HYALURONIDASE, OVINE
| Hyaluronidase, Ovine (hi-a-lu-ron'i-dase) Amphadase, Vitrase Classifications: enzyme; absorption and dispersing enhancer; Therapeutic: absorption and dispersing enhancer Pregnancy Category: C |
Availability
150 units/mL and 200 units/mL for injection; lyophilized powder, 6200 units
Action
Hyaluronidase is a diffusing substance that modifies the permeability of connective tissue through the hydrolysis of hyaluronic acid found in the intercellular substance of connective tissue. It temporarily decreases the viscosity of cellular cement and promotes diffusion of injected fluids or exudates, adding to their absorption.
Therapeutic Effect
It increases the absorption and dispersion of solutions in the intercellular spaces.
Uses
Adjuvant to increase the absorption and dispersion of other injected drugs; hypodermoclysis; adjunct in subcutaneous urography for improving resorption of radiopaque agents.
Unlabeled Uses
Adjunct for ophthalmic anesthesia, treatment of vitreous hemorrhage and diabetic retinopathy.
Contraindications
Hypersensitivity to hyaluronidase or any other ingredient in formulation; concurrent use with dopamine or alpha-agonist drugs; injection into infected or acutely inflamed area, area of swelling due to bites or stings; corneal injection; injection by IV; pregnancy (category C).
Cautious Use
Lactation.
Route & Dosage
| Adjuvant to Increase the Absorption and Dispersion of Other Drugs Adult: 150 units (range: 50–300) added to solution Child: 150 units (range: 50–300) added to solution Hypodermoclysis Adult: 15 units added to each 100 mL of fluid Child (≥3 y): 15 units added to each 100 mL of fluid Subcutaneous Urography Adult: SC 75 units prior to contrast medium Child: SC 75 units prior to contrast medium |
Administration
Subcutaneous or Solution Additive- Reconstitute vial with 6.2 mL NS for injection to yield 1000 U/mL. Apply the 5-micron filter needle to the 1 mL syringe in injection kit and further dilute: To produce 50 U/mL, withdraw 0.05 mL reconstituted solution and add 0.95 mL NS. To produce 75 U/mL, withdraw 0.075 mL reconstituted solution and add 0.925 mL NS. To produce 150 U/mL, withdraw 0.15 mL reconstituted solution and add 0.85 mL NS. To produce 300 U/mL, withdraw 0.3 mL reconstituted solution and add 0.7 mL NS. Use immediately after preparation.
- Give SC prior to contrast media. Do not inject near an infected or acutely inflamed area.
- Store unopened vial at 2°–8° C (35°–46° F). After reconstitution, store at 20°–25° C (59°–77° F), and use within 6 h. Protect from light.
Adverse Effects (≥1%)
CV: Edema. Other: Injection site reaction (e.g., erythema, irritation); enhanced adverse events associated with coadministered drugs.Interactions
Drug: salicylates, corticosteroids, estrogens, or h1-blockers may confer partial resistant to the action of hyaluronidase in some tissues.Nursing Implications
Assessment & Drug Effects
- Monitor for S&S of hypersensitivity: urticaria, erythema, chills, nausea, vomiting, dizziness, tachycardia, and hypotension. Withhold and notify physician if hypersensitivity occurs.
- Note: Those receiving large doses of salicylates, cortisone, ACTH, estrogens, or antihistamines may require larger amounts of hyaluronidase for equivalent dispersing effect.
Patient & Family Education
- Report immediately any of the following: rash, itching, chills, nausea, vomiting, dizziness, or palpitations.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug