Recommended Hyaluronidase Duration
Reconstituted hyaluronidase should be used within 6 hours after reconstitution when stored at 4°C to maintain optimal enzymatic activity. 1
Storage and Handling Guidelines
Hyaluronidase is an enzyme that breaks down hyaluronic acid and is used in various medical applications. Proper storage and handling are critical to maintain its efficacy:
- Store reconstituted hyaluronidase at 4°C (refrigerated) to minimize potency loss 1
- Use within 6 hours after reconstitution when stored at 4°C 1
- Avoid room temperature storage which causes rapid deterioration 1
- Never store at temperatures above 4°C for extended periods 1
- Avoid freezing and thawing cycles as they further degrade enzymatic activity 1
- Do not remove from refrigeration multiple times as this accelerates degradation 1
- Monitor solution for clarity; visible turbidity may indicate contamination or degradation 1
Clinical Applications
When used in dermatologic procedures, hyaluronidase has specific considerations:
- When mixed with local anesthetics, hyaluronidase should be freshly prepared to ensure optimal spreading effect 2
- The mixing of hyaluronidase with infiltrative anesthesia is safe as demonstrated by controlled trials 2
- Cross-reactivity between bee venom and hyaluronidase exists; avoid use in patients with bee sting allergy 2
Preparation Best Practices
For optimal efficacy:
- Reconstitute immediately before intended use whenever possible 1
- Use appropriate diluent as specified by manufacturer 1
- Discard any unused portion after 6 hours 1
- Avoid reconstituting multiple vials in advance (do not batch prepare) 1
Special Considerations
In specific clinical scenarios, hyaluronidase may be used differently:
- For hypodermoclysis (subcutaneous fluid administration) in geriatric patients, hyaluronidase can be added to infused solutions to augment the rate of fluid uptake, allowing volumes up to 3000 ml to be delivered over 24 hours 2
- For management of hyaluronic acid filler complications, particularly vascular events, high-dose pulsed hyaluronidase protocols may be used with repeated administration until clinical resolution 3
Cautions and Contraindications
- Allergy to hyaluronidase should be considered if focal erythema and swelling occur after injection 4
- Skin testing may be considered when allergy to hyaluronidase is in question 2
- Avoid use in patients with known bee sting allergy due to potential cross-reactivity 2
While there is variability in practice patterns regarding hyaluronidase use among practitioners 5, adhering to the 6-hour usage window after reconstitution when stored at 4°C represents the most evidence-based approach to maintain optimal enzymatic activity.