Comprehensive medication guide to Monovisc including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$100–$350 estimated patient copay/coinsurance with commercial insurance after prior authorization approval; Medicare Part B patients pay 20% coinsurance after the annual Part B deductible, typically $300–$400 out of pocket. Many commercial plans require prior authorization and some classify Monovisc as non-preferred.
Estimated Cash Pricing
$1,521–$2,047 retail for one syringe (4 mL / 88 mg) without insurance; coupons through SingleCare and GoodRx can reduce the cost to approximately $1,469. Total procedure cost (including provider administration fee) ranges from $955 to $2,291 depending on provider and location.
Medfinder Findability Score
62/100
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Monovisc is a single-injection viscosupplement used to treat pain caused by knee osteoarthritis (OA). It contains high molecular weight, cross-linked sodium hyaluronate — a form of hyaluronic acid (HA) derived from bacterial fermentation — delivered as a single 4 mL intra-articular injection. Monovisc is manufactured by Anika Therapeutics, Inc. and distributed in the U.S. by DePuy Synthes (Johnson & Johnson).
The FDA cleared Monovisc as a Class III medical device (PMA P090031) in 2014 — not as a traditional drug. It is approved for adults 21 years of age and older who have knee OA and have not responded adequately to conservative non-pharmacologic therapy and simple analgesics. With a single injection delivering 88 mg of HA (the highest single-injection dose available in the U.S.), Monovisc may provide pain relief lasting up to 6 months.
Unlike most prescriptions, Monovisc is not dispensed at retail pharmacies. It is ordered by physician offices (orthopedic surgeons, rheumatologists, sports medicine specialists) from specialty distributors and administered in a clinical setting. As of 2026, there is no FDA-approved generic equivalent to Monovisc.
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Monovisc works through a process called viscosupplementation — supplementing the degraded hyaluronic acid in an arthritic knee with an exogenous, high-quality HA preparation. In a healthy knee, synovial fluid is rich in high molecular weight hyaluronic acid (2–4 million Daltons), which provides the fluid's lubricating and shock-absorbing properties. In osteoarthritis, both the concentration and molecular weight of HA in synovial fluid decline significantly, leading to thin, watery fluid that no longer protects the joint adequately.
When injected into the knee joint, Monovisc's cross-linked HA (1–2.9 million Daltons, 22 mg/mL) integrates with the existing synovial fluid, restoring its viscoelastic properties. The cross-linking technology — developed by Anika Therapeutics — creates a three-dimensional HA mesh that is more mechanically robust and more resistant to enzymatic degradation than non-cross-linked HA, extending its residence time in the joint and contributing to the potential 6-month duration of effect.
The mechanism is not simply mechanical. Research suggests that hyaluronic acid may also interact with receptors on synovial cells and chondrocytes, potentially modulating the inflammatory environment and offering some degree of chondroprotection. These effects take time to develop — most patients notice meaningful pain relief 2–4 weeks after injection, with maximum benefit at 4–8 weeks.
88 mg / 4 mL (22 mg/mL) — intra-articular injection (pre-filled syringe)
Single intra-articular injection administered by a trained healthcare provider directly into the knee joint. Uses an 18–20 gauge needle. One syringe per treatment course; may be repeated every 6 months.
Finding Monovisc is moderately challenging — not because of a formal shortage, but due to the specialty nature of its distribution. As of 2026, there is no FDA-declared shortage of Monovisc. The product is manufactured by Anika Therapeutics and available through specialty medical distributors nationwide. However, it is classified as non-preferred by major insurers including Aetna and many BCBS plans, which reduces the number of provider offices that actively stock it.
Unlike retail medications, Monovisc is not found at pharmacies — it is ordered and administered by physician offices. A provider near you may use a different viscosupplement brand (Synvisc-One, Durolane, Euflexxa) exclusively, simply because that's what they stock by default or what their insurance contracts favor. This creates a real but navigable access challenge.
The fastest way to find a provider near you who stocks Monovisc is to use medfinder, which calls providers on your behalf and texts you the results. Commercial insurance patients should verify prior authorization requirements with their plan before scheduling. Medicare Part B covers Monovisc using J-code J7327.
Monovisc is a prescription-only medical device that requires administration by a trained healthcare provider. It is not a controlled substance, so there are no DEA scheduling requirements for prescribers — any licensed practitioner with appropriate training can prescribe and administer it within their scope of practice.
Orthopedic surgeons — most commonly prescribe and administer viscosupplements for knee OA
Rheumatologists — specialists in arthritis and joint disease; frequently use HA injections
Sports medicine physicians — routinely perform intra-articular injections
Primary care physicians — some with musculoskeletal training; less common
Nurse practitioners and physician assistants — can administer Monovisc within applicable state scope-of-practice law, typically within an orthopedic or rheumatology practice
Telehealth visits can be used for initial evaluation, prescription generation, and follow-up. The injection itself must be administered in person at a clinical facility by a provider with appropriate injection training. Finding a provider near you who stocks Monovisc can be accomplished quickly using medfinder.
No. Monovisc is not a controlled substance and is not scheduled by the DEA. It is classified by the FDA as a Class III medical device (PMA P090031) rather than a traditional pharmaceutical drug. It does not have abuse potential, does not require DEA registration by the prescriber, and has no restrictions on the number of refills.
Monovisc is a prescription-only medical device — federal law restricts it to sale by or on the order of a licensed practitioner. But these are medical practice restrictions, not Schedule II-V controlled substance regulations. Patients do not need to worry about controlled substance dispensing rules, early refill restrictions, or pharmacy monitoring programs in connection with Monovisc.
Monovisc is generally well-tolerated. Most side effects are mild, localized to the injection site, and resolve within 1–3 days. Common side effects include:
Joint pain and swelling at the injection site (very common, resolves in 1–3 days)
Warmth or heat around the knee joint
Temporary stiffness in the injected knee
Redness or bruising at the needle entry site
Rash, itching, headache, dizziness, chills (less common)
Allergic reaction: Hives, difficulty breathing, swelling of face/lips/tongue/throat — seek emergency care
Signs of infection: Fever, chills, worsening redness, warmth — contact your provider immediately
Severe or worsening joint pain: Pain that worsens significantly beyond 3 days post-injection — should be evaluated
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Synvisc-One (hylan G-F 20)
Single-injection viscosupplement; avian-derived; 6 mL per injection; widely preferred by commercial insurers including Aetna; clinically comparable to Monovisc
Durolane (sodium hyaluronate)
Single-injection; non-avian; 3 mL per injection; preferred by Aetna and many BCBS plans; does not require prior authorization when preferred status applies
Euflexxa (1% sodium hyaluronate)
Three-injection series (weekly x3); non-avian; excellent Medicare and commercial coverage; lower cost per injection than single-injection products
Orthovisc (sodium hyaluronate)
Three to four injection series; non-avian; same manufacturer as Monovisc (Anika Therapeutics); clinically closest multi-injection equivalent to Monovisc
Corticosteroid injections
Faster onset (days) but shorter duration (4–12 weeks); reduces inflammation rather than adding lubrication; widely covered; useful bridge therapy while awaiting Monovisc authorization
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Quaternary ammonium disinfectants (e.g., benzalkonium chloride)
moderateCan cause precipitation of hyaluronate — do NOT use quaternary ammonium-based skin disinfectants for injection site preparation. Use povidone-iodine or chlorhexidine gluconate instead.
Anticoagulants (warfarin, apixaban, rivaroxaban, dabigatran)
moderateIncreased bleeding risk at injection site. Discuss timing and safety with provider before injection. May require temporary dose adjustment with prescriber's guidance.
Antiplatelet agents (clopidogrel, high-dose aspirin, ticagrelor)
moderateImpaired platelet function increases injection site bleeding risk. Discuss with provider before scheduling injection.
Intra-articular corticosteroids (same joint, same visit)
minorCombined use in same joint at same visit is not standard; some evidence supports combination but requires specific medical necessity documentation and insurer approval.
Monovisc offers a compelling option for knee osteoarthritis patients who have not responded to conservative treatment: a single injection delivering the maximum available HA dose, derived from a non-avian, bacterially fermented source, with a strong clinical safety record and potential for up to 6 months of pain relief. Its single-injection convenience is a meaningful advantage for patients who find multi-visit series burdensome.
The primary challenges with Monovisc are financial and administrative rather than clinical. At $1,521–$2,047 per syringe without insurance, it is expensive. Many commercial insurers classify it as non-preferred, requiring prior authorization and potentially step therapy. Understanding these hurdles ahead of time — and working proactively with your provider to address them — is the key to timely access.
If you've been prescribed Monovisc and need help finding a provider who has it in stock near you, medfinder calls providers near you to find out who can fill your prescription, then texts you the results. It's the fastest way to get from prescription to injection without wasting time on hold.
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