Parenteral Manual

Hyaluronidase (SPECIAL ACCESS PROGRAM)

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

Alternate Name(s): 
AMPHADASE
Classification: 
Antidote, Extravasation
Original Date: 
October 2013
Revised Date: 
December 2020
Indications: 
  • Management of IV extravasation
Reconstitution and Stability: 
  • Available as a 150 units/mL 2mL vial
  • Store unopened vials refrigerated (2-8°C)
Compatibility: 

-  Solutions Compatible:  D5W, D10W, 0.45% NaCl, 0.9% NaCl, Ringer's solution, Ringer's lactate

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC YES
IM NO
IV Push NO
IV Intermittent
Infusion
NO
IV Continuous
Infusion
NO

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Attach a 25 or 27 gauge needle to the syringe and administer 0.2 mL subcutaneously into the leading edge of the extravasation.  Remove needle and apply new 25 or 27 gauge needle for each 0.2 mL injection around the site
  • Administer a total of 150 units (5 x 0.2 mL injections) subcutaneously into the extravasation site at the leading edge
  • A dose of 300 units (10 x 0.2 mL or 5 x 0.4 mL injections) can be used for large infiltrates of grade +2 or greater
  • Use within 1 hour of extravasation for maximal effect
  • Must be given within 4 hours of infiltration

 

Potential hazards of parenteral administration: 
  • Hyaluronidase is NOT for intravenous administration
  • DO NOT inject into tumors, acute inflamed or infected areas
  • Hyaluronidase has an immediate onset of action and a 24 - 48 hour duration of effect
  • Corticosteroids may worsen toxicity
  • Toxicity of hyaluronidase is NOT increased by the use of a cold pack
  • Side effects:  local swelling may occur.  Urticaria and erythema possible

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