Gyurlan implant for intra-articular injection

Diuralan is a sterile implant manufactured by the American company Smith & Nefte Inc., intended for intraarticular injections.

The active ingredient of the drug is hyaluronic acid, obtained by biosynthesis, as an auxiliary substance is used saline solution.

Pharmacological properties and mechanism of action

The pharmaceutical representsa transparent gel, a visco-elastic consistency, produced in glass syringes with a volume of 3 ml, intended for a singleNogo application.

Refers to the pharmacological group of drugs that replace synovia and tear fluid.

Intraarticular injections of hyaluronic acid restore the viscosity of synovia, relieve pain syndrome and increase the amplitude of motion.

Hyaluronic acid is the basic substance of synovia, which is responsible for its viscosity, performs the amortization function. It is the same for all living organisms.

Getting into the body of the implant Duralan, it passes all the same metabolic reactions that internal hyaluronic acid.

When is intraarticular injection needed?

Gyuralan is prescribed for the treatment of symptoms of osteoarthritis of knee and hip joints of mild and moderate degree.

In the EU countries, the drug is prescribed for relief of a mild and moderate pain syndrome in degenerative-dystrophic diseases of the following joints:

• intervertebral;
• ankle;
• temporomandibular;
• finger;
• shoulder;
• ulnar;
• wrist bandages.

Implant is administered to eliminate pain syndrome after arthroscopy or against osteoarthritis, or after surgery for 90 days after the procedure.

When to refuse injections

Absolute contraindication to prescription of the drug are:

• individual intolerance to hyaluronic acid;
• gestation period;
• breast-feeding;
• children under 18 years;
• severe infectious-inflammatory diseases of the synovial joint;
• exacerbation of dermatological diseases or infection of the skin at the injection site and near it.

Be wary of prescribing the drug if the patient has lymphostasis and passive hyperemia in the lower extremities. The introduction of hyaluronic acid can lead to an exacerbation of chondrocalcinosis.

Implant application in pediatrics and during pregnancy

At present, there is no reliable data on the safety of the drug for treating children, so you should refrain from prescribing it to patients under 18 years of age.

It is not known what effect the implant has on the embryo and fetus, so it is advisable to refrain from injecting hyaluronate before delivery.

It is not known whether the active substance penetrates into the mother's milk and how it affects the baby, so it is advisable to transfer the baby to artificial feeding for a while.

Undesirable effects of

Most patients with osteoarthrosis of the knee and hip joint who participated in clinical studies, noted experiencing pain, pasty and / or a decrease in the amplitude of joint motion.

All these undesirable reactions were not pronounced, and only some patients needed analgesics or NSAIDs.

No additional adverse reactions to the administration of other agents containing hyaluronic acid have been observed.

The observed side effects were neither acute inflammatory arthritis nor allergy and did not require surgical therapy, systemic or intraarticular administration of glucocorticosteroids or antibacterial agents.

Diagram and application features of

Pharmaceutical Duralan contains a single dose for a single injection.

According to the instructions for use, the following dosages of Duralan are required:

• in the knee, hip or shoulder joint, 3 ml of the drug solution are administered;
• in the intermediate joints( ulnar, ankle) inject 1-2 ml;
• in synovial joints , such as intervertebral, temporomandibular or joints of the fingers, administer only 1 ml.

The duration of treatment is chosen individually depending on the severity of the disease. But should exceed more than 5 injections. Usually the therapeutic effect of substitutions after 3 injections and persists up to 6 months.

How to inject the implant

The injection of the drug can only be done by a specialist who has the appropriate permission, familiar with the technique of introducing funds into the synovial joint.

For this it is necessary: ​​

• to enter the drug is allowed only in a medical institution that is equipped for intraarticular injections;
• to enter a drug is needed only in the joint cavity;
• should be injected in accordance with the rules of asepsis;
• remains in the syringe remnants of pharmaceutical products are not subject to storage;
• it is necessary that no air gets into the syringe;
• to correctly insert a needle and not to damage vital organs in some cases requires control of visualization tools;
• for this purpose use ultrasound and fluoroscopic X-ray examination with contrast agent;
• if, when the implant is inserted into the joint cavity, a pain syndrome is observed, the injection should be stopped;
• before injection the injection site must be treated with an antiseptic and wait until it completely dries;
• as an anesthetic during the procedure it is permissible to use local anesthetics, of course, if they are not allergic;
• if there is an effusion in the joint, it must first be removed;
• remove the effusion and inject the drug through the same needle;
• before administration of the drug, it is necessary to study the composition of the aspiration liquid to exclude bacterial arthritis;
• it is desirable to make injections with needles, whose diameter is 18-22 G;
• if you take smaller needles, then you need to apply more pressure to inject the drug;
• after use, the syringe with the needle is recycled.

At the moment, not one case of drug overdose has been registered.

The drug does not have a sedative effect and does not affect the ability to drive.

Drug interaction

Do not simultaneously enter the drug with other solutions intended for intra-articular injection. Since there is no reliable data proving the safety and effectiveness of their joint use.

It is not allowed to use antiseptic agents containing ammonium salts, since hyaluronic acid is precipitated when interacting with them.

Precautions

Each injection of the drug must be carried out with a separate syringe. It is worth to abandon the injection, if the integrity of the packaging is violated.

As with any invasive procedure at the joint, there is a low risk of infection.

After the drug is injected into the joint, it is necessary to avoid excessive physical exertion during the first 48 hours, such as playing tennis, running, long walks.

The implant should be stored at a temperature of maximum 30 degrees, not allowing it to freeze. The drug is dispensed from the pharmacy strictly according to the doctor's prescription.

Opinion of doctors and patients

From the comments of doctors and patients who were injected with Duralan.

Similar products

The pharmaceutical industry produces the following analogues of Duralan:

• Fermatron;
• Hyaluron;
• Ostenil.

It is permissible to replace the drug Diuralan by analogue only after consulting a doctor.

The preparation has practically no contraindications, it is well tolerated, after treatment a long-term effect persists.