Hyaluronidase is an injectable enzyme with potential adjuvant activity. Upon subcutaneous administration, hyaluronidase modifies the permeability of connective tissue by hydrolyzing hyaluronic acid. This temporarily decreases interstitial viscosity and allows drugs that are co-injected to spread rapidly through the interstitial space, thereby facilitating absorption and/or distribution of the co-injected agents.
Hyaluronidase is an enzyme used to improve the absorption and dispersion of parenterally administered fluids, drugs, and contrast agents. The action of hyaluronidase was first described in 1936 and named in 1939. Early research into hyaluronidase identified it as a “spreading factor” that allowed for increased permeability of the connective tissue. Hyaluronidase has been used in surgical settings for at least the past 60 years to improve the diffusion of local anesthetics. Hyaluronidase was first used in prescription products in the United States on 5 May 2004.
An enzyme that catalyzes the random hydrolysis of 1,4-linkages between N-acetyl-beta-D-glucosamine and D-glucuronate residues in hyaluronate. (From Enzyme Nomenclature, 1992) There have been used as ANTINEOPLASTIC AGENTS to limit NEOPLASM METASTASIS.
Hyaluronidase is an enzyme used to improve the absorption and dispersion of parenterally administered fluids, drugs, and contrast agents. The action of hyaluronidase was first described in 1936 and named in 1939. Early research into hyaluronidase identified it as a “spreading factor” that allowed for increased permeability of the connective tissue.[rx] Hyaluronidase has been used in surgical settings for at least the past 60 years to improve the diffusion of local anesthetics.[rx]
Hyaluronidase was first used in prescription products in the United States on 5 May 2004.
Mechanism of Action
Hyaluronidase cleaves hyaluronic acid at the glucosaminidic bond between C1 of glucosamine and C4 of glucuronic acid. Hyaluronic acid is a key component of the extracellular matrix. Injection of hyaluronidase with other fluids, drugs, or radiopaque agents improves the ability of these other compounds to permeate the extracellular space more easily.
Indications
- Hyaluronidase is indicated for subcutaneous fluid administration for hydration and increasing resorption of radiopaque agents in subcutaneous urography. Hyaluronidase is also indicated by multiple routes to increase the dispersion of other injectable drugs.
- Hyaluronidase is indicated for subcutaneous fluid administration for hydration and increasing resorption of radiopaque agents in subcutaneous urography. Hyaluronidase is also indicated by multiple routes to increase the dispersion of other injectable drugs.
- As an adjuvant in subcutaneous fluid administration (hypodermoclysis) for achieving hydration.
- As an adjuvant in subcutaneous urography for improving the resorption of radiopaque agents
- Hyaluronidase is an enzyme used to improve the absorption and dispersion of parenterally administered fluids, drugs, and contrast agents
- Parenteral rehydration therapy
- Parenteral drug administration
- Subcutaneous urography
FDA Approved Indications
- Absorption and dispersion enhancer of injected drugs
- Subcutaneous fluid administration for hydration therapy – hypodermoclysis
- Subcutaneous urography to improve absorption of radiopaque agents
Non-FDA Approved Uses
- Extravasation of medications from intravenous lines management
- Adjunct to local anesthetic eye blocks for ophthalmic surgery
- Keloid scar treatment – involves cryosurgery followed by injections with hyaluronidase, triamcinolone, and 5-fluorouracil
- Reversing cosmetic facial fillers composed of hyaluronic acid
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
- headache
- difficulty falling asleep or staying asleep
- pain, burning, or tingling in the hands or feet
- swelling of the hands, ankles, or feet
- 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
| DRUG | INTERACTION |
|---|---|
| 1,2-Benzodiazepine | The therapeutic efficacy of 1,2-Benzodiazepine can be decreased when used in combination with Hyaluronidase. |
| Acetylsalicylic acid | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Acetylsalicylic acid. |
| Amitriptyline | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Amitriptyline. |
| Antazoline | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Antazoline. |
| Aripiprazole | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Aripiprazole. |
| Aripiprazole lauroxil | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Aripiprazole lauroxil. |
| Articaine | Hyaluronidase can cause an increase in the absorption of Articaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Azelastine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Azelastine. |
| Benzatropine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Benzatropine. |
| Benzocaine | Hyaluronidase can cause an increase in the absorption of Benzocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Benzyl alcohol | Hyaluronidase can cause an increase in the absorption of Benzyl alcohol resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Betamethasone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Betamethasone. |
| Betamethasone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Betamethasone phosphate. |
| Bethanidine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Bethanidine. |
| Brompheniramine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Brompheniramine. |
| Bupivacaine | Hyaluronidase can cause an increase in the absorption of Bupivacaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Butacaine | Hyaluronidase can cause an increase in the absorption of Butacaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Butamben | Hyaluronidase can cause an increase in the absorption of Butamben resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Butriptyline | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Butriptyline. |
| Cetirizine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Cetirizine. |
| Chloroprocaine | Hyaluronidase can cause an increase in the absorption of Chloroprocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Chlorpheniramine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Chlorpheniramine. |
| Chlorpromazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Chlorpromazine. |
| Cimetidine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Cimetidine. |
