to osteoarthritis.

  • obesity causes OA by increasing the mechanical stress on the cartilage;
  • joint abnormalities – if you were born with abnormalities, they can lead to earlier and more severe OA than usual;
  • alcohol and tobacco abuse;
  • a diet low in antioxidants;
  • injury and overuse – repetitive movements or injuries to joints can lead to this condition;
  • age – the risk of OA increases substantially as you get older due to weaker joints or muscles which may have become worn out.


Although osteoarthritis doesn’t have a cure, there are different treatments available to maintain your mobility and ease your pain. Therefore, here are 2 of them:


It is a solution of highly purified hyaluronan in saline. Hyaluronan is a product extracted from bacterial cells. It is the first non-avian derived hyaluronan.


It is a sterile viscous fluid that is designed to prevent inflammation. The active ingredient is called Hylan G-F 20, a medication that belongs to the group of medications known as synovial fluid replacements.



It is used to relieve knee pain due to osteoarthritis in patients who do not get enough relief from simple pain drugs (like – acetaminophen) or from physical therapy and physical exercise.


It is indicated for the treatment of pain in osteoarthritis of the knee in sufferers who have failed to respond adequately to simple analgesics, e.g., acetaminophen and conservative nonpharmacologic therapy.

Mechanism of Action


This injection works by eliminating friction and increases the effectiveness of the fluid within the knee joint to act as a shock absorber and lubricant.


This medication achieves its therapeutic effect through viscosupplementation, a process whereby the rheological and physiological states of the arthritic joint tissues are restored.

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Side Effects


The most common adverse events associated with this medication treatment during clinical studies included:

  • joint swelling;
  • musculoskeletal pain;
  • pain in the arms or legs;
  • back pain;
  • arthralgia (joint pain).

Call your doctor at once if you experience serious side effects such as:

  • confusion;
  • severe swelling or pain around the knee after the injection;
  • anxiety;
  • heavy feeling;
  • chills or shaking;
  • sweating;
  • fast heart rate.


The most commonly reported adverse events were:

  • joint effusion;
  • injection site pain;
  • dizziness;
  • nausea;
  • headache;
  • arthropathy;
  • arthritis;
  • arthralgia.

Call your doctor at once if you experience serious side effects such as:

  • muscle cramps;
  • burning or tingling sensations in the feet;
  • tiredness;
  • redness of the affected joint with or without fever;
  • swelling of the feet or ankles;
  • flushing or swelling of the face;
  • fever or chills.

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Inject 2mL intra-articularly in each affected knee weekly for 3 weeks. For best results, your healthcare professional will administer 3 injections, using separate syringes for each knee.


It is administered by intra-articular injection once a week (one week apart) for a total of 3 injections.

Warnings & Precautions


You should not receive sodium hyaluronate if you have an infection in your knee or in the skin around your knee, or if you are allergic to it.

For at least 48 hours after your injection, avoid strenuous activity, jogging, or high-impact sports, like – tennis, basketball, or soccer. In addition, avoid standing for longer than 1 hour at a time.


To make sure that this medicine is safe for you, tell your healthcare provider if you:

  • have an infected or severely swollen joint;
  • have circulation problems in your legs;
  • have fluid that doesn’t flow properly in the lymphatic system or veins of the leg to be injected;
  • have an allergy to feathers, birds, or egg products;
  • have skin disease near the planned injection area;
  • have an allergy to the active ingredient of the medication (Hylan G-F 20) or to any of the ingredients of the medicine.

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Mixing of quaternary ammonium salts (4 ammonium salt) with sodium hyaluronate solutions results in the formation of a precipitate.


It may negatively interact with:

  • cetylpyridinium topical (a quaternary ammonium with broad-spectrum antiseptic properties);
  • benzalkonium chloride topical;
  • benzocaine/cetylpyridinium/menthol/zinc chloride topical;
  • benzalkonium chloride/pramoxine topical.

Alcohol or Tobacco

Mixing alcohol or tobacco with certain medicines may also cause interactions to occur. Ask your doctor to provide you information about the use of your medicine with alcohol, or tobacco.

Is It Safe During Pregnancy or Breastfeeding?


This medication has not been tested on lactating women, pregnant women, or children under 18 years.


It is not known whether this medication passes into breast milk or if it could affect a nursing baby in a negative way. Tell your physician if you are breastfeeding a baby.

It is not known whether this medication will affect an unborn baby in a negative way. Tell your physician if you are pregnant or plan to become pregnant.


The cost of a Euflexxa Injection is $348. The cost of a Synvisc Injection ranges from $740 to $754.

Conclusions – Euflexxa vs Synvisc

Euflexxa is a very highly purified product extracted from bacterial cells. Your healthcare professional will give you the injection into your affected knee joint once a week, for a total of 3 injections.

Synvisc (Hylan G-F 20) is used to treat knee pain caused by OA. This medicine is similar to the fluid which surrounds the joints in your body. It acts as a lubricant and shock absorber for the joints. Hylan G-F 20 is typically administered by a specialist trained in treating knee osteoarthritis, like – a rheumatologist or orthopedic surgeon.

According to a randomized, double-blind controlled trial, 321 patients with confirmed knee OA were randomized to treatment with either Euflexxa or Synvisc.

Euflexxa showed a substantial advantage over Synvisc in the number of joint effusions and the requirement of supplemental simple analgesics. However, both treatment groups experienced statistically substantial improvements from baseline.



Monday 13th of March 2023

have people tried one for X period of time then the other? outcome?

and ANY treatment requirements of other meds before either can be tried?