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Hyalgan Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 12/2/2015

Hyalgan (sodium hyaluronate) is a synovial fluid replacement that works by acting as a lubricant and shock absorber in the joint used to treat knee pain in patients with joint inflammation (osteoarthritis). Hyalgan is usually used in patients who have not responded to other treatments such as acetaminophen, exercise, or physical therapy. Common side effects of Hyalgan include injection site reactions (pain, swelling, redness, warmth, bruising, stiffness, or puffiness), headache, nausea, stomach pain, back pain, numbness or tingly feeling, cold symptoms (stuffy nose, sneezing, sore throat), tired feeling, or itching or skin irritation around the knee.

Hyalgan is given by intramuscular (IM) injection. A treatment cycle consists of a dose of five injections, given at weekly intervals. Hyalgan may interact with other drugs. Tell your doctor all medications and supplements you use. During pregnancy, Hyalgan should be used only when prescribed. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Our Hyalgan (sodium hyaluronate) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Hyalgan in Detail - Patient Information: Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

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

Less serious side effects may include:

  • warmth, pain, stiffness, swelling, or puffiness where the medicine was injected;
  • nausea, stomach pain;
  • headache;
  • back pain;
  • numbness or tingly feeling;
  • cold symptoms such as stuffy nose, sneezing, sore throat;
  • tired feeling; or
  • itching or skin irritation around the knee.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Hyalgan (Hyaluronate)

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Hyalgan Overview - Patient Information: Side Effects

SIDE EFFECTS: See also How to Use section.

Pain, swelling, redness/warmth/bruising at the injection site, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: back pain, severe headache, fast/pounding heartbeat, fever, tingling skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Hyalgan (Hyaluronate)

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Hyalgan FDA Prescribing Information: Side Effects
(Adverse Reactions)


Hyalgan® (hyaluronate) was investigated in a pivotal clinical investigation conducted in the United States in which there were three arms (164 subjects treated with Hyalgan® (hyaluronate) ; 168 with placebo; and 163 with naproxen) (refer to Table 1).

Incidence1 of Adverse Events Occuring in More Than 5% of All Subjects

Adverse Event Hyalgan®
Gastrointestinal complaints2 48 (29%) 59 (36%)
Injection site pain3 38 (23%)4 22 (13%)
Headache 30 (18%) 29 (17%)
Local skin5 23 (14%) 17 (10%)
Local joint pain and swelling6 21 (13%) 22 (13%)
Pruritus (local) 12 (7%) 7 (4%)
1 Notes: Number and % of subjects
 Severe in 4 Hyalgan® (hyaluronate) -treated subjects and 4 placebo-treated subjects
 Severe in 5 Hyalgan® (hyaluronate) -treated subjects and 2 placebo-treated subjects
Statistically significant (p=0.02)
Includes ecchymosis and rash
 Severe in 2 Hyalgan® (hyaluronate) -treated subjects (1.2%) and 1 placebo-treated subject

Common adverse events reported for the Hyalgan® (hyaluronate) -treated subjects were gastrointestinal complaints, injection site pain, knee swelling/effusion, local skin reactions (rash, ecchymosis), pruritus, and headache. Swelling and effusion, local skin reactions (ecchymosis and rash), and headache occurred at equal frequency in the Hyalgan® (hyaluronate) and placebo-treated groups. Hyalgan® (hyaluronate) -treated subjects had 48/164 (29%) incidents of gastrointestinal complaints that were not statistically different from the placebo-treated group. A statistically significant difference in the occurrence of pain at the injection site was noted in the Hyalgan® (hyaluronate) -treated subjects; 38/164 (23%) in comparison to 22/168 (13%) in the placebo-treated subjects (p=0.022). There were 6/164 (4%) premature discontinuations in Hyalgan® (hyaluronate) -treated subjects due to injection site pain in comparison to 1/168 ( < 1%) in the placebo-treated subjects. These differences were not statistically significant.

Two (2/164, 1.2%) Hyalgan® (hyaluronate) -treated subjects and 3/168 (1.8%) placebo-treated subjects were reported to have positive bacterial cultures of effusion aspirated from the treated knee. The two Hyalgan® (hyaluronate) -treated subjects and two of the placebo-treated subjects did not exhibit evidence of infection clinically or subsequently and were not treated with antibiotics. One of the placebo-treated subjects was hospitalized and received presumptive treatment for septic arthritis.

Hyalgan® (hyaluronate) has been in clinical use in Europe since 1987. Analysis of the adverse events that have been reported with the use of Hyalgan® (hyaluronate) in Europe reveals that most of the events are related to local symptoms such as pain, swelling/effusion, and warmth or redness at the injection site. In the two events reported as anaphylactoid reactions, Hyalgan® (hyaluronate) treatment was discontinued and both had favorable outcomes. Three cases of allergic reactions were reported in which the patients were discontinued from Hyalgan® (hyaluronate) treatment and the incidents resolved. Seven cases of fever were reported in which three of the cases were reported to be associated with local reactions; pyogenic arthritis was reported to be ruled out in these three cases. All the fever patients were discontinued from Hyalgan® (hyaluronate) treatment and all incidents resolved. One incident of shock (which was described as a "hypotensive crisis") was reported. The incident resolved and Hyalgan® (hyaluronate) treatment was continued.

Adverse experience data from the literature contain no evidence of increased risk relating to retreatment with Hyalgan® (hyaluronate) . The frequency and severity of adverse events occurring during repeat treatment cycles did not increase over that reported for a single treatment cycle. (Carrabba et al., 1995; Carrabba et al., 1991; Kotz and Kolarz, 1999; Scali, 1995).

Read the entire FDA prescribing information for Hyalgan (Hyaluronate)

Hyalgan - User Reviews

Hyalgan User Reviews

Now you can gain knowledge and insight about a drug treatment with Patient Discussions.

Here is a collection of user reviews for the medication Hyalgan sorted by most helpful. Patient Discussions FAQs

Report Problems to the Food and Drug Administration


You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


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