The enzyme hyaluronidase is used in medicine. Alternative options for removing fillers

Elena 03/15/2018 cheekbone contouring 3 answers from doctors

Hello, after hypercorrection with Belotero filler under the eyes, on the recommendation of your specialists, I did hyaluronidase. Now it's even worse. There was a large swelling under one eye, probably a hematoma and bruise at the site where the needle was inserted. I can’t remove this swelling with anything, I tried Traumeel gel, Lyoton, and applied cold. In the morning it's just terrible. It's scary to watch. I just don’t know what to do anymore. 5 days have passed since the injection. The cosmetologist said that the swelling can last up to a week. But I don’t see any decrease.

Doctors' answers

Hello, Elena! Indeed, after the administration of hyaluronidase, there may be swelling; on average, it can last up to a week, because Hyaluronidase significantly increases the permeability of blood vessels and the zone is quite delicate, if there is a hematoma (it’s hard to see from the photo - an objective examination is needed), then it and the swelling itself compress the vessels, further complicating the lymph flow. See a doctor and discuss the possibility of using microcurrents to improve lymphatic drainage function.

Hello Elena. I agree with my colleague, a microtome really helps solve the problem with swelling. If you do not see the result of lymphatic drainage microcurrent therapy, then the drug MesoAI MESOEYE will help very well. I’ll write right away that the procedure is not cheap, unlike microcurrent therapy. If you have any questions, please contact us

Good night! If the problem has not yet been solved, I invite you to our clinic. We will help you for free. No amount of mesoai will help here. don't waste your money. In order to decide what to do, you need to understand what you have now. If it is a bruise, as you suggested, then within 5 days some dynamics would appear. If this is a reaction to Longidase (but I don’t see any redness), then you just need to just inject dexamethasone in the butt. But, most likely, this is a filler that has swollen from longidase and increased in volume, but has not been removed due to the fact that longidase was in insufficient quantities of saline solution. In general, you need to figure it out in person. In any case, there is no need to be upset, everything will be fixable.

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ART Clinic

Moscow, 1st Tverskoy Yamskaya lane, 13/5, Institute of Neurosurgery named after. N.N.Burdenko, 1st building, 3rd floor

"ART-Clinic" - clinic plastic surgery and cosmetology The Clinic of Plastic Surgery and Cosmetology “ART-Clinic” operates on the basis of the Institute of Neurosurgery named after N.N. Burdenko since 2003. Its founder, Alexander Ivanovich Nerobeev, is an outstanding surgeon, professor, doctor medical sciences, Honored Scientist Russian Federation, laureate of the State Prize of the Russian Federation, an extra-class specialist, recognized not only in our country, but also abroad, to this day he personally conducts the most complex operations. Through the efforts and energy of Professor Alexander Ivanovich Nerobeev, a school of unique specialists has been created who are able to successfully manage the most serious cases, including complications after plastic surgery. The priority of ART-Clinic is the enormous experience of its specialists in the field of cosmetology, plastic and maxillofacial surgery, as well as a first-class scientific and technical base. Over the years of successful work, ART-Clinic has earned a reputation as a company that meets international standards of quality and professionalism. Therefore, today it is here that not only the most popular and sought-after aesthetic surgeries are performed, but also the most complex, rare and even unique corrections. The ART-Clinic team is: Many years of successful experience A team of highly qualified doctors Modern minimally invasive methods of operations and reconstructions Responsibility, openness and professionalism More than 10,000 satisfied patients Beauty will save the world, and aesthetic medicine will support it in this

Hyaluronidase – active substance, which is included in a number of drugs, it is a lyophilized powder, or a light beige porous mass that dissolves quite easily in water.

Action of Hyaluronidase

Hyaluronidase has a proteolytic effect, as it reduces viscosity hyaluronic acid, increases the permeability of tissues, in addition, improves trophic processes in them, increases the elasticity of directly scarred areas, making them softer.

Preparations containing hyaluronidase promote the resorption of hematomas, in addition, improve joint mobility, and also eliminate existing contractures (scar tightening of the skin, leading to limited movement in the joint).

In addition, hyaluronidase preparations facilitate the diffusion of fluids directly into the interstitial space. When carrying out intradermal application, when the amount medicinal substance varies from 0.002 to 20 U/ml, the active substance is effective for up to two days.

Hyaluronidase has antigenic properties, which repeated administrations V large quantities may lead to the formation of neutralizing antibodies.

Indications for use of Hyaluronidase

I will list when hyaluronidase preparations are indicated for use:

If there is joint contracture;
With ankylosing spondylitis;
Enzyme medications are prescribed for scleroderma;
At traumatic lesions peripheral nerves;
If there are hematomas;
With damage to the lumbar discs;
An effective remedy for myocardial infarction;
For hydrocephalus;
Drugs are prescribed to improve the absorption of injectable solutions, as well as radiocontrast agents, in addition local anesthetics;
For keratitis, for better scarring of damaged areas of the cornea;
For scars after burns and transferred operations;
For long-term non-healing ulcers of trophic and radiation origin.

In addition to the listed situations, hyaluronidase preparations are used in complex therapy pulmonary tuberculosis, allergic rhinitis, as well as arachnoiditis and rheumatoid arthritis.

Contraindications to the use of Hyaluronidase

I will list the contraindications when similar drugs cannot be used:

With hypersensitivity to hyaluronidase;
For acute inflammatory and infectious diseases;
With recent hemorrhages;
For pulmonary tuberculosis occurring with severe respiratory failure;
With pulmonary hemorrhage;
In the presence of hemoptysis;
For malignant neoplasms;
With simultaneous use of estrogens.

In addition, a contraindication is fresh hemorrhage in the organ of vision, in particular in vitreous.

Application and dosage of Hyaluronidase

When using drugs parenterally, in particular subcutaneously and intramuscular injection, it is recommended to prescribe a dosage of 64 units daily or every other day, while the therapeutic course is designed for 10 or 20 injections.

Inhalation use of drugs involves a dosage of 320 units daily, with a therapeutic course designed for 20 or 25 inhalations. The medicine is used using this method for twenty minutes, and the number of sessions can vary from 10 to 15.

In ophthalmology, similar products containing hyaluronidase are also used by electrophoresis, in addition, subconjunctivally, as well as parabulbarly.

Side effects Hyaluronidase

Introduction of similar medicines may cause allergic reactions, including anaphylactoid manifestations. In addition, ventricular fibrillation is possible. Infiltration and soreness may be observed at the immediate injection site.

Overdose from Hyaluronidase

In case of overdose will be noted following symptoms: chills will appear, nausea, vomiting will appear, there may be dizziness, in addition, tachycardia and decreased blood pressure, and also characteristic local swelling, redness and development of urticaria.

In this case, the patient is administered epinephrine, glucocorticoids are prescribed, in addition, antihistamines, as well as other symptomatic medications.

special instructions

Before using the drugs, the patient should undergo a sensitivity test directly to hyaluronidase.

Preparations containing Hyaluronidase (analogs)

The active substance hyaluronidase is contained in the drug Lidaza, which is produced in a lyophilisate for the preparation medicinal solution for injections, as well as for local use. The product is effective in the presence of postoperative scars, burns and traumatic injury skin, in addition, in other conditions.

The next medicine that contains hyaluronidase is Lyrase, it is available in lyophilisate and powder. Another enzyme preparation called Nidaza-ImBio. In addition, there are the following medications: Ronidase and Actinogial.

Conclusion

We talked about Hyaluronidase. Instructions for use indicate its contraindications.
The use of such medications should be carried out on the advice of a qualified specialist.

Svetlana Kryukova, Ph.D., dermatovenerologist, cosmetologist, certified teacher, leading specialist of the UMC GK

Injection procedures, despite their pain and mixed reviews in the media, have not lost popularity for many years. It's no coincidence that contour plastic surgery, biorevitalization and mesotherapy account for the lion's share of services in therapeutic cosmetology, since these are the methods that allow you to get the fastest and most visible results when solving a whole range of aesthetic problems.

The most popular component in preparations for intradermal administration is hyaluronic acid (HA) - a substance that naturally present in human skin and is considered the most physiological and safe agent. As is known, manufacturers of HA preparations initially used raw materials of animal origin - cockscombs, umbilical cord of mammals and even humans. This hyaluronic acid is still used today, but is becoming less and less in demand due to its pronounced antigenic properties and high risk complications. Modern biotechnological methods allow the use of much safer non-animal, or biotechnological, HA obtained by bacterial fermentation with streptococci.

In aesthetic medicine, intradermal administration of HA has been used for more than 15 years. This is a long enough period to evaluate the pros and cons of various methods.
The advantages, of course, include very fast and visible result, physiology, a small number of contraindications, minimal risk of side effects and complications, including allergic reactions (the latter applies to drugs based on HA of non-animal origin). Numerous Scientific research objectively confirm the effectiveness of HA for solving a variety of aesthetic problems.
The disadvantages include the rather careless attitude of many patients and doctors towards these “universal methods of rejuvenation and correction of aesthetic defects”, which often leads to their use without objective reasons, simply to please fashion and the desire of the patient. It is unfortunate that many specialists accept the patient's decision to perform a procedure as a guide to action without thinking twice.
Does the dream of such patients about eternal youth and beauty? And what are long-term consequences abuse of HA injection procedures? These are questions that are increasingly being raised at scientific events dedicated to the problems of dermatology and cosmetology, both in Russia and abroad.

Over the past five to seven years, the expression “hyaluronic acid eater” has become firmly established in the lexicon of specialists to identify people with increased activity endogenous hyaluronidase, in which injection administration of even stabilized HA does not give prolonged results. At first, it was suggested that there was some kind of genetic malfunction in the body’s enzyme system, which is why the production of hyaluronidase increases. However, it has been observed that the vast majority of such patients have repeatedly resorted to hyaluronic acid therapy in their lives. In their case, hyperstimulation of the skin led to the depletion of their own reserves of self-healing and self-regulation, so pronounced signs of early aging appeared very quickly.
Thus, the phenomenon of “hyaluronic acid eater” can be attributed to acquired pathological condition iatrogenic nature. To understand this phenomenon, it is necessary to consider the features of the physiological functioning of the skin at the cellular level.

The role of hyaluronic acid in the functioning connective tissue
Our skin is by no means an autonomous structure: all organs are constantly in close interaction. Each of them contains specialized cells that perform its inherent functions (in the liver - hepatocytes, in the brain - neurons, in the blood - erythrocytes and leukocytes, etc.). Between these cells is connective tissue, which makes up about 85% of our body and can be in various forms. states of aggregation- solid (bone), liquid (blood, lymph, cerebrospinal fluid), gel-like (cartilage, intercellular substance). IN human body connective tissue can be considered as unified system with the principle of feedback, which implements the interaction between other tissues (epithelial, muscle, nervous, etc.). One of the organs where connective tissue is most widely represented is the skin, or more precisely, its structures such as basement membrane, dermal layer and hypodermis.
The main difference between connective tissue and all other tissues of the body is the development of the intercellular matrix with a relatively small number of cellular formations. The intercellular matrix is ​​built from molecules of proteoglycans and glycosaminoglycans (including hyaluronic acid) and collagen and elastin fibers.

Like all living things on Earth, the matrix obeys certain biorhythms. The main thing in the restoration of connective tissue is the daily rhythmic alternation of the reactions of acidosis and alkalosis, which occur under conditions acid-base balance. The adenopituitary-adrenal axis, through hormonal induction, interferes with the acid-base balance, initiating acidification of the matrix at three o'clock in the morning, which is replaced by alkalization after 15 o'clock.
Acidosis is a phase of physiological inflammation during which sympathetic activity predominates. nervous system and the hormones adrenaline and thyroxine, they stimulate the activity of hyaluronidase, which destroys the molecules of glycosaminoglycans, proteoglycans and collagen, making the main substance more liquid, thereby accelerating metabolic processes aimed at neutralizing and eliminating toxic substances.
Alkalosis - the recovery phase - coincides with the activity of the parasympathetic nervous system. During this phase, synthetic enzymes are activated, restoring matrix components destroyed during the acidosis phase. The “purity” of connective tissue and, accordingly, the life, health and beauty of a person depend on the normal course of acidosis and alkalosis and their timely alternation.

