Monovisc Prescribing Information for Practitioners

Accurate prescribing information is crucial for healthcare professionals to ensure patient safety and treatment efficacy. Monovisc, a high-molecular-weight hyaluronan injection, comes with detailed guidelines for physicians outlining pharmacology, adverse reactions, warnings, and side effects to aid in proper administration.

Monovisc is specifically indicated for the treatment of pain in osteoarthritis of the knee in patients who have not responded adequately to conservative non-pharmacologic therapy or simple analgesics. It offers up to six months of pain relief with a single injection, making it a valuable option for long-term pain management.

This article will provide practitioners with comprehensive Monovisc prescribing information, including dosage instructions, potential side effects, and patient care considerations.

Key Takeaways

• This article provides a comprehensive guide for medical practitioners on prescribing Monovisc for knee osteoarthritis.
• It covers indications, contraindications, dosage regimen, patient selection, injection procedure preparation, post-injection care, side effects, and clinical guidelines.
• Reading about clinical guidelines and expert recommendations ensures healthcare professionals have accurate and up-to-date information when prescribing Monovisc.

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Indications and Contraindications

Monovisc is designed for patients with osteoarthritis knee pain who have not found relief with conservative treatments. This one-time injection uses high-molecular-weight hyaluronic acid to alleviate pain and improve joint function.

However, not all patients are suitable candidates for Monovisc. Those with allergies to hyaluronic acid products should avoid this treatment. Additionally, if there is an infection or skin disease around the injection site, Monovisc is not recommended. This treatment is specifically intended for adults with knee osteoarthritis who have not achieved adequate relief from other therapies.

Dosage and Administration

Monovisc is designed as a single-dose treatment for knee osteoarthritis. The recommended dosage regimen is a one-time injection of 4 mL directly into the affected knee joint. This single administration is intended to provide relief from pain and improve joint function for an extended period, potentially up to six months.

Administration Guidelines

• Aspiration and Needle Selection: Before injecting Monovisc, the healthcare provider may aspirate any joint effusion to improve patient comfort and the efficacy of the injection. Then, they use an appropriate needle size for the injection, typically a 18- to 22-gauge needle, depending on the patient’s anatomy and the physician’s preference.
• Determining the Injection Site and Technique: The injection should be administered into the synovial space of the knee joint. Proper anatomical landmarks should be used to identify the injection site. The injection should be performed using a sterile technique. The healthcare provider should insert the needle into the joint space and ensure correct placement by confirming the absence of resistance when injecting.

Patient Selection and Preparation

Picking suitable patients for Monovisc treatment is critical. This decision relies on understanding who will benefit the most from this viscosupplementation therapy. Here’s a detailed list focusing on patient selection criteria:

• Patients must have knee osteoarthritis. This condition causes pain and stiffness in the knee joint.
• They should not respond well to conservative non-pharmacologic therapy. Examples include physical therapy or exercise.
• The individual has tried other treatments without enough relief. These might be pain medications or corticosteroid injections.
• Age is also a consideration. Monovisc is usually for adults who are experiencing joint pain due to aging.
• The severity of osteoarthritis matters, too. Monovisc works best for those with mild to moderate knee pain.
• Patient’s lifestyle can influence their eligibility. Those active and seeking mobility tend to do well with this treatment.
• Lastly, patients must understand what Monovisc treatment involves. They need to know it’s a single injection that can provide long-term relief but might only work for some people differently.

Preparing Patients for the Injection Procedure

Before administering Monovisc, healthcare providers should thoroughly evaluate the patient’s medical history, focusing on any potential allergies to hyaluronic acid or related products. They should also ensure that all components used during the procedure are sterile. The injection area should be thoroughly cleaned to reduce the risk of infection. 

Professionals can also take this opportunity to explain further what Monovisc is and how it can help with knee osteoarthritis. During preparation, they can also provide a brief background on the treatment, including the manufacturer of Monovisc, to make patients feel at ease before the injection.

Post-Injection Care

Patients are advised to avoid strenuous activities for 48 hours after the injection. Light activities and normal walking are generally permissible. Patients should also be monitored for any adverse reactions post-injection, such as pain, swelling, or signs of infection at the injection site.

Patient Education and Follow-Up

Educating patients and scheduling follow-up visits after administering Monovisc is crucial. This process ensures they know what to expect and helps monitor their recovery.

• Explain the Purpose of Monovisc: It treats knee pain caused by osteoarthritis in patients who have not received relief from other treatments.
• Describe the Injection Process: Patients should know it involves a single injection into the knee joint.
• Discuss Expected Benefits: Share that Monovisc can provide long-term relief from knee pain.
• Outline Possible Side Effects: Brief patients on potential reactions like pain at the injection site or swelling.
• Stress the Importance of Reporting Problems: Urge them to contact a healthcare provider if they experience unusual symptoms following the injection.
• Advise on Post-injection Activities: Suggest limiting strenuous activities for 48 hours to allow the knee to rest.
• Schedule a Follow-up Appointment: Set a date to check the patient’s progress and address concerns.

