Hyaluronate Sodium
Sodium salt of hyaluronic acid
Also known as: Hyalovet · Hyvisc · Legend · Hylartin-V · Equron · Synacid · Conquer · An-HyPro · ClinaDry · Remend · Hyabak · HyloForte · Hylo-Tear · Vismed Multi · HA · hyaluronan · rooster juice · hyaluronic acid · natrii hyaluronas · Sodium hyaluronate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Adjunctive treatment of synovitis | 3-5 mg | IA | weekly | — | 🌎 NA |
| Keratoconjunctivitis sicca (dry eye) or corneal ulceration | 1-2 drops per eye | Topical | q4h to q12h (or as needed) | As needed | 🌍 EU |
- Adjunctive treatment of synovitis: Use a high molecular weight compound. Administer using sterile technique. Long-term effects are not achieved.
- Keratoconjunctivitis sicca (dry eye) or corneal ulceration: Frequency depends on the severity of the condition and the viscosity of the product.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Keratoconjunctivitis sicca (dry eye) or corneal ulceration | 1-2 drops per eye | Topical | q4h to q12h (or as needed) | As needed | 🌍 EU |
- Keratoconjunctivitis sicca (dry eye) or corneal ulceration: Frequency depends on the severity of the condition and the viscosity of the product.
Small Mammals
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Ocular lubrication / corneal ulceration | 1 drop per eye | Topical | q4h to q12h | As needed | 🌍 EU |
- Ocular lubrication / corneal ulceration: Commonly used in rabbits with exophthalmos or lagophthalmos.
Ferrets
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Ocular lubrication / corneal ulceration | 1 drop per eye | Topical | q4h to q12h | As needed | 🌍 EU |
- Ocular lubrication / corneal ulceration: Frequency depends on the severity of the condition.
Birds
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Ocular lubrication / corneal trauma | 1 drop per eye | Topical | q6h to q12h | As needed | 🌍 EU |
- Ocular lubrication / corneal trauma: Use with care to avoid stressing the bird during frequent handling.
Reptiles
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Ocular lubrication / corneal trauma | 1 drop per eye | Topical | q6h to q12h | As needed | 🌍 EU |
- Ocular lubrication / corneal trauma: Useful for retained spectacles or post-traumatic ulceration.
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Osteoarthritis / Synovitis (Hylartin-V, Hyvisc, Hyalovet) | 20 mg | IA | As directed | — | 🌎 NA |
| Osteoarthritis / Synovitis (Equron) | 10 mg | IA | As directed | — | 🌎 NA |
| Osteoarthritis / Synovitis (Synacid) | 50 mg | IA | As directed | — | 🌎 NA |
| Osteoarthritis / Synovitis (Legend) | 40 mg IV or 20 mg IA | IV/IA | As directed | — | 🌎 NA |
| Reduce joint effusion post-arthroscopic surgery for osteochondritis dissecans (OCD) | 100 mg | PO | once daily | 30 days | 🌎 NA |
- Osteoarthritis / Synovitis (Hylartin-V, Hyvisc, Hyalovet): Check individual product label for specific dosing.
- Osteoarthritis / Synovitis (Equron): Check individual product label for specific dosing.
- Osteoarthritis / Synovitis (Synacid): Check individual product label for specific dosing.
- Osteoarthritis / Synovitis (Legend): Check individual product label for specific dosing.
- Reduce joint effusion post-arthroscopic surgery for osteochondritis dissecans (OCD): Administered as an oral gel (Conquer)
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Hyaluronate sodium (often referred to as hyaluronic acid or HA) is a naturally occurring, high-viscosity mucopolysaccharide found abundantly in the connective tissues, synovial fluid, umbilical cord, and the vitreous humor of the eye. In veterinary medicine, it is primarily utilized for the management of synovitis and osteoarthritis, particularly when not associated with severe degenerative joint disease or full-thickness cartilage loss.
Key Clinical Points:
- Molecular Weight (MW) Variations: Commercially available products vary significantly in molecular weight. High MW products (>1x10^6) are often preferred when synovial adhesions and pannus formation need to be avoided (e.g., post-surgical fragment removal), as they inhibit the proliferation of synovial fibroblasts. Low MW products are generally less expensive and can also effectively ameliorate signs of joint disease.
- Source: Many commercial veterinary HA products are derived from rooster combs, though bio-fermentation sources exist.
- Administration: Primarily administered via intra-articular (IA) or intravenous (IV) injection, though oral gel formulations have shown efficacy in reducing post-operative joint effusion in horses.
