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Synvisc-One Side Effects

Generic Name: hylan g-f 20

Note: This document contains side effect information about hylan g-f 20. Some of the dosage forms listed on this page may not apply to the brand name Synvisc-One.

For the Consumer

Applies to hylan g-f 20: injection solution

Along with its needed effects, hylan g-f 20 (the active ingredient contained in Synvisc-One) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking hylan g-f 20:

More Common

  • Difficulty with moving
  • fluid build up around the knee
  • muscle pain or stiffness
  • pain and stiffness in the joints

Less Common

  • Bleeding after defecation
  • bluish color
  • changes in skin color
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • pain or aching in the lower legs
  • swelling of the ankles, feet, or legs
  • tenderness
  • uncomfortable swelling around the anus
  • warmth or swelling of the joints


  • Redness in the joints
  • trouble with walking

Incidence Not Known

  • Black, tarry stools
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine or stools
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chills
  • difficulty with breathing
  • feeling of warmth
  • general feeling of discomfort or illness
  • muscle cramps
  • pinpoint red spots on the skin
  • rapid weight gain
  • redness of the face, neck, arms, and occasionally, upper chest
  • shortness of breath
  • tingling of the hands or feet
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss

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

Less Common

  • Itching of the skin
  • rash
  • sprain in the lower back


  • Pain at the injection site

Incidence Not Known

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. 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

6. 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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.