Side Effects and Management

Monovisc helps many with knee osteoarthritis by easing pain. Like all treatments, it can have side effects.

• Pain at the injection site is joint. This process usually goes away in a few days.
• Some might feel swelling or warmth in the knee after getting Monovisc.
• Bruising around the area where the needle went in can happen.
• Some patients report feeling stiffness in the knee.
• A small number might get a headache or feel dizzy.
• Itching or skin irritation near the injection spot is possible.
• Rarely, someone might have a more serious allergic reaction to Monovisc.
• There could be temporary fluid buildup in the knee joint.
• Muscle pain or cramps may occur for a short time after the treatment.

Managing Side Effects and Complications

After talking about the side effects of Monovisc, it’s crucial to know how to manage these side effects and complications. Here’s what healthcare professionals need to focus on:

• Spot early signs of inflammation or infection at the injection site. Look for redness, swelling, or heat, and start treatment.
• Use ice packs on the knee to reduce swelling and pain following the injection. This process can provide immediate relief for patients.
• Advise patients to rest the injected knee for a couple of days. Avoid strenuous activities that could put extra stress on the joint.
• Recommend over-the-counter pain relievers if necessary, but confirm they don’t have contraindications with other medications the patient might be taking.
• Keep an eye out for allergic reactions. Although rare, some patients might react to hyaluronic acid in Monovisc.
• Educate patients on signs of severe complications like deep infection, which requires immediate medical attention.
• Stay updated with current guidelines on managing osteoarthritis pain post-viscosupplementation to offer evidence-based care.
• Build a good communication line with patients, encouraging them to report any discomfort or unusual symptoms they experience after their Monovisc injection.

Clinical Guidelines and Expert Recommendations

Monovisc provides a significant option for managing knee osteoarthritis pain. Healthcare professionals must understand the best practices for prescribing this treatment.

• Assess patient history thoroughly before considering Monovisc as a treatment option. Ensure they have not responded adequately to conservative non-pharmacologic therapy.
• Confirm the diagnosis of osteoarthritis in the knee through imaging studies such as X-rays or MRI to ensure appropriate use of Monovisc.
• Discuss with patients about their previous treatments for osteoarthritis and reasons for lack of response to gauge suitability for Monovisc.
• Educate patients on the potential benefits and risks of viscosupplementation with high molecular weight hyaluronic acid (HA).
• Explain that Monovisc is intended for single injection use, which might appeal to patients concerned about the discomfort or inconvenience of multiple injections.
• Ensure patients understand that while some may experience relief soon after injection, it may take others longer to feel improvements.
• Prepare patients for the procedure by discussing post-injection care and advising them on activities to avoid immediately after the injection to minimize the risk of adverse effects.
• Monitor patients after the injection for any immediate side effects and have a clear plan for managing them should they occur.
• Schedule a follow-up appointment to assess treatment efficacy and discuss any concerns or unexpected outcomes with the patient.
• Encourage patients to report their pain levels and any side effects experienced following the injection using tools like pain diaries or symptom trackers.
• Utilities clinical guidelines and expert recommendations when deciding on treatment plans involving Monovisc, ensuring alignment with current practices and evidence-based approaches.

Conclusion

This guide offers vital details doctors need to prescribe Monovisc. It helps patients with knee osteoarthritis who didn’t get better with other treatments. Doctors learn how much to give, how to do it, and what to watch for after the shot.

They also find out about possible side effects and how to handle them. This information makes treating knee pain with Monovisc more straightforward for healthcare professionals.

FAQs

1. What is Monovisc, and when should it be prescribed?

Monovisc is a medical solution for treating knee pain in osteoarthritis patients. It’s typically prescribed when other treatments, such as physical therapy or over-the-counter drugs, have failed.

2. How does Monovisc work?

Monovisc mimics the body’s synovial fluid, naturally lubricating and cushioning the joints. This process helps to reduce pain and inflammation and improve mobility in affected knees.

3. Do practitioners need to know about any side effects before prescribing Monovisc?

Yes, potential side effects can include joint pain or swelling after injection, itching or rash at the injection site, headache, or dizziness. These are usually mild, but patients should contact their doctor immediately if they persist or worsen.

4. How often can Monovisc be administered?

The frequency of administration depends on each patient’s needs and response to treatment. However, as a general rule of thumb, one injection per week for three weeks is standard practice.

References

EMPR. (n.d.). Monovisc. June 24, 2024, from https://www.empr.com/drug/monovisc/ 

RxList. (n.d.). Monovisc: Uses, dosage, and side effects. RxList. Retrieved June 24, 2024, from https://www.rxlist.com/monovisc-drug.htm

Anika Therapeutics. (n.d.). Monovisc: Product information. Anika Therapeutics. Retrieved June 24, 2024, from https://anika.com/medical/products/monovisc/