| Cinchocaine | Hyaluronidase can cause an increase in the absorption of Cinchocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Clemastine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Clemastine. |
| Clobetasol propionate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Clobetasol propionate. |
| Clonazepam | The therapeutic efficacy of Clonazepam can be decreased when used in combination with Hyaluronidase. |
| Clonidine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Clonidine. |
| Conjugated estrogens | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Conjugated estrogens. |
| Corticotropin | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Corticotropin. |
| Cortisone acetate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Cortisone acetate. |
| Cyclizine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Cyclizine. |
| Dexamethasone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Dexamethasone. |
| Dexamethasone acetate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Dexamethasone acetate. |
| Dexmedetomidine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Dexmedetomidine. |
| Diazepam | The therapeutic efficacy of Diazepam can be decreased when used in combination with Hyaluronidase. |
| Diethylstilbestrol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Diethylstilbestrol. |
| Dimenhydrinate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Dimenhydrinate. |
| Dimetindene | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Dimetindene. |
| Dimetotiazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Dimetotiazine. |
| Diphenhydramine | Hyaluronidase can cause an increase in the absorption of Diphenhydramine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Dobutamine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Dobutamine. |
| Dopamine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Dopamine. |
| Dyclonine | Hyaluronidase can cause an increase in the absorption of Dyclonine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Emedastine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Emedastine. |
| Ephedrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Ephedrine. |
| Epinastine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Epinastine. |
| Epinephrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Epinephrine. |
| Ergometrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Ergometrine. |
| Esterified estrogens | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Esterified estrogens. |
| Estetrol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estetrol. |
| Estradiol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estradiol. |
| Estradiol acetate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estradiol acetate. |
| Estradiol benzoate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estradiol benzoate. |
| Estradiol cypionate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estradiol cypionate. |
| Estradiol valerate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estradiol valerate. |
| Estriol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estriol. |
| Estrone sulfate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Estrone sulfate. |
| Ethinylestradiol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Ethinylestradiol. |
| Etidocaine | Hyaluronidase can cause an increase in the absorption of Etidocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Etilefrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Etilefrine. |
| Etomidate | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Etomidate. |
| Famotidine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Famotidine. |
| Fluocinolone acetonide | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Fluocinolone acetonide. |
| Fluorometholone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Fluorometholone. |
| Fluprednisolone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Fluprednisolone. |
| Fosphenytoin | The therapeutic efficacy of Fosphenytoin can be decreased when used in combination with Hyaluronidase. |
| Furosemide | The therapeutic efficacy of Furosemide can be decreased when used in combination with Hyaluronidase. |
| Halazepam | The therapeutic efficacy of Halazepam can be decreased when used in combination with Hyaluronidase. |
| Hydrocortisone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Hydrocortisone. |
| Hydrocortisone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Hydrocortisone succinate. |
| Hydroxyzine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Hydroxyzine. |
| Imipramine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Imipramine. |
| Lidocaine | Hyaluronidase can cause an increase in the absorption of Lidocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Lorazepam | The therapeutic efficacy of Lorazepam can be decreased when used in combination with Hyaluronidase. |
| Maprotiline | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Maprotiline. |
| Meloxicam | Hyaluronidase can cause an increase in the absorption of Meloxicam resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Mephentermine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Mephentermine. |
| Mepivacaine | Hyaluronidase can cause an increase in the absorption of Mepivacaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Meprednisone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Meprednisone. |
| Mestranol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Mestranol. |
| Metaraminol | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Metaraminol. |
| Methantheline | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Methantheline. |
| Methdilazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Methdilazine. |
| Methotrimeprazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Methotrimeprazine. |
| Methoxamine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Methoxamine. |
| Methyldopa | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Methyldopa. |
| Methylprednisolone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Methylprednisolone. |
| Methylprednisolone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Methylprednisolone hemisuccinate. |
| Midazolam | The therapeutic efficacy of Midazolam can be decreased when used in combination with Hyaluronidase. |
| Mirtazapine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Mirtazapine. |
| Nizatidine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Nizatidine. |
| Norepinephrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Norepinephrine. |
| Olanzapine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Olanzapine. |
| Orphenadrine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Orphenadrine. |
| Oxybuprocaine | Hyaluronidase can cause an increase in the absorption of Oxybuprocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Oxymetazoline | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Oxymetazoline. |
| Phenindamine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Phenindamine. |
| Pheniramine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Pheniramine. |
| Phenol | Hyaluronidase can cause an increase in the absorption of Phenol resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Phenyl aminosalicylate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Phenyl aminosalicylate. |
| Phenylephrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Phenylephrine. |
| Phenytoin | The therapeutic efficacy of Phenytoin can be decreased when used in combination with Hyaluronidase. |
| Polyestradiol phosphate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Polyestradiol phosphate. |
| Prednisolone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Prednisolone. |
| Prednisolone acetate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Prednisolone acetate. |
| Prednisone acetate | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Prednisone acetate. |
| Prilocaine | Hyaluronidase can cause an increase in the absorption of Prilocaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Procaine | Hyaluronidase can cause an increase in the absorption of Procaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Promazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Promazine. |
| Promethazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Promethazine. |
| Proparacaine | Hyaluronidase can cause an increase in the absorption of Proparacaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Propiomazine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Propiomazine. |
| Propoxycaine | Hyaluronidase can cause an increase in the absorption of Propoxycaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Quinestrol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Quinestrol. |
| Racepinephrine | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Racepinephrine. |
| Ranitidine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Ranitidine. |
| Remimazolam | The therapeutic efficacy of Remimazolam can be decreased when used in combination with Hyaluronidase. |
| Risperidone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Risperidone. |
| Salicylic acid | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Salicylic acid. |
| S Estrogens, A | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Synthetic Conjugated Estrogens, A. |
| S Estrogens, B | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Synthetic Conjugated Estrogens, B. |
| Tetracaine | Hyaluronidase can cause an increase in the absorption of Tetracaine resulting in an increased serum concentration and potentially a worsening of adverse effects. |
| Tetryzoline | The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Tetryzoline. |
| Tibolone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Tibolone. |
| Trazodone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Trazodone. |
| Triamcinolone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Triamcinolone. |
| Trilostane | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Trilostane. |
| Tritoqualine | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Tritoqualine. |
| Ziprasidone | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Ziprasidone. |
| Zuclopenthixol | The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Zuclopenthixol. |
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.
How should this medicine be used?
Daratumumab and hyaluronidase-fihj injection comes as a solution (liquid) to be injected subcutaneously (just under the skin) into the abdomen (stomach) over 3 to 5 minutes. The length of your treatment will depend on your condition and how well your body responds to treatment.
A doctor or nurse will watch you closely while you are receiving the medication and afterwards to be sure you are not having a serious reaction to the medication. You will be given other medications to help prevent and treat reactions to daratumumab and hyaluronidase-fihj before and after you receive your medication. Tell your doctor or nurse immediately if you experience any of the following symptoms: difficulty breathing or shortness of breath, chest pain, wheezing, throat tightness and irritation, cough, runny or stuffy nose, headache, itching, nausea, vomiting, fever, chills, rash, hives, blurred vision or other vision changes, or dizziness or lightheadedness.
Your doctor may temporarily or permanently stop your treatment. This depends on how well the medication works for you and the side effects you experience. Be sure to tell your doctor how you are feeling during your treatment with daratumumab and hyaluronidase-fihj. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
What special precautions should I follow?
Before receiving daratumumab and hyaluronidase-fihj injection,
- tell your doctor and pharmacist if you are allergic to daratumumab, hyaluronidase-fihj, any other medications, or any of the ingredients in daratumumab and hyaluronidase-fihj injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had shingles (a painful rash that occurs after infection with herpes zoster or chickenpox), hepatitis B (a virus that infects the liver and may cause severe liver damage), glaucoma (a type of eye disease), high blood pressure, or breathing problems or a lung disease such as chronic obstructive pulmonary disease (COPD; a group of lung diseases, which includes chronic bronchitis and emphysema). If you are being treated for amyloidosis, tell your doctor if you have heart failure or heart disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should use birth control to prevent pregnancy during your treatment with daratumumab and hyaluronidase-fihj and for at least 3 months after your final dose. Talk to your doctor about types of birth control that will work for you. If you become pregnant while receiving daratumumab and hyaluronidase-fihj injections, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving daratumumab and hyaluronidase-fihj injections.
References
