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Hyaluronidase dosing

`We were discussing the dose of hyaluronidase used for treating infiltration/extravasation. we find that sometimes there are instances where the single dose of 300mg in 2cc is not adequate to treat the entire area of injury. Is there anyone out there using more than the 300 mg dose and if so based on any research data?

 I don't remember seeing a

 I don't remember seeing a protocol for 300 mg or seen it measured in mg. The ONS guidelines book lists Amphadase 150 units per mL; Hydase 150 units per mL; Vitrase 200 units per mL. ONS protocol states to inject 0.2 mL in 5 locations SC with 5 different 25 g needles. No discussion of any higher doses. To my knowledge, these are the only 3 brands of hyaluronidase on the US market. Are you talking about very large and extensive extravasations to require more than 2 mLs? Or some other reason? Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861


Yes Lynn you are right. We have at times used higher dosing of 30mmg in up to 4cc mix for extensive areas of extravasation..... wondering if anyone else is doing this also.

Jose Delp RN BSN VA-BC

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