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Hyaluronidase (injectable enzyme)

Hyaluronidase (injectable enzyme)

Misc (Generics)

Injectable enzyme
  • Hyaluronidase is regulated as a prescription Only injectable medicine or medical device component in many jurisdictions; specific approvals, marketing authorisations and classification vary by country and by brand.
  • Use in aesthetic medicine should comply with local legislation, professional guidelines and product Specific prescribing information.
  • Online supply of prescription Only injectables should be checked carefully for regulatory compliance, authenticity and professional dispensing requirements in the user’s jurisdiction.
Hyaluronic acid\u2013degrading enzyme for dispersion of injected fluids and hyaluronic acid fillers

Description

Hyaluronidase is an enzyme preparation used to increase the permeability of connective tissue by depolymerising hyaluronic acid in the extracellular matrix. In medical and aesthetic practice it is administered by qualified healthcare professionals to enhance the absorption and dispersion of other injected fluids (such as local anaesthetics or subcutaneous infusions) and, in aesthetic medicine, to break down hyaluronic acid–based dermal fillers in situations such as overcorrection, unwanted product placement or certain complications.

Bnefits

  • Facilitates more rapid dispersion and absorption of injected solutions in subcutaneous or intradermal tissues.
  • Enables targeted breakdown of hyaluronic acid–based dermal fillers when medically indicated (for example, overfilling, nodules or certain vascular complications, according to local protocols).
  • Can reduce tissue oedema and improve spread of local anaesthetics in specific clinical situations when used under medical supervision.
  • Acts locally at the injection site and is eventually neutralised or metabolised by the body.
  • Provides clinicians with a reversible option for managing and adjusting hyaluronic acid filler outcomes.

Indications

  • Enhancing dispersion and absorption of compatible injected solutions (e.g. some local anaesthetics, subcutaneous infusion fluids) in line with the product’s prescribing information.
  • Medical and aesthetic management of hyaluronic acid filler overcorrection, misplaced product or nodules when dissolution of the filler is required.
  • Adjunctive use in certain extravasation or infiltration scenarios where improved dispersion of the infiltrated solution is clinically indicated (according to local protocols and product labelling).
  • Other approved indications as specified in the relevant country’s product information for licensed hyaluronidase medicines.

Composition

  • Active ingredient: hyaluronidase (an enzyme that depolymerises hyaluronic acid in connective tissue).
  • Excipients: brand-dependent buffer salts, stabilisers and lyophilisation components (exact composition varies by manufacturer and specific medicinal product).

Formulation

  • Typically supplied as a sterile lyophilised (freeze-dried) powder or pellet in a glass vial for reconstitution with a suitable diluent prior to injection.
  • Intended for parenteral administration (e.g. subcutaneous) by trained healthcare professionals following the specific product’s summary of product characteristics (SmPC) or prescribing information.
  • Potency and exact unit strength (e.g. IU per vial) vary between brands and should always be checked against the specific product packaging and documentation.

Packaging

  • Individual sterile glass vials of hyaluronidase powder (unit strength and number of vials per pack vary by brand).
  • Vials may be supplied alone or together with a separate ampoule or vial of diluent, depending on manufacturer.
  • Outer carton containing vials, package leaflet and labelling with batch number and expiry date.

Usage

  • For use only by appropriately qualified healthcare professionals with training in injectable medicines and management of potential complications.
  • The vial contents must be reconstituted with an appropriate diluent immediately before use, strictly following the instructions in the specific product’s prescribing information (SmPC) for volume, diluent type and handling.
  • Route of administration, dose, injection pattern and frequency must be determined by a clinician according to the licensed indications, local guidelines and the patient’s individual clinical situation.
  • In aesthetic indications (e.g. reversal of hyaluronic acid filler), treatment planning should take into account filler type, location, time since injection and risk–benefit considerations, and should follow recognised clinical protocols.
  • Resuscitation equipment and appropriate emergency medication should be immediately available in case of allergic or anaphylactic reactions.
  • This product is not intended for self-administration or use outside a clinical setting; patients should never attempt to inject or dissolve fillers themselves.

Contraindications

  • Known hypersensitivity to hyaluronidase or to any excipient in the specific product formulation.
  • History of severe allergic or anaphylactic reactions to hyaluronidase or similar preparations.
  • Use in or around areas of active infection or inflamed skin unless the potential benefit outweighs the risk, as determined by a clinician.
  • Use for facilitating the spread of potentially harmful or contraindicated substances (e.g. certain toxic drugs or vasoconstrictors) where dispersion could worsen tissue injury, according to product labelling.
  • Caution or avoidance in patients with conditions where increased tissue permeability may be undesirable, as guided by the product’s prescribing information.
  • Not recommended for use in individuals without a clear medical or aesthetic indication established by a qualified healthcare professional.

Adverse Effects

  • Local injection-site reactions such as pain, redness, swelling, itching, bruising or tenderness.
  • Transient oedema or discomfort at or near the injection area due to increased tissue permeability and fluid movement.
  • Allergic reactions ranging from mild local hypersensitivity (rash, urticaria) to rare severe systemic reactions, including anaphylaxis; emergency management may be required in severe cases.
  • Potential acceleration of dispersion of co-administered drugs, possibly altering their expected pharmacological effect if not taken into account by the prescriber.
  • In aesthetic use, over-treatment may lead to excessive reduction of hyaluronic acid filler or loss of desired volume in the treated area.
  • Other adverse effects specific to individual licensed products, as described in their SmPC/prescribing information.

Storage Conditions

  • Store in accordance with the specific product’s labelling and package leaflet (conditions may vary between manufacturers).
  • Typically stored in a cool, dry place away from direct light; some medicinal brands may require refrigeration (for example 2–8 °C) before reconstitution—always check the carton or leaflet.
  • Do not freeze unless explicitly stated as acceptable by the product manufacturer.
  • Reconstituted solutions should be used within the time frame specified in the prescribing information, and any unused portion should be discarded.
  • Keep out of the sight and reach of children and do not use after the expiry date printed on the packaging.

Duration

Onset and duration of effect depend on dose, route of administration, indication and tissue characteristics; when used to disperse injected solutions or dissolve hyaluronic acid fillers, activity is generally rapid and transient, with clinical effects observed within minutes to hours and tapering as the enzyme is inactivated and eliminated.

Onset

Typically rapid: increased dispersion of injected fluids or softening of hyaluronic acid deposits is often observed within a short period after injection (from minutes up to the first few hours), depending on dose, location and the amount and type of hyaluronic acid present.

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