Hyaluronic acid belongs to the group of medications known as synovial fluid replacements. It is used to relieve the symptoms of osteoarthritis (a condition causing joint "wear and tear" and pain) in the hip, knee, and shoulder joints. It works by mimicking the body's own synovial fluid (a fluid that lubricates and cushions the joints). Pain relief can last for 6 to 12 months after the injection schedule.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop receiving this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

This medication is injected directly into the joint that is affected by osteoarthritis. Your doctor or another health care professional will give you the injection, usually at a clinic. The usual recommended dose is one injection per week for a total of 3 to 5 injections.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a different dose than the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important that you receive this medication exactly as prescribed by your doctor. If you miss an appointment for a dose, contact your doctor as soon as possible to reschedule your appointments.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not use hyaluronic acid if you:

• are allergic to hyaluronic acid (sodium hyaluronate) or any ingredients of the medication
• are allergic to bird proteins (also called avian proteins)
• have an infection or skin disease surrounding the injection area

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• mild pain, redness, or swelling around the area of injection

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• fever or chills
• headache
• muscle pain or cramps
• severe pain; warmth or swelling of one or more joints, which may include joints in your knees, ankles, hands, wrist, elbows, and shoulders; rarely, joint in your back, neck, and head may be affected

Stop taking this medication and seek immediate medical attention if any of the following occur:

• signs of an allergic reaction (hives; difficulty breathing; swelling of the face, tongue, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergies: The safe use of this medication has not been established for people who are allergic to products from birds, such as feathers, eggs, and poultry. Tell your doctor if you are allergic to any of these products.

Joint protection: For a few days after the injection, avoid activities that may aggravate the joint. This includes jogging, tennis, heavy lifting, or standing for a long time. Consult your doctor before restarting these activities.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under the age of 18.

There may be an interaction between hyaluronic acid and any of the following:

• other medications injected into the joint

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.