VITRASE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for VITRASE (VITRASE).
VITRASE (hyaluronidase) hydrolyzes hyaluronic acid, a component of the extracellular matrix, thereby increasing tissue permeability to fluids and facilitating the absorption and dispersion of injected drugs.
| Metabolism | Not fully characterized; presumed to be metabolized locally at injection site and in the liver via proteolysis. |
| Excretion | Renal: <10% unchanged; remainder metabolized locally. |
| Half-life | Approximately 24 hours for the enzymatic activity; clinical effect persists beyond half-life due to drug action. |
| Protein binding | Minimal, if any; specific binding proteins not well characterized. |
| Volume of Distribution | Not applicable; acts locally at injection site; systemic distribution negligible. |
| Bioavailability | Subcutaneous: 100% at local site; Intravitreal: 100% locally; not systemically available. |
| Onset of Action | Subcutaneous: Within minutes for spreading effect; Intravitreal: Immediate enzymatic dissolution. |
| Duration of Action | Subcutaneous: 24-48 hours for spreading effect; Intravitreal: Single administration usually sufficient for vitreous liquefaction. |
| Molecular Weight | 55000 |
Intravenous administration of 150 units as a bolus injection prior to subcutaneous fluid or medication administration to increase absorption and dispersion.
| Dosage form | INJECTABLE |
| Renal impairment | No dose adjustment required for renal impairment; Vitrase is not renally cleared. |
| Liver impairment | No dose adjustment required for hepatic impairment; metabolism is not hepatic-dependent. |
| Pediatric use | Intravenous administration of 150 units as a bolus injection prior to subcutaneous fluid or medication administration; same dosing as adults. |
| Geriatric use | No specific dose adjustment; standard adult dose of 150 units intravenously is appropriate. |
| 1st trimester | No well-controlled studies; hyaluronidase is used as a dispersing agent. Avoid unless clearly needed. |
| 2nd trimester | Use only if potential benefit justifies risk to fetus. |
| 3rd trimester | Use only if potential benefit justifies risk to fetus. |
Clinical note
Comprehensive clinical and safety monograph for VITRASE (VITRASE).
| Placental transfer | Hyaluronidase is a large molecule (55 kDa) and is unlikely to cross the placenta in significant amounts, but no human data. |
| Breastfeeding | Systemic absorption is minimal after local injection; however, no data on excretion in human milk. Consider benefit of therapy versus potential risk. |
| Lactation Rating |
■ FDA Black Box Warning
None
| Serious Effects |
Hypersensitivity to hyaluronidaseKnown allergy to any component of the formulation
| Precautions | Hypersensitivity reactions, including anaphylaxis, have been reported., Do not use in patients with known hypersensitivity to hyaluronidase or any ingredient in the formulation., Avoid injection into or around infected or inflamed areas., Use with caution in patients with thrombophlebitis or venous insufficiency., Fertility and pregnancy: Category C; use only if clearly needed. |
| Food/Dietary | None known. Vitrase is not known to interact with any foods or beverages. No dietary restrictions are required. |
Loading safety data…
| L3 - Moderately Safe |
| Teratogenic Risk | Vitrase (hyaluronidase) is classified as FDA Pregnancy Category C. Animal studies have shown no teratogenic effects, but no adequate human data exist. Risk cannot be ruled out; use only if clearly needed. |
| Fetal Monitoring | Monitor for signs of hypersensitivity, local adverse reactions. No specific fetal monitoring required. |
| Fertility Effects | No studies on fertility effects. Potential for local inflammation possibly affecting conception. |
| Clinical Pearls |
| Vitrase (hyaluronidase) is used as a spreading agent to enhance the absorption and dispersion of injected drugs, particularly in ophthalmic surgery (e.g., cataract extraction) and for subcutaneous hydration. It should not be used to treat extravasation of vasoconstrictive agents like dopamine or epinephrine. Allergic reactions, especially in patients with bee sting allergies, are possible. Do not use in the presence of infection or inflammation at the injection site. Store refrigerated and protect from light. |
| Patient Advice | This medication is given as an injection and helps other injected medicines spread more easily under the skin or in the eye. · You may experience temporary swelling, redness, or pain at the injection site. · Inform your healthcare provider if you have a history of allergies, especially to bee stings or other insect venoms. · If you experience signs of an allergic reaction (e.g., hives, difficulty breathing, swelling of the face), seek immediate medical attention. · Avoid rubbing or massaging the injection area unless instructed by your doctor. |