What Is Euflexxa and How Does It Work?

Euflexxa is a brand of drug used to treat pain caused by knee osteoarthritis (OA). OA, also called “wear and tear” arthritis, is the most common and long-term degenerative joint condition that causes joint pain, stiffness, and swelling. 

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In OA, the strong fibrous tissue surrounding the ends of the bones (cartilage) breaks down or changes in structure resulting in symptoms such as pain, joint swelling, and stiffness.

A doctor may prescribe Euflexxa for patients whose pain is not relieved by simple pain medications, such as acetaminophen (Tylenol), or non-drug treatments, such as exercise and physical therapy.

Euflexxa contains the active drug sodium hyaluronate. Sodium hyaluronate is a thick gel-like substance naturally present in our joint tissue acting as the fluid between our joints. It lubricates the joint, absorbs shock during movement, and allows the joint to function properly. 

Other brands that contain sodium hyaluronate are:

• Durolane
• Synvisc
• Gel-One
• Hyalgan
• Hyalgan LL
• Supartz
• Supartz FX

How Is Euflexxa Supplied and Used?

Euflexxa comes in disposable, pre-filled glass syringes. Each syringe contains 2 ml of the product or 20 mg of the active drug. A doctor or other healthcare professional injects the product into the affected knee. 

How Does Euflexxa Work?

Euflexxa contains sodium hyaluronate, which helps joint pain by: 

• Increasing the amount of hyaluronic acid in the joint tissue and fluid
• Reducing inflammation in the affected knee
• Blocking sensitivity to pain stimulus
• Stimulating natural hyaluronic acid production 

What Are the Side Effects of Euflexxa?

Common Side Effects

• Feeling of warmth, pain, or redness at the injection site
• Nausea
• Stomach pain
• Loss of appetite
• Diarrhea
• Difficulty walking
• Swelling in your hands or feet
• Back pain
• Joint pain
• Muscle pain
• Numbness
• Headache
• Dizziness
• Runny or stuffy nose
• Sneezing
• Sore throat

Most patients do not experience any side effects, or if they do, the side effects are temporary and usually subside quickly after the injection. However, if a side effect does not go away after the injection, it is best to contact your healthcare provider immediately. 

Serious Side Effects

Contact your doctor immediately if any of the following side effects occur during treatment:

• Bluish discoloration or flushing 
• Cough
• Difficulty swallowing
• Severe dizziness
• Fever
• Persistent or worsening pain at the injection site
• Skin rash/hives with or without itching
• Swelling of eyelids, face, or lips
• Tightness in chest
• Difficulty breathing
• Wheezing
• Severe headache
• Pounding heartbeat

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Can This Medication Cause Severe Allergic Reactions?

A life-threatening allergic reaction to this drug is rare. However, seek immediate medical care if you notice the signs and symptoms of a serious allergic reaction, such as:

• Rash
• Hives
• Swelling of the face, tongue, or throat
• Severe itching
• Severe dizziness
• Breathing difficulty

Euflexxa Dosage

Your doctor or a healthcare professional will inject 2 ml of Euflexxa into the affected joint every week for three weeks total. 

What Should You Know Before Taking Euflexxa?

Patients should be advised to avoid taking this drug if they have a history of allergy to the product or other hyaluronic acid products. Furthermore, they should not receive the injection in case of a knee infection or skin infection around the knee. 

Please inform your doctor if you are pregnant or planning to become pregnant, as safety and efficacy have not been established in specific populations. Your doctor should also be informed if you are breastfeeding or younger than 18 years of age. 

What Should You Not Do After Taking Euflexxa?

• Avoid physical activities, such as jogging, tennis, and heavy lifting, for at least 48 hours after receiving the injection.
• Do not stand on your feet for more than 60 minutes without a break during the 48-hour period after taking this medication. 

What Should You Do After Taking Euflexxa?

• Ask your doctor when you can return to doing physical activities that require using your leg. 
• You may apply a cold pack to relieve mild pain or swelling near the injection site. 
• Call your doctor right away if you have severe joint pain, back pain, or muscle pain. 

How Long Will Euflexxa Relieve Pain?

After receiving all three injections, you can expect pain relief for about 6 months. However, results can and will be different for each patient.  For optimal benefits, you should get all the injections on time without delay. It is unknown if repeating treatment cycles for more than one year is safe. 

How Long Does It Take For Euflexxa to Work?

The time it takes for Euflexxa to work can vary. However, it is common for most users to start feeling better 2 weeks after the third injection. 

Can Pregnant Women Use This Medication?

Euflexxa has not been tested in pregnant patients, and it is unclear if this drug is safe and effective for use in pregnant women. Nonetheless, a doctor may prescribe it if the potential benefits clearly outweigh the risks. 

Can Breastfeeding Women Use This Medication?

It is unclear if this drug is safe and effective for use in breastfeeding women as it was not tested. Furthermore, researchers have yet to determine if Euflexxa passes into breast milk. Therefore, talk to your doctor before breastfeeding and starting Euflexxa.

Euflexxa vs. Corticosteroid Injection: Which Is Better?

Corticosteroid injections have been used to help manage joint pain for many years. While they help by reducing inflammation in the joints, injections such as Euflexxa consist of sodium hyaluronate, which acts as a lubricant for the joints providing better and longer pain-free periods. Both have comparable benefits in improving knee function. Nonetheless, according to a 2017 study, injectable corticosteroids may be more effective in the short term, while Euflexxa appears better for long-term pain relief [1].

Which Is the Cheapest Injectable Hyaluronate Brand?

A 2016 study compared the costs and benefits (in terms of quality of life) of different hyaluronic acid injection products: Euflexxa, Synvisc, Durolane, Hyalgan, and Supartz. 

It was found that Euflexxa had the lowest cost–utility ratio among all the five products, which indicates that Euflexxa users paid the lowest for improved quality of life.

Can You Use Euflexxa for Shoulder or Hip Pain Due to Osteoarthritis?

No. Euflexxa is only intended for use only in the knees.  

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Is the Injection Painful?

Pain, regardless of the type, is subjective. Yet, there are several ways to reduce injection pain. For instance, your doctor will likely use a numbing agent on the site of injection to reduce pain and discomfort. 

How Much Does Euflexxa Cost?

The amount you pay for the treatment can vary, depending on your insurance plan, geographical location, and pharmacy. Contact your insurance provider to find out if your plan covers this product or if you need prior authorization. 

REFERENCES:

1. He, Wei-wei et al. “Efficacy and safety of intraarticular hyaluronic acid and corticosteroid for knee osteoarthritis: A meta-analysis.” International journal of surgery 39 (2017): 95-103.
2. Rosen, J., Sancheti, P., Fierlinger, A. et al. Cost-Effectiveness of Different Forms of Intra-Articular Injections for the Treatment of Osteoarthritis of the Knee. Adv Ther 33, 998–1011 (2016). https://doi.org/10.1007/s12325-016-0331-8