At the matrix level, a phase change occurs through the interaction of the enzyme hyaluronidase and glycosaminoglycans, the most important of which is hyaluronic acid. Half of all HA in the human body is concentrated in the skin, where it is located in the dermis between collagen and elastin fibers, as well as in the cells of the stratum corneum - corneocytes. Hyaluronic acid has a much longer molecule than other glycosaminoglycans and is the only member of this family that is not associated with a sulfate group. Compared to other glycosaminoglycans, HA also has the most pronounced hydrophilic properties.

On average, in a person up to 40 years of age, the GC content in tissues remains fairly stable, and then begins to steadily decline, as the number of fibroblasts and their synthetic activity in relation to the production of glycosaminoglycans decreases. The process is accelerated by negative factors that cause oxidative stress at the skin level: smoking, UV irradiation, uncontrolled medication use, poor nutrition, etc. They largely contribute to changes in the very structure of HA molecules, which polymerize and lose their ability to release water molecules with preserved ability to bind them.

As a person ages, HA in the skin is concentrated mainly deep in the dermal layer, therefore, at the junction of the dermis and hypodermis, stagnation of fluid occurs - intercellular edema, which is visually manifested by pastiness and swelling. The more superficial layers of the skin, on the contrary, under such conditions are deprived of the necessary moisture, which leads to severe dehydration (so-called age-related dryness), thinning of the skin, the appearance of wrinkles, and disruption of pigment metabolism. Polymerization of HA molecules makes their degradation and renewal difficult. HA is destroyed by the enzyme hyaluronidase. Synthesis and catabolism normally occur very quickly: in fact, 70 HA is destroyed and synthesized every 24 hours, and when its molecules polymerize, the renewal rate decreases tenfold.

With age and/or under the influence of negative external influence glycosaminoglycans and proteoglycans of the matrix are partially replaced by defective molecules that are not able to fully perform their physiological functions. It leads to increased production hyaluronidase, which should restore their normal structure, but at the same time the aggressiveness of the enzyme itself increases. It should be noted that under such conditions, the synthesis of hyaluronidase in different areas of the skin occurs unevenly, the biological rhythms of the matrix are disrupted and “cold” and “hot” areas appear.
In “cold” areas, the production of hyaluronidase is reduced, as a result of which the alkalosis phase is prolonged, clinically this is manifested by fibrous-granulomatous formations. In “hot” conditions, the synthesis of hyaluronidase is increased, which leads to the transition of physiological basic inflammation into pathological inflammation, quickly spreading to both the intercellular and intracellular matrix, and to the vascular formations of the skin, etc.

Due to the increased aggressiveness of hyaluronidase, the “hyaluronic acid eater” phenomenon occurs, in which allopathic therapy with HA drugs is not only ineffective, but it leads to even greater activation of endogenous hyaluronidase and the manifestation of its auto-aggressive properties. Each new dose of exogenously administered HA only “inflames the appetite” of hyaluronidase, and when the received portion runs out, the enzyme begins to destroy its own molecules, regardless of their importance for the body.
The intradermal administration of allopathic forms of hyaluronidase temporarily switches “cold” areas into the inflammation phase, facilitating the removal of accumulated toxic substances and restoration of normal tissue structure, but at the same time (in accordance with the Arndt-Schultz dose law) the activity of endogenous hyaluronidase is suppressed, which ultimately, after some time, leads to an even greater blocking of the inflammatory phase, and, consequently, the accumulation of new toxins.

New biorevitalization strategy
Regulation of the mechanism of action of hyaluronidase is one of the most important goals of true biorevitalization. Ultra-small, that is, homeopathic, doses of hyaluronidase and hyaluronic acid can help accomplish this task without harm to the body. Homeopathic medicines refer to biological medicine that takes into account the integrity of processes in the human body. Substances in homeopathic form act