Amphadase

1 What is Amphadase?

Brand: Amphadase, Hydase, Hylenex, Vitrase

Generic: Hyaluronidase (Injection Route, Subcutaneous Route)

Amphadase is an enzyme which is responsible for modification of tissue permeability. It reduces the viscosity of the ground substance i.e. intracellular matrix by breaking down hyaluronic acid, thus making the tissue more permeable to injected fluids.

As a result, the distribution and absorption of locally injected substances are facilitated. Moreover, this enzyme enhances the resorption of excess fluid and extravasated blood in the body tissues.

Biochemically, hyaluronidase is a mucolytic enzyme found as a natural substance in the testes, in snake venom, and in hemolytic streptococci.

It is also produced in the laboratory from human albumin sources as a commercial form in order to promote the diffusion of intradermally injected medicines.

Indeed, hyaluronidase injection is considered as a spreading substance that is used with other drugs given under the skin to promote their dispersion and absorption by the body.

It is often indicated as an adjunct in subcutaneous urography for improving resorption of radiopaque agents. It is also used as an adjuvant in subcutaneous fluid administration for achieving hydration i.e. hypodermoclysis, especially in elderly patients.

However, this product is indicated as miscellaneous prophylactic migraine preparations. In addition, it is used as an aid in diffusion of local anesthesia in ophthalmology.

This medicine is recommended to be given only by or under the direct supervision of a healthcare professional. This medication is available in solution as well as powder forms. This powder is dissolved in sterile water at the time of injection.

2 What To Know Before Using

If you are about to start Amphadase, the risk-benefit ratio of this drug should be considered. This is a decision that your doctor will make with your active participation.

There are some important factors such as drug interactions, metabolic impairment, hypersensitivity reaction, pregnancy, lactation etc. which may alter the therapeutic effects of the medicine.

Sometimes, the presence of other health disorders affects the beneficial effects of this medicine and may even cause serious complications. Make sure you mention to your doctor if you have any other medical problems.

The use of hyaluronidase is contraindicated in those patients with known hypersensitivity, malignancy, and unexplained premature labor. This medicine should not be injected into or around infected areas. Direct application to the cornea should not be carried out as well.

Certain drugs should not be used concurrently with such medications. It is always recommended to consult with your doctor if you are in need of some other drugs for another health problem in order to avoid unwanted serious effects.

In addition, you should not use urokinase, local anesthetics (e.g. procaine, tetracaine, lidocaine, etc.), heparin, salicylates, NSAIDs and some other medications along with hyaluronidase in order to avoid following drug interactions:

  • Action potentiated by urokinase especially in the treatment of MI.
  • May increase absorption and toxicity of local anesthetics.
  • Heparin, salicylates, antihistamines, cortisone, ACTH, estrogens and NSAIDs may inhibit the spreading action and efficacy of hyaluronidase.
  • Furosemide, benzodiazepines, and phenytoin have been reported to be incompatible with hyaluronidase.

Animal studies have shown an adverse effect on the fetus. On the contrary, there are no adequate and well-controlled studies in pregnant women. Thus, this medicine is considered in pregnancy category C.

In addition, there are no adequate studies in women for determining infant risk when using this medicine during breastfeeding. But the potential benefits may warrant the use of this medication during pregnancy and lactation despite potential risks.

3 Proper Usage

Amphadase is usually given to the patients as a shot beneath the skin by a trained health professional or a nurse in healthcare settings.

A skin test should be carried out before receiving this medication to make sure you are not allergic to this drug.

The frequency of your daily drug administration and the duration of drug therapy depend on the particular health disorder for which you are taking the medicine. That’s why; the therapeutic dose may vary with patient’s condition or requirement.

For subcutaneous fluid administration (Hypodermoclysis):

  • The needle is inserted with aseptic precautions keeping the tip free and movable between skin and muscle.
  • Then clysis is started and hyaluronidase is injected into rubber tubing close to needle respectively. 150 U hyaluronidase will facilitate absorption of 1,000 ml or more of the solution.

For absorption and dispersion of injected fluids:

Absorption and dispersion of other injected drugs may be enhanced by adding 50-300 Units, most typically 150 U hyaluronidase, to the injection solution.

For subcutaneous urography:

The subcutaneous route of administration of urographic contrast media is indicated when intravenous administration cannot be successfully accomplished, particularly in infants and small children.

75 U of hyaluronidase is injected subcutaneously over each scapula, followed by injection of the contrast medium at the same sites.

You should take this medicine in time until the prescribed course is finished. If you miss any dose of this medicine, you should take it as soon as possible. But if it is time for your next dose, then you should skip the missed dose and go back to your regular treatment schedule.

You should store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. Moreover, outdated medicines should be disposed in an appropriate way.

4 Precautions To Take

Before using Amphadase, there are some precautions you must take. Visual inspection of all the parenteral medications for particulate matter and discoloration prior to administration is recommended.

The healthcare professional will check your progress closely while you are receiving this medicine. This will help your doctor to see whether the medicine is working properly or not.

Additionally, some people may be found allergic to this drug. You should not delay informing your doctor if you develop a rash, hives, red or itching skin, or trouble breathing after receiving hyaluronidase.

It is also advised not to take other medicines, even the over-the-counter drugs, and herbal or vitamin supplements unless they have been discussed with your doctor.

Moreover, this product should be used cautiously in infants, elderly, pregnancy and lactation, as well as in patients with impaired renal functions, and/or infections.

5 Potential Side Effects

There are some unwanted side-effects associated with Amphadase that usually do not need medical attention. These side-effects usually go away during the treatment episode as your body adjusts to the medicine. Your healthcare professional may advise you about the ways to prevent or reduce those unwanted side-effects.

Sometimes you may need to consult with the doctor if you feel any of the following serious toxic effects:

More Common

Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration or warmth at the injection site.

Less Common

Cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, redness of the skin, skin rash, tightness in the chest, unusual tiredness or weakness, and angioneurotic edema are the less common side effects.

Hypersensitivity reactions and anaphylaxis may also take place which is considered as potentially fatal conditions.

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