Neonatal Drug Therapy Manual

Hyaluronidase

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated January 26, 2022 - 6:00pm

Alternate Name(s): 
Amphadase , Hyalase (Special Access Program)
Classification: 
Antidote, extravasations
Original Date: 
February 2005
Revised Date: 
December 2020
Indications: 
  • Management of IV extravasation (excluding dopamine and alpha agonist)
Administration: 
  • SC
Dosage: 

Be aware there are 2 concentrations that exist for hyaluronidase. Please double check the vial before mixing. Current brands are listed below, but stock sources can change. 

CHEO (Amphadase brand)

  • Take 1 mL (150 units) and add to 9 mL of 0.9% NaCl. Resultant solution is 15 units/mL
  • Using a 27 gauge needle, administer five 0.2 mL injections (for a total of 15 units) subcutaneously into the extravasation site at the leading edge, changing the needle after each injection
  • Use within 1 hour of extravasation for maximal effect

TOH (Hyalase brand)

  • Reconstitute the 1500 units ampoule with 1 mL of 0.9% NaCl to obtain 1500 units/mL solution. Draw up 0.1 mL (150 units) into a 10 mL syringe and further dilute with 0.9% NaCl to a final volume of 10 mL. Resultant solution is 15 units/mL
  • Using a 27 gauge needle, administer five 0.2 mL injections (for a total of 15 units) subcutaneously into the extravasation site at the leading edge, changing the needle after each injection
  • Use within 1 hour of extravasation for maximal effect
Side Effects: 
  • Local: swelling may occur
  • Urticaria, erythema
Reconstitution and Stability: 

N/A

Compatibility: 

- Incompatible: benzodiazepines, furosemide, phenytoin 

Notes: 
  • Hyaluronidase has an immediate onset of action and a 24-48 hours duration effect
References: 

- Extravasation injury from chemotherapy and other non-antineoplastic vesicants. Uptodate. Updated Aug 31. 2017

- Children's Hospital of Eastern Ontario (2014 Revision).  Treatment of Infiltrated Vesicant or Irritant Drugs

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