Hyaluronidase

Registered South African indications:

• Hypodermoclysis
• Obstetric anaesthesia
• Prevention of post-partum haemorrhage
• Local anaesthesia in ophthalmology
• Local anaesthesia in fracture reduction
• Radiography

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Intravenous administration
• Not to be used to reduce the swelling of bites or stings or at sites where infection or malignancy is present
• Not to be used for anaesthetic procedures in cases of unexplained premature labour

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Elderly
• Corneal application

Forms avail. in SA and covered in this monograph: inj

Hypodermoclysis

• SC: 1500 IU dissolved in 1ml sterile water, bolus given into infusion site prior to infusion

OR

• SC: 1500 IU dissolved in 1ml sterile water, bolus given into the tubing of the infusion set

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1500 IU is sufficient for administration of 500-1000ml of most fluids

Discard after 12-24hrs

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Repeat infusion can be given if required, provided at different sites

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Administration site: Axillae, pectoral regions, subscapular and trunk areas, thighs and calves, intramedullary route has also been used successfully. Children: anterior abdominal wall

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Obstetric anaesthesia (additional agent(s) required)

• Local infiltration: 1500 IU

Prevention of post-partum haemorrhage (additional agent(s) required)

• IM: 1500 IU

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Inject into thigh

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Local anaesthesia in ophthalmology (additional agent required)

• Local infiltration: 30 IU/ml

Local anaesthesia in fracture reduction (additional agent required)

• Local infiltration: 1500 IU

Radiography
- Pyelography

• SC: 1500 IU, in 2 divided doses

See adult dosage

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution; no information available

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended

Skin and Subcutaneous Tissue Disorders

• Oedema
• Local irritation
• Infection
• Bleeding
• Bruising

Immune, Blood and Lymphatic System Disorders

• Allergic reactions
• Anaphylaxis

Sensory Disorders

• Periorbital swelling

No information available

None routine

Hyaluronidase has a temporary and reversible depolymerizing action on the polysaccharide hyaluronic acid which is present in the intercellular matrix of connective tissue. This intercellular “cement” is thereby made more permeable, permitting the rapid dispersal and absorption of injected substances, the reduction of tissue tension and the dispersal of extravascular fluid in joint and tissue damage.

Injection (per amp) 1500 IU

• Hyalase (Xixia) originator