There exists a natural occurring fluid between our joints known as Synovial fluid. It acts as a cushion and a lubricant, it is and is essential for proper working of the joints. Orthovisc is similar to the body synovial fluid, it is a sterile, non-pyrogenic, clear, viscous solution that contains high molecular content of hyaluronan extracted from rooster comb. It is majorly given to patients suffering from Osteoarthritis and arthritis after failing to respond to other medications like simple pain relievers and therapy. Nevertheless, with other joint problems, you can recommend it as a solution.
Osteoarthritis is a condition whereby a person lacks adequate natural hyaluronan in the joint or it is of low quality than normal. On the other hand, Orthovisc relieves arthritis by replacing the lubricating fluid in the joint.
Dosing of Orthovisc
How is Orthovisc given?
Having assessed the patient’s condition, you can determine the amount of Orthovisc you are to give them. However, Orthovisc is typically administered as a single injection to the knee joint for a total of 3 to 4 weeks. For patients with Osteoarthritis, it is usually, 2 mL of intra-articular injection into the knee once a week for the 3 or 4 weeks as well.
After the drug has been induced, for the next least 48 hours, the patient should avoid any strenuous activates that cause pressure on the joints for example; standing for long (more than an hour), any sports, carrying heavy objects or jogging.
Studies have shown that after the third or fourth injection, the medicine relief lasts to at least 6 months. However, the results also vary from one individual to another as some patients feel relief after the first or second injection. You as the doctor can, help them determine the appropriate number of injections.
Before deciding to administer Orthovisc
Before coming to the conclusion of trying Orthovisc as treatment, you can first ensure they try out the following solutions or alternatives to their joint problems:
- Physical therapy or
- Removal of the excess fluid from the joint
- Drug therapy
- Use of pain relievers such as narcotics and acetaminophen
- Use of ‘nonsteroidal anti-inflammatory’ (NSAI1D) agents and other treatments for reducing inflammation like asprins
When should you not administer Orthovisc
While assessing your patient note that it is not advisable for them to take Orthovisc if:
- they have any bleeding disorders for instance, hemophilia
- they have some allergies especially to hyaluronan, avian or any avian products (eggs, feathers or poultry); ensure you are aware of any allergies they could be having and their body reaction or
- any infection around the joint that is to be treated or a skin problem where you are to give shot. Also, always ensure strict aseptic technique is being used.
- It is unknown whether Orthovisc can harm an unborn baby or a pregnant woman therefore, make sure you are informed whether the patient is pregnant, planning to get pregnant or if they are breast feeding as it would pass through breast-milk to the baby. In fact, anyone under the age of 21 especially children are not allowed to use Orthovisc.
Side Effects of Orthovisc
Here are some common side effects of Orthovisc:
- Pain in the joints, stiffness or swelling
- Itchiness, tingling or numbness
- Dizziness or headaches
- Where the drug was injected, they might turn red, swell, and feel pain or mild discomfort
- Back pain
However, most of these side effects are usually mild, for instance you can advise the patient to wrap ice around the injection site or joints to ease the pain or swelling.
Ensure you are also up to speed of medicines the person would be taking whether as prescribed drugs, over-the-counter medicine, herbal products and vitamins that may react with Orthovisc. In addition, due to variation of our bodies and their reaction to Orthovisc, ensure you are fully in the loop of any conditions they would be having for certainty of enough closure before administering the drug.
Orthovisc interactions with food
There are no known harmful reactions of Othorvisc interactions with any specific food.
In case of serious later effects, the person should contact you or visit the emergency room for checkup.
Even though some patients might feel relief of the pain after the first or second Orthovisc shot, they should avoid missing the extra scheduled appointments.
You should be informed in case they are to miss any scheduled appointment so that both of you can make plans for another appointment of the next injection.
The patient should avoid using any disinfectant without you having approved it while they are under-going the treatment. For example, disinfectants containing quarternary ammonium salts because, hyaluronic acid can react by precipitating in their presence on your skin.
As a result of Orthovisc being administered by a trained healthcare professional in a medical setting, cases of overdosing rarely occur. Nevertheless, in case overdose ever happens, the patient should seek immediate medical attention.