HYALURONIDASE

Adults, children and the elderly:

With subcutaneous infusion (hypodermoclysis): 1500iu of Hyaluronidase dissolved in 1ml of water for injections or normal saline injected into the site, before the infusion is set up, or injected into the tubing of the infusion set, about 2cm back from the needle, at the start of the infusion.

1500iu is sufficient for administration of 500-1000ml of most fluids. 4 for information on solutions for hypodermoclysis. Care should be taken in young children and the elderly to control the speed and total volume of fluid administered and to avoid over-hydration, especially in renal impairment.

With subcutaneous or intramuscular injections: 1500iu of Hyaluronidase dissolved directly in the solution to be injected. With local anaesthetics: 1500iu Hyaluronidase is mixed with the quantity of local anaesthetic solution to be used.

In ophthalmology, 15iu of Hyaluronidase per ml is recommended.

Extravasation:

Where dispersal rather than localisation is indicated, 1500iu of Hyaluronidase in 1ml water for injections or normal saline infiltrated into the affected area as soon as possible after the extravasation is noted. Haematoma: 1500iu of Hyaluronidase dissolved in 1ml water for injections or normal saline infiltrated into the affected area.

Immediately before use dissolve the freeze-dried powder in approximately 1ml of water for injections or directly in the solution with which Hyaluronidase is to be combined.

Oedema has been reported in association with hypodermoclysis. There have been rare reports of periorbital oedema occurring with the use of hyaluronidase in conjunction with local anaesthetics in ophthalmology; in most cases, the doses of hyaluronidase exceeded the licensed dose.

Severe allergic reactions including anaphylaxis have been reported rarely. Local irritation, infection, bleeding and bruising occur rarely.

Do not apply directly to the cornea. Hyaluronidase should not be used to enhance the absorption and dispersion of dopamine and/or alpha agonist drugs. Solutions for subcutaneous administration should be isotonic with extracellular fluid.

Hyaluronidase is physically compatible with the commonly used infusion fluids. 5% glucose and 5% glucose. U/litre hyaluronidase. Electrolyte-free fluids are less preferable than those containing electrolytes and should not be given too rapidly.

2. Incompatibilities).

Hypersensitivity to hyaluronidase Not to be used for intravenous injections. 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.