Hyaluronidase Injection

Hyaluronidase is a prescription medication used together with fluids to treat dehydration and is also used to help contrast dyes in the body show more clearly on certain types of x-rays or scans .

• Hyaluronidase is available under various brand names: Amphadase, Hydase, Hylenex, Vitrase, Wydase 

Common side effects of Hyaluronidase include:

• pain, 
• swelling, 
• itching, or redness where the injection was given

Serious side effects of Hyaluronidase include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• chills,
• fast or irregular heartbeat,
• lightheadedness,
• loss of coordination,
• nausea,
• vomiting, and
• swelling at the in

Rare side effects of Hyaluronidase include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors.
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Injectable solution

• 150 unit/mL
• 200 unit/mL

Skin Test

Adult dosage and dosage

• 0.02 mL (3 units) of 150 units/mL solution intradermally; a wheal with pseudopods appearing within 5 min and persisting for 20-30 min with itching will indicate a positive hypersensitivity reaction

Extravasation

Adult dosage

• Indicated to absorb and disperse injected drugs to treat extravasation
• Add 50-300 units (typically 150 units) to the injection solution

Hypodermoclysis

Adult dosage

• Amphadase/Hylenex: Inject 150 units before subcutaneous fluid administration; this will facilitate absorption of 1000 mL or more of solution
• Vitrase: Inject 200 units before subcutaneous fluid administration; this will facilitate absorption of 1000 mL or more of solution

Pediatric dosage

• Children above 3 years: May be added to small volumes of solution (up to 200 mL), such as or solutions of drugs for subcutaneous injection
• Infants and children below 3 years: The volume of a single class should be limited to 200 mL
• For premature infants or during the neonatal period: Do not exceed a daily dosage of 25 mL/kg of body weight; the rate of administration should not be greater than 2 mL/min

Adjunct Subcutaneous Urography

Adult dosage

• Improves resorption of radiopaque agents; indicated when intravenous administration cannot be accomplished with the patient prone
• Inject 75 units subcutaneous over each scapula, followed by injection of the contrast medium at the same sites

Pediatric dosage

• Used when Intravenous administration cannot be accomplished, particularly in infants and small children, with the patient prone
• Inject 75 units subcutaneous over each scapula, followed by injection of the contrast medium at the same site

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Hyaluronidase has severe interactions with no other drugs.
• Hyaluronidase has serious interactions with the following drugs:
  • beclomethasone, inhaled
• Hyaluronidase has moderate interactions with at least 46 other drugs.
• Hyaluronidase has minor interactions with the following drugs:
  • bupivacaine
  • mepivacaine
  • prilocaine
  • ropivacaine

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• You should not be treated with hyaluronidase if you are allergic to it.
• Your doctor may perform a skin test to see if you are allergic to hyaluronidase before you receive the medication.
• Some medicines can cause unwanted or dangerous effects when used with hyaluronidase. Your doctor may change your treatment plan if you also use:
• furosemide (Lasix).
• phenytoin (Dilantin).
• a sedative or anxiety medication (such as diazepam, lorazepam, alprazolam, Valium, Xanax, Ativan, Tranxene, and others).
• aspirin or salicylates.
• cortisone or ACTH (Corticotropin).
• estrogens; or
• an antihistamine (such as a cold or allergy medicine).

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Hyaluronidase?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Hyaluronidase?”

Cautions

• Serious drug interactions can occur when certain medicines are used together with hyaluronidase. Tell your doctor about all your current medicines.
• Serious drug interactions can occur when certain medicines are used together with hyaluronidase. Tell your doctor about all your current medicines.

Pregnancy and Lactation

• Tell your doctor if you are pregnant.
• Human studies of hyaluronidase as an aid to conception and as an aid to delivery were conducted without reports of maternal or fetal harm; non-human animal reproduction studies were not conducted
• Hyaluronidase has been used as a component to aid the in vitro fertilization of human eggs; administration of hyaluronidase during labor was reported to cause no complications; no increase in blood loss or differences in cervical trauma were observed
• Lactation
  • It may not be safe to breastfeed while using this medicine. Ask your doctor about any risks.
  • There is no information regarding the presence of drugs in human milk, effects on breastfed infants, or on milk production to inform the risk of drugs to an infant during lactation; developmental and health benefits of breastfeeding should be considered, along with the mother’s clinical need for therapy, and any potential adverse effects on the breastfed infant from the drug.