hyaluronidase: clinical use

Prescribing considerations

• Confirm that tissue dispersal is clinically intended; localisation may be preferable for some extravasated substances.
• For subcutaneous fluids, use an appropriate isotonic solution and control fluid volume and administration speed, particularly in young children, older people and renal impairment.
• Assess compatibility with every co-administered medicine or fluid.
• The aesthetic dissolution of hyaluronic-acid filler is non-licensed and requires competence in recognising vascular compromise and managing anaphylaxis.

Contraindications and cautions

• Hypersensitivity to hyaluronidase.
• Intravenous administration.
• Use for swelling caused by bites or stings.
• Administration at infected or malignant sites.
• Direct application to the cornea.
• Anaesthetic procedures during unexplained premature labour.

Monitoring

• Observe for immediate or delayed hypersensitivity, including anaphylaxis.
• Monitor the injection or extravasation site for pain, swelling, bruising, bleeding, infection and tissue changes.
• During subcutaneous fluid administration, monitor fluid balance and signs of overhydration.

Clinical pharmacology

Hyaluronidase temporarily and reversibly depolymerises hyaluronic acid in connective tissue, increasing local permeability and facilitating dispersion and absorption. Product-specific pharmacokinetic data are not provided.

Formulation and product differences

• The selected product is a sterile, freeze-dried powder for injection or infusion in a single-use glass ampoule.
• No excipients are listed.
• The solution must be prepared immediately before use and discarded after use.