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Frequently Asked Questions

1. What is FLEXISEQ™?
Flexiseq is an innovative topical gel applied to joints affected by osteoarthritis (OA).

Flexiseq lubricates the cartilage in joints to relieve pain and stiffness and improve impaired joint function associated with all stages of osteoarthritis.

Flexiseq contains tiny lipid spheres called Sequessome vesicles suspended in the gel which are capable of passing through the skin.

2. Where can I purchase FLEXISEQ™?

You can purchase Flexiseq right here via the Australian website – Buy Flexiseq now.

3. How much does FLEXISEQ™ cost?
The price of Flexiseq will vary in different countries so please contact your local stockist or refer to the “How to Buy Flexiseq” section.

4. How does FLEXISEQ™ work?
FLEXISEQ™ is a topical gel that relieves pain and stiffness associated with osteoarthritis (OA). FLEXISEQ™ exerts its pain-relieving effect via lubrication of the joint which is a physical mode of action. It has no pharmacological, metabolic or immunological activity.

FLEXISEQ™ is a gel containing Sequessome™ vesicles, which are tiny phospholipid spheres. As the gel dries on the skin, these spheres change their shape and pass through the skin, then on into the joint where they lubricate the surface of the cartilage to provide relief from pain and stiffness.

Phospholipids are naturally occurring substances in the body and are known to have numerous functions, including lubrication of articulating cartilage. Patients with joint disorders such as OA have been found to have reduced levels of phospholipids in their synovial fluid and this is one of the factors contributing to the pain and loss of joint function in patients with OA.

Research has shown that following topical application of FLEXISEQ™, the Sequessome™ vesicles pass through the skin and penetrate the synovial fluid within the joint where they collect on cartilage surfaces. The physical properties of the Sequessome™ vesicles make them particularly efficient at lubricating.

5. What are the commonly reported side effects?
FLEXISEQ™ is a topical treatment and the side effects most commonly reported for FLEXISEQ™ are mild or moderate skin irritations with rash, dry skin and erythema (redness) being the most commonly reported events. The majority of the skin irritations reported were temporary and minor and will resolve over time without stopping treatment.

The extensive clinical programme and market experience demonstrates the safety of FLEXISEQ™. There have been over 6 million applications of the product in early markets and, unlike other routinely used oral and topical treatments, there have been no reported incidences of systemic side effects (such as heart attacks, strokes and gastro-intestinal problems linked to NSAIDs) related to the use of FLEXISEQ.

6. How should I apply the gel?
FLEXISEQ™ should be applied twice daily to the affected joint, usually in the morning and the evening. Use enough gel to evenly cover the soft tissue around the joint.

For the knee: a twice daily dose of 2.2 g corresponding to approximately 7 cm line of gel as squeezed from the tube is recommended. The gel should not be applied to the patella (knee cap) and should include the area at the back of the knee. FLEXISEQ™ must be allowed to dry before covering; drying should take no longer than 10 minutes if the product is applied to clean, dry skin. If drying takes longer than this, ensure that the skin is dry (for example if applying after a bath or shower) and try using a little less gel. Alternatively a hair dryer [on a low / cool setting] can be used to speed up the drying time. If the drying time is considerably less than 10 minutes then a little more gel can be used next time. Please wash your hands after applying the gel.

For the hip: Locate the edge of your pelvis (or hipbone) at your side and apply the gel approximately two inches below where you can no longer feel bone but soft tissue. Do not spread towards the buttocks but instead towards your centre line. It is difficult to give precise dosing amounts for the hip as the size of this joint can vary widely from patient to patient. If you consider yourself to be of average weight, use approximately 3 g (approximately 10 cm line of gel as squeezed from the tube) to cover an area of approximately the size of your hand. If you believe you are above average size, you may need to apply a little more. You will know if you have applied the correct amount as it should take around 10 minutes to dry. For the first few applications the amount applied may need to be increased or decreased to achieve a 10 minute drying time. Alternatively a hair dryer [on a low / cool setting] may be used gently to dry the area. In order to achieve optimum effect, FLEXISEQ™ gel should be applied twice daily to the whole affected joint, not rubbed in but left to dry. The joint should not be covered until the gel has completely dried. Please wash your hands after applying the gel.

