NEODOSE

INDICATIONS

Prevention of tissue injury caused by IV extravasation. Suggested indications (some anecdotal) are for extravasations involving drugs that are irritating to veins because of hyperosmolarity or extreme pH (e.g. aminophylline, amphotericin B, calcium, diazepam, erythromycin, gentamicin, methicillin, nafcillin, oxacillin, phenytoin, potassium chloride, rifampin, sodium bicarbonate, tromethamine, vancomycin, and TPN, and concentrated IV solutions). Hyaluronidase is not indicated for treatment of extravasations of vasoconstrictive agents (eg, dopamine, epinephrine, and norepinephrine).

FDA APPROVED INDICATION

Adjuvant in subcutaneous fluid administration for achieving hydration. Human recombinant product (Hylenex®) is preferred over animal derived products in children to decrease potential for allergic reactions. Adjuvant to increase dispersion and adsorption of other injectable agents. Adjunct in subcutaneous urography to improve resorption of radiopaque agents.

PRECAUTIONS

Precautions Not recommended for IV use. Discontinue use if sensitization occurs. Should not be used to enhance the absorption and dispersion of dopamine and/or alpha agonist agents. Do not inject near area of infection or acutely inflamed area because of the risk of spreading a localized infection. To rule out a potential hypersensitivity reaction, a skin test (0.02 mL intradermally of a 150 unit/mL or 200 unit/mL of hyaluronidase) may be performed . Hylenex® contains albumin; therefore, there is a rare chance for transmission of viral and variant Creutzfeldt-Jakob disease.

ADVERSE EFFECTS

The most frequent adverse events reported are injection site reactions. Allergic reactions have occurred rarely.

ADMINISTRATION

Extravasation Use at concentrations of 15 units/mL or undiluted at 150 units/mL. Increase therapeutic success:

• Initiating treatment within 1 to 2 hours of extravasation; however benefit may be observed with administration as long as 10 days after extravasation incident
• Elevate extremity, place saline soaked gauze over the area, and gently squeeze out fluid from the open insertion site
• Covering with a hydrogel/hydrocolloid dressing

Hypodermoclysis When administering fluids by subQ route, do not exceed the rate and volume of fluids administered by IV route. The maximum volume of fluids is 25 mL/kg at a rate no faster than 2 mL/min for premature or full-term infants. Hyaluronidase may be added to small volumes of solutions (up to 200 mL) or solutions of subQ drugs Hydase May be administered for infiltration use, interstitial use, intramuscular use, intraocular use, retrobulbar use, soft tissue use, or subcutaneous use. Hylenex Do not administer IV. May be administered for infiltration, interstitial, IM, intraocular, peribulbar, retrobulbar, soft tissue, or subQ use.

MONITORING

No specific monitoring required.