Hyaluronidase Use and Handling Guidelines

General Considerations

Hyaluronidase should be freshly prepared when mixed with local anesthetics to ensure optimal spreading effect, as recommended by the American Academy of Dermatology 1
The mixing of hyaluronidase with infiltrative anesthesia is safe, according to the American Academy of Dermatology 1
Cross-reactivity between bee venom and hyaluronidase exists, and it should be avoided in patients with bee sting allergy, as noted by the American Academy of Dermatology 1
Skin testing may be considered when allergy to hyaluronidase is in question, as suggested by the American Academy of Dermatology 1

Reconstituted hyaluronidase should be stored at 4°C to minimize potency loss, as recommended by the Journal of Allergy and Clinical Immunology 2
Reconstituted hyaluronidase should be used within 6 hours after reconstitution when stored at 4°C to maintain optimal enzymatic activity 2
Room temperature storage, freezing and thawing cycles, and removing from refrigeration multiple times should be avoided as they cause rapid deterioration of enzymatic activity 2, 3
Visible turbidity may indicate contamination or degradation, and the solution should be monitored for clarity 3

Hyaluronidase can be added to infused solutions for hypodermoclysis (subcutaneous fluid administration) in geriatric patients, allowing volumes up to 3000 ml to be delivered over 24 hours, as reported in Clinical Nutrition 4
Hyaluronidase is an enzyme that breaks down hyaluronic acid and is commonly used in various medical applications, including as an adjunct to local anesthetics and for managing hyaluronic acid filler complications 2

Reconstitute hyaluronidase immediately before intended use whenever possible, and use the appropriate diluent as specified by the manufacturer 2
Discard any unused portion after 6 hours, and avoid reconstituting multiple vials in advance (do not batch prepare) 2
Avoid repeated warming and removing from refrigeration multiple times 3