Hyaluronidase – Uses, Dosage, Side Effects, Interaction

Contraindications

• Hyaluronidase hypersensitivity.
• Extravasation, intravenous administration.
• Ocular exposure, ocular surgery.
• Infection?.
• Children, hypervolemia, infants.
• Pregnancy.
• Breast-feeding.
• Viral? infection?.

Dosage?

Strengths: 150 units; 1500 units; 150 units/mL; human recombinant 150 units/mL; 200 units/mL; 6200 units

Hypodermoclysis

• After inserting the needle, begin clysis with the tip of the needle lying free and movable between the skin and muscle. The fluid should start in readily without pain? or lump. Then hyaluronidase should be injected into the rubber tubing close to the needle.
• Alternate method: Inject hyaluronidase under the skin before clysis. 150 to 200 units will facilitate the absorption of 1000 mL or more of the solution.
• The dose, rate of injection, and type of solution should be individualized; the rate of infusion and volume of administration should not exceed those used for intravenous infusion.
• Hypovolemia may occur if electrolyte-free solutions are given.
• Adding adequate quantities of electrolytes and/or controlling the volume and rate of administration will prevent hypovolemia.

Subcutaneous Urography

• With the patient prone, inject 75 Units subcutaneously over each scapula, followed by injection of contrast medium at the same sites

Hypodermoclysis

After inserting the needle, begin clysis with the tip of the needle lying free and movable between the skin and muscle. The fluid should start in readily without pain? or lump. Then hyaluronidase should be injected into the rubber tubing close to the needle.

Alternate method: Inject hyaluronidase under the skin before clysis. 150 to 200 units will facilitate the absorption of 1000 mL or more of the solution.

Under 3 years of age:

• Limit the volume of a single class to 200 mL

Premature Infants or During the Neonatal Period:

• Maximum daily dosage?: 25 mL/kg of body weight
• The maximum rate of administration: 2 mL/minute
• The dose, rate of injection, and type of solution should be individualized; the rate of infusion and volume of administration should not exceed those used for intravenous infusion.
• Hypovolemia may occur if electrolyte-free solutions are given.
• Adding adequate quantities of electrolytes and/or controlling the volume and rate of administration will prevent hypovolemia.

Pediatric Dose for Subcutaneous Urography

• With the patient prone, inject 75 Units subcutaneously over each scapula, followed by injection of contrast medium at the same sites
• As an adjuvant in subcutaneous urography for improving the resorption of radiopaque agents

Administration advice:

• Do not give intravenously
• For infiltration, interstitial, intramuscular, intraocular, peribulbar, retrobulbar, soft tissue, or subcutaneous use.

Side Effects

The Most Common

• constipation?
• diarrhea?
• vomiting?
• nausea?
• stomach pain?
• loss of appetite
• tiredness
• pain? in the head or upper neck. সহজ বাংলা: মাথাব্যথা।" data-rx-term="headache" data-rx-definition="Headache means pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।">headache?
• difficulty falling asleep or staying asleep
• pain?, burning, or tingling in the hands or feet
• swelling? of the hands, ankles, or feet
• pain?: Back pain means pain in the spine, muscles, discs, joints, or nerves of the back. সহজ বাংলা: পিঠ/কোমরের ব্যথা।" data-rx-term="back pain" data-rx-definition="Back pain means pain in the spine, muscles, discs, joints, or nerves of the back. সহজ বাংলা: পিঠ/কোমরের ব্যথা।">back pain?
• muscle spasms
• itching, swelling?, bruising, or redness of the skin at the injection site
• unusual bruising or bleeding
• pale skin, fatigue?, or shortness of breath
• fever?, cough, or other signs of infection?
• yellow eyes or skin; dark urine; or pain? or discomfort in right upper stomach area
• chest pain?, feeling faint, swollen legs, or shortness of breath (especially if you are being treated for amyloidosis)

More Common

• Blurred vision
• swelling? in your hands, feet, or other body areas; or
• pain?, swelling?, itching, or redness where the injection was given.
• chills
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast, pounding, or irregular heartbeat or pulse
• nausea? or vomiting?
• redness of the skin
• sweating
• swelling?
• unusual tiredness or weakness?
• unusually warm skin

Rare

• Cough
• difficulty swallowing
• dizziness
• fast heartbeat
• hives or welts
• itching
• large, hive-like swelling? on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness of the skin
• skin rash
• tightness in the chest
• unusual tiredness or weakness

Drug Interaction

Pregnancy and Lactation

AU TGA pregnancy category: Exempt
US FDA pregnancy category: Not assigned

Pregnancy

Medications exempted from pregnancy classification are not absolutely safe for use in pregnancy in all circumstances. Some exempted medicines, for example, the complementary medicine, St John’s Wort, may interact with other medicines and induce unexpected adverse effects in the mother and/or fetus.

Lactation

Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for this medication as well as any potential adverse effects from this drug or the underlying maternal condition.

References