For the shoulder: It is difficult to give precise dosing amounts for the shoulder as the size of this joint and location of the pain varies from patient to patient. If you consider yourself to be of average weight, use approximately 2.2 g corresponding to approximately 7 cm line of gel as squeezed from the tube to cover the area corresponding to the location of your pain. If you believe you are above average size, you may need to apply a little more. You will know if you have applied the correct amount as it should take around 10 minutes to dry (although may remain tacky after this time). Alternatively a hair dryer [on a low / cool setting] may be used gently to dry the area. For the first few applications the amount applied may need to be increased or decreased to achieve a 10 minute drying time. In order to achieve optimum effect, FLEXISEQ™ gel should be applied twice daily to the whole affected joint, not rubbed in but left to dry. The joint should not be covered until the gel has completely dried. Please wash your hands after applying the gel.

7. What should I do if the product is applied incorrectly?
FLEXISEQ™ has an excellent tolerability and safety profile.

a. If too much gel has been applied – there are no safety issues with applying too much gel. It will simply take longer for all of the gel to dry off. You can wipe off excess gel and apply less the next time. As a general guidance it should not take longer than 10 minutes for the gel to dry off completely.

b. If gel has entered the eyes – as with most topical treatments, you should avoid allowing the gel to enter the eyes. If gel does enter the eyes, they should be rinsed with plenty of cold water. If excessive stinging/symptoms occur, please consult a pharmacist or doctor.

c. If gel has been eaten –the gel should not be taken orally, but if it has been ingested, it should not cause major problems. As with other medical products, care should be taken to store it out of reach of children. If symptoms occur, please consult a pharmacist or doctor.

As with all treatments, if you have any concerns, please consult a doctor or pharmacist.

8. What is the evidence that the Sequessome™ vesicles get into the joint?
A study using fluorescent labelled Sequessome™ vesicles demonstrated that following topical application of FLEXISEQ™, they pass through the skin, penetrate the synovial fluid within the joint and collect on cartilage surfaces.

9. How quickly does FLEXISEQ™ work?
Twice-daily treatment with FLEXISEQ™ provides pain relief after as little as 2 days (the earliest measured timepoint in clinical trials), which is comparable with the onset of sustainable pain relief to other OA therapies. It may take up to 14 days for the full effect to be seen.

10. How long can I use FLEXISEQ™ for?
The clinical evidence is from studies ranging from 6 to 52 weeks and showed excellent safety and tolerability throughout these periods. Given the physical action of FLEXISEQ™ and the excellent safety and tolerability data, there is no reason to advise a maximum duration of treatment. In addition, since the launch of FLEXISEQ™ over 12 months ago there have now been over 6 million applications of the product in early markets and, unlike other oral and topical treatments, there have been no reported incidences of systemic side effects related to the use of FLEXISEQ. This lack of systemic exposure also makes FLEXISEQ™ safe to use alongside any other therapy.

11. How long does the pain relief last once treatment is stopped?
As above. FLEXISEQ™ works by delivery of lubricating vesicles into the joint. These vesicles are made of naturally occurring phospholipids and will be broken down over time and will need replacing. Therefore patients will need to continue to use FLEXISEQ™ in order to maintain efficacy.

12. Can FLEXISEQ™ be used alongside medications?
FLEXISEQ™ does not contain any active pharmaceutical ingredients and therefore cannot compromise any existing oral medications, such as low-dose aspirin, paracetamol, diuretics. If you have any specific concerns, a pharmacist or doctor should be consulted.

13. Is FLEXISEQ™ as effective on other joints as it is on the knee?
FLEXISEQ™ is registered for treatment of all joints affected by OA. The joints affected by OA, such as the knee, the hip, the hand, the elbow, etc., are all synovial joints and it is understood that any pain-reducing treatment would benefit a joint with OA, regardless of its location. In addition, a study of a gel containing a similar phospholipid vesicle found that the gel was effective for reducing OA pain in several different types of joints, including the knee, hand, hip and shoulder, and there were no differences in effectiveness between the indications.

14. I have not received any beneficial effect from FLEXISEQ™ – why?
No treatment will work for all patients. However, before it is assumed that you are one of those for whom this treatment does not work, please check that:

a) You are applying the treatment correctly (see question 6) – the product will not be effective if under-dosed or if you are covering the treated area too soon
b) treatment has been ongoing for long enough for an effect to be seen (we recommend 4 weeks although an effect will usually be seen sooner; some patients may take longer)
c) the pain or other symptom being treated is caused by OA and not another unrelated condition
If you are using the gel correctly and not receiving benefit, then unfortunately it may simply not be the treatment for you.

15. Where is FLEXISEQ™ manufactured?
FLEXISEQ™ is manufactured in Germany.