Hylan g-f 20 Side Effects

Not all side effects for hylan g-f 20 may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to hylan g-f 20: injection injectable, injection solution

In addition to its needed effects, some unwanted effects may be caused by hylan g-f 20. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking hylan g-f 20, check with your doctor or nurse as soon as possible:

  • Difficulty breathing
  • hives
  • shortness of breath

Some of the side effects that can occur with hylan g-f 20 may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Knee pain
  • pain at the injection site
  • swelling of the knee
  • Calf cramps
  • dizziness
  • facial flushing with swelling of the lips
  • headache
  • infection of the joint
  • itching of the skin
  • muscle pain
  • nausea
  • pain on one side of the body with anxiety, nausea, and tiredness
  • rapid heartbeat
  • skin rash

For Healthcare Professionals

Applies to hylan g-f 20: intra-articular solution


A retrospective study reported pain, warmth, and swelling after 11% of injections, in some cases lasting up to 3 weeks.[Ref]

In clinical trials with 511 patients who received a total of 1771 injections, knee pain and/or swelling were reported in 7.2% patients or 2.2% of injections and were the most common adverse reactions.[Ref]


Dermatologic side effects have included individual cases of rash, itching, generalized urticaria, recurring small hives, facial flush with lip swelling, and body prickling. These symptoms did not reoccur upon rechallenge.[Ref]


Gastrointestinal side effects have included nausea and hemorrhoids.[Ref]


Musculoskeletal side effects have included calf cramps, ankle edema, muscle pain, low back sprain, and pseudosepsis.[Ref]

Pseudosepsis has been characterized as severe joint inflammation with pain and effusion occurring 24 to 72 hours after injection and it may be more likely to occur after the second or third injection or with repeated courses. Nonsteroidal anti-inflammatory drugs, intra-articular steroids, and/or arthrocentesis are often required to treat pseudosepsis.[Ref]


Cardiovascular side effects have included tachyarrhythmia and phlebitis with varicosities.[Ref]

Nervous system

Nervous system side effects have included anxiety and listlessness, dizziness, headache, shivering, and body pain.[Ref]


Respiratory side effects have included respiratory difficulties.[Ref]


Metabolic side effects have included one case report of pseudogout and one of acute gout in a patient with no prior episodes.[Ref]


Hypersensitivity reactions have included one reported case of a suspected allergic reaction with fever, large effusion in the knee, and synovial eosinophilia.[Ref]


Local reactions have included acute painful joint effusions after injection into the knee in 1% to 11% of patients.[Ref]


1. "Product Information. Synvisc (viscoelastic solution)." Wyeth-Ayerst Laboratories, Philadelphia, PA.

2. Isomoto H, Saenko VA, Kanazawa Y, et al. "Enhanced Expression of Interleukin-8 and Activation of Nuclear Factor Kappa-B in Endoscopy-negative Gastroesophageal Reflux Disease." Am J Gastroenterol 99 (2004): 589-97

3. Yacyshyn EA, Matteson EL "Gout after intraarticular injection of hylan GF-20 (Synvisc) [letter]." J Rheumatol 26 (1999): 2717

4. Allen E, Krohn K "Adverse reaction to Hylan GF-20." J Rheumatol 27 (2000): 1572

5. Pullman-Mooar S, Mooar P, Sieck M, Clayburne G, Schumacher HR "Are there distinctive inflammatory flares after hylan g-f 20 intraarticular injections?" J Rheumatol 29 (2002): 2611-4

6. Puttick MP, Wade JP, Chalmers A, Connell DG, Rangno KK "Acute local reactions after intraarticular hylan for osteoarthritis of the knee [see comments." J Rheumatol 22 (1995): 1311-4

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.