No

Antidote

Increases the dispersion and absorption of other drugs; increases rate of absorption of parenteral fluids given by hypodermoclysis; enhances diffusion of locally irritating or toxic drugs in the management of I.V. extravasation

C

Hypersensitivity to hyaluronidase or any component; do not inject in or around infected, inflamed, or cancerous areas

Drug infiltrates in which hyaluronidase is contraindicated: Dopamine, alpha-adrenergic agonists; an intradermal skin test for sensitivity should be performed before actual administration using 0.02 mL of a 150 units/mL of hyaluronidase solution

<1%: Tachycardia, hypotension, dizziness, chills, urticaria, erythema, nausea, vomiting

Symptoms of overdose include local edema, urticaria, erythema, chills, nausea, vomiting, hypotension

Decreased effect: Salicylates, cortisone, ACTH, estrogens, antihistamines

Reconstituted hyaluronidase solution remains stable for only 24 hours when stored in the refrigerator; do not use discolored solutions

Modifies the permeability of connective tissue through hydrolysis of hyaluronic acid, one of the chief ingredients of tissue cement which offers resistance to diffusion of liquids through tissues

Onset of action: Immediate by the subcutaneous or intradermal routes for the treatment of extravasation

Duration: 24-48 hours

Infants and Children:

Management of I.V. extravasation: Reconstitute the 150 unit vial of lyophilized powder with 1 mL normal saline; take 0.1 mL of this solution and dilute with 0.9 mL normal saline to yield 15 units/mL; using a 25- or 26-gauge needle, five 0.2 mL injections are made subcutaneously or intradermally into the extravasation site at the leading edge, changing the needle after each injection

Hypodermoclysis:

S.C.: 1 mL (150 units) is added to 1000 mL of infusion fluid and 0.5 mL (75 units) in injected into each clysis site at the initiation of the infusion

I.V.: 15 units is added to each 100 mL of I.V. fluid to be administered

Children <3 years: Limit volume of single clysis to 200 mL

Premature Infants: Do not exceed 25 mL/kg/day and not >2 mL/minute

Adults: Absorption and dispersion of drugs: 150 units are added to the vehicle containing the drug

May cause dizziness

None reported

No information available to require special precautions

No effects or complications reported

Report itching, pain, changes in respiration, or excessive dizziness. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Appropriate drugs for the management of an acute hypersensitivity (epinephrine, corticosteroids, and antihistamines) should be readily available

Injection, stabilized solution: 150 units/mL (1 mL, 10 mL)

Powder for injection, lyophilized: 150 units, 1500 units

Berger EY, "Nutrition by Hypodermoclysis," J Am Geriatr Soc, 1984, 32(3):199-203.

Bertelli G, "Prevention and Management of Extravasation of Cytotoxic Drugs," Drug Saf, 1995, 12(4):245-55.

Bertelli G, Dini D, Forno GB, et al, "Hyaluronidase as an Antidote to Extravasation of Vinca Alkaloids: Clinical Results," J Cancer Res Clin Oncol, 1994, 120(8):505-6.

Dorr RT, "Vinca Alkaloid Ulceration: Experimental Mouse Model and Effects of Local Antidotes," Proc Am Soc Clin Oncol, 1982, 1:428.

Elam EA, Dorr RT, Lagel KE, et al, "Cutaneous Ulceration Due to Contrast Extravasation. Experimental Assessment of Injury and Potential Antidotes," Invest Radiol, 1991, 26(1):13-6.

Lipschitz S, Campbell AJ, Roberts MS, et al, "Subcutaneous Fluid Administration in Elderly Subjects: Validation of an Underused Technique," J Am Geriatr Soc, 1991, 39(1):6-9.

Raszka WV Jr, Kueser TK, Smith FR, et al, "The Use of Hyaluronidase in the Treatment of Intravenous Extravasation Injuries," J Perinatol, 19909, 10(2):146-9.

Zenk KE, "Hyaluronidase: An Antidote for Intravenous Extravasations," CSHP Voice, 1981, 66-8.

Zenk KE, "Management of Intravenous Extravasations," Infusion, 1981, 5:77-9.

Zenk KE, "Treating I.V. Extravasations With Hyaluronidase," ASHP Signal, 1986, 10:25,29.

Zenk KE, Dungy CI, and Greene GR, "Nafcillin Extravasation Injury: Use of Hyaluronidase as an Antidote," Am J Dis Child, 1981, 135(12):1113-4.