Mechanism of action
Hyaluronate sodium provides both mechanical and pharmacological benefits to the diseased joint:
- Mechanical Support: Restores the viscoelastic properties of synovial fluid, providing a cushioning effect and boundary lubrication for articular cartilage.
- Anti-inflammatory Pathway:
- Free Radicals → Scavenged directly by HA molecules, reducing oxidative damage within the joint capsule.
- Prostaglandins → Synthesis and release are suppressed, mitigating local inflammation and pain.
- Cellular Modulation: Reduces the influx of inflammatory proteins and leukocytes into the joint space. Interacts with CD44 receptors on synoviocytes and macrophages to downregulate pro-inflammatory cytokines.
Safety & warnings
Contraindications
- Injection through skin that has been recently fired or blistered
- Injection through skin with excessive scurf or counterirritants
- Use as a substitute for adequate diagnosis (e.g., failing to rule out fractures via radiography)
- Hypersensitivity to hyaluronate or any component of the formulation
Adverse effects
- Local joint flare (heat, swelling, and/or effusion) post-injection
- Increased incidence of flares when combined with other intra-articular drugs
- Mild transient ocular irritation (rare)
- Temporary blurred vision immediately after application (especially with higher viscosity gels)
Precautions
Do not use as a substitute for adequate diagnosis; radiographic examinations should be performed to rule out serious fractures. Strict aseptic technique is mandatory for intra-articular injections. Safe use in breeding animals has not been established, and most manufacturers caution against its use in these populations.
Monitoring
- Resolution of clinical signs (lameness, joint effusion)
- Injection site for signs of local reaction (heat, swelling, pain) within 24-96 hours post-injection
- Resolution of clinical signs (e.g., blepharospasm, conjunctival hyperemia)
- Corneal ulcer healing via fluorescein staining
- Schirmer tear test (STT) for dry eye management
Pharmacokinetics
Half-life
Absorption
Intra-articular administration provides immediate local effects. Oral formulations have demonstrated clinical efficacy in reducing joint effusion, suggesting adequate bioavailability or systemic signaling.
Distribution
Naturally concentrates in synovial fluid, the vitreous of the eye, and the umbilical cord.
Metabolism
Degraded locally within the joint space and systemically via hepatic pathways.
Elimination
Cleared from the synovial fluid into the systemic circulation before final excretion.
Overdose
Acute toxicology studies performed in horses have demonstrated no systemic toxicity associated with overdoses.
Available products
Formulations
- Intra-articular (IA) injection
- Intravenous (IV) injection
- Oral gel
- Ophthalmic solution: 0.1%, 0.15%, 0.2%, 0.4% in 10 ml bottle
- Ophthalmic gel: 0.4% and 0.75% Hyasent-S (modified, cross-linked hyaluronic acid) in Remend products
Veterinary
- Hyalovet: 20 mg/mL in 2 mL disposable syringes
- Legend: 2 mL vial for IA administration; 4 mL & 20 mL vials for IV administration
- Hyvisc: 11 mg/mL in 2 mL syringes
- Hylartin V: 10 mg/mL in 2 mL disposable syringes
- Conquer Equine Gel: 10 mg/mL (100 mg/10 mL) oral gel
- An-HyPro
- ClinaDry
- Remend Corneal Lubricant
- Remend Corneal Repair Gel
Human-labeled
- Hyabak
- HyloForte
- Hylo-Tear
- Vismed Multi
Regulatory status
Often classified as a Pharmacy (P) medicine or general sales list depending on the specific product and country.
Some human products are Pharmacy (P) medicines; veterinary products like Remend are widely available.
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at room temperature or refrigerate depending on the specific product used (always check the label). Do not freeze. Protect from light.
Client information
Important: Injectable forms of this medication must be administered exclusively by a veterinarian using strict sterile techniques to prevent joint infections.
- What to Expect: It is relatively common for animals to experience a temporary "joint flare" (mild heat, swelling, or fluid buildup in the joint) after an injection. This typically resolves on its own within 24 to 48 hours, though occasionally it may take up to 4 days.
- Oral Supplements: If your veterinarian has prescribed an oral gel (like Conquer), administer it exactly as directed. It is often used to help reduce joint swelling after certain types of orthopedic surgeries.
- Safety: This medication is very safe systemically, but let your veterinarian know if your animal is intended for breeding, as its safety in pregnant animals has not been fully established.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.