Euflexxa vs Synvisc – Compare Differences Between Side Effects & Uses

Euflexxa vs Synvisc – detailed comparison:


It is the brand name of a drug called sodium hyaluronate (injection). It is a gel-like, elastic, sterile product containing hyaluronan (obtained from the bacterial cells and dissolved in a sterile saline solution).

This injection helps to lubricate the joint which leads to a greater flexibility and mobility of the treated joint, therefore, reducing pain in the affected joint.


It is typically used to relieve joint pain caused by medically diagnosed osteoarthritis (“wear and tear” arthritis) of the knee joint or other synovial joints.

Osteoarthritis (OA) is the most common form of arthritis. It is actually a degenerative joint disease that affects the cartilage on the end of the bones.

An estimated 27 million people in the United States have OA, with the knee being one of the most commonly affected areas, according to the Arthritis Foundation. Statistically, most individuals with osteoarthritis are 45 years old, with more women having osteoarthritis than men.

The main symptoms of OA of the knee are:

  • soft swellings (caused by extra fluid in the joint);
  • hard swellings and inflammation (caused by osteophytes);
  • the muscles around the joint looking thin or wasted;
  • a grinding sensation when you move the joint;
  • the knees becoming bent and bowed;
  • stiffness (particularly after rest – this typically eases after a minute or so as you get moving);
  • the knee is not moving as freely or as far as normal;
  • pain (especially when you are moving your knee or at the end of the day).

Note – this injection is usually given after other OA medications have been tried without successful treatment of symptoms.

For at least 48 hours after you have received the injection, avoid weight-bearing activity or standing for longer than 60 minutes at a time as well as high-impact sports, like – tennis, soccer or running.

Mechanism of Action

It functions similarly to the synovial fluid (which protects the knee from injuries and shocks) because of the presence of sodium hyaluronate as an active ingredient. Hence, it gives relief from knee pain for up to 180 days.


The usual recommended dose is 2 mL injected into the affected knee at 3 weeks interval, for a total of 3 injections. For the optimum effect, all 3 injections must be administered.

Tips – do not use disinfectants for skin preparation that contain quaternary ammonium salts (also referred to as quats). In addition, this medication should not be administered through a needle previously used with medical solutions containing BZK (benzalkonium chloride). Store the medicine in the original package at 2°-25°C (36°-77°F). Do not freeze.

Side Effects and Precautions

Common side effects may include:

  • stomach pain;
  • pain where the medicine was injected;
  • muscle pain;
  • nausea;
  • headaches;
  • numbness or tingly feeling;
  • trouble walking;
  • a sore throat;
  • joint pain;
  • sneezing;
  • back pain;
  • skin irritation around the knee;
  • tired feeling;
  • runny or stuffy nose.

Rare side effects may include:

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

To be sure that this injection is safe for you, tell your healthcare provider about all your medical conditions. Especially tell your healthcare provider if you:

  • take other medicines including herbal supplements, prescription and non-prescription medicines, and vitamins;
  • have a skin disease in the area in which the injection is to be given;
  • are allergic to products from birds, like – eggs, feathers, or poultry;
  • are allergic to any type of medication.

Pregnancy & Lactation

Because this injection has not been tested on pregnant women or lactating women, consult your doctor before use.


It is the brand name of a drug called Hylan g-f 20 that belongs to the group of drugs known as synovial fluid replacements.

The medication is made of a naturally occurring substance called hyaluronic acid. HA is found in rooster combs and helps cushion and lubricate the joints.

This synovial fluid replacement works by mimicking the body’s own synovial fluid (a viscous fluid found in the cavities of synovial joints). Relief from pain can last up to 6 to 12 months.

The US Food and Drug Administration originally approved it in 1997.


It is typically used to relieve the symptoms of osteoarthritis (the most common form of degenerative joint disease) in the ankle, hip, shoulder, and knee joints.


It is injected directly into the knee joint by a doctor. It is typically given once every week for 3 weeks. It may take a few weeks or even a few months to feel the full effect.

Side Effects and Precautions

Common side effects may include:

  • trouble walking;
  • warmth, pain, or puffiness where the medicine was injected;
  • a prickly feeling in the skin;
  • muscle pain;
  • dizziness;
  • skin irritation around the knee;
  • nausea;
  • headaches;
  • chills;
  • fever.

Rare side effects may include:

  • skin rash;
  • facial swelling;
  • itching;
  • facial flushing.

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

  • an allergy to feathers, birds, or egg products;
  • circulation problems in your legs;
  • high LDL and total cholesterol levels;
  • blood clots.

Euflexxa vs Synvisc – Which Synovial Fluid Replacement Is Better?

A 2016 study that was conducted at the Department of Orthopaedics and Rehabilitation, New York, USA, that compared investigated synovial fluid replacements, established that Euflexxa had the most favorable cost-utility ratio when compared to all other products.

Image credit – Shutterstock

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