Cingal, 4 ml, Anika Therapeutics

Properties:
CINGAL® is the first and only approved viscosupplement, combined formula, which offers the benefit of a highly cross-linked hyaluronic acid and a fast-acting steroid anti-inflammatory.
CINGAL® is designed for administration in a single injection, which consists of a steroid anti-inflammatory (triamcinolone hexacetonide TH) and a highly cross-linked hyaluronic acid, with a high molecular weight (HA).

How to use:
Cingal® is injected into the chosen intra-articular space through a sterile, single-use hypodermic needle of appropriate caliber. The sterile needle must be attached to the Cingal® syringe by a medical professional, using the aseptic technique approved by the health facility. The recommended gauge of needles for knee injections is 18-21 G. The final choice of needle for any procedure is determined by the doctor. The medical staff must ensure adequate penetration of the needle into the synovial space of the joint before injecting Cingal®.

Ingredients:
Component Nominal quantity (%)
Sterile water for injection QS
Crosslinked HA 2.20%
Dibasic sodium phosphate 0.15%
Sodium phosphate monobasic, monohydrate 0.03%
Triamcinolone hexacetonide 0.45%
Polysorbate 80 0.22%
Sorbitol 5.30%
Total 100.00%

Precautions:
We recommend those precautions that must be taken into account during the injection of any substance into the joints.
- proper examination of any joint fluid present is necessary to rule out a septic process
- for this application, it is recommended to inject Cingal® only by medical personnel trained in the accepted injection techniques for the administration of substances in joint spaces.
- excessive filling of the synovial space is prohibited. For small joints, such as the hands, no more than 1 ml is needed.
- if the pain intensifies during the injection procedure, the injection will stop and the needle will be withdrawn.
- a sharp increase in pain, accompanied by local inflammation, additional restriction of joint movement, fever and indisposition suggests septic arthritis. If this complication occurs and the diagnosis of septicemia is confirmed, appropriate antimicrobial therapy will be instituted.
- single use only; reusing the contents of the syringe can lead to infections and can increase the occurrence of adverse events.

Presentation:
A dose of 4 ml