hyaluronidase (Rx)

Brand and Other Names:Amphadase, Hylenex Recombinant, more...Vitrase
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 150unit/mL
  • 200unit/mL

Skin Test

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 positive hypersensitivity reaction

Extravasation

Indicated to absorb and disperse injected drugs to treat extravasation

Add 50-300 units (typically 150 units) to the injection solution

Hypodermoclysis

Amphadase/Hylenex: Inject 150 units prior to SC fluid administration; this will facilitate absorption of 1000 mL or more of solution

Vitrase: Inject 200 units prior to SC fluid administration; this will facilitate absorption of 1000 mL or more of solution

Adjunct Subcutaneous Urography

Improves resorption of radiopaque agents; indicated when IV administration cannot be successfully accomplished with the patient prone

Inject 75 units SC over each scapula, followed by injection of the contrast medium at the same sites

Dosage Forms & Strengths

injectable solution

  • 150unit/mL
  • 200unit/mL

Skin Test

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 positive hypersensitivity reaction

Hypodermoclysis

Children ≥3 years: May be added to small volumes of solution (up to 200 mL), such as or solutions of drugs for SC injection

Infants and children <3 years: Volume of a single clysis 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; rate of administration should not be greater than 2 mL/min

Adjunct in Subcutaneous Urography

Used when IV administration cannot be successfully accomplished, particularly in infants and small children, with the patient prone

Inject 75 units SC over each scapula, followed by injection of the contrast medium at the same sites

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Interactions

Interaction Checker

and hyaluronidase

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            <1%

            Angioedema, urticaria, allergic reactions (<0.1%)

            Frequency Not Defined

            Edema

            Local injection site reactions

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            Do not use to enhance dispersion and absorption of dopamine &/or alpha agonists

            Not for IV use; effects relative to dispersion and absorption of other drugs are not produced when it is administered IV because enzyme is rapidly inactivated

            Do not use in/around inflamed/infected areas

            Not for reducing swelling due to stings/bites

            Do not use directly on cornea; not for topical use

            Furosemide, benzodiazepines & phenytoin incompatible with hyaluronidase

            Hastens onset and shortens duration of effect, increases incidence if systemic reactions with local anesthetics

            Large doses of salicylates may require larger amount of hyaluronidase for equivalent dispersing effect

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            Pregnancy & Lactation

            Pregnancy

            Human studies of hyaluronidase as an aid to conception and as an aid to delivery conducted without reports of maternal or fetal harm; non-human animal reproduction studies not conducted

            Hyaluronidase has been used as 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

            There is no information regarding presence of drug in human milk, effects on breastfed infants, or on milk production to inform risk of drug 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 breastfed infant from drug

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Dispersion agent, which modifies permeability of connective tissue through hydrolysis of hyaluronic acid, a polysaccharide found in the intercellular ground substance of connective tissue, and of certain specialized tissues, such as the umbilical cord and vitreous humor

            Amphadase: Purified preparation of bovine testicular hyaluronidase

            Hylenex: Purified preparation of the enzyme recombinant human hyaluronidase

            Vitrase: Purified preparation of ovine testicular hyaluronidase

            Pharmacokinetics

            Onset of action: Immediate (SC)

            Duration: 24-48 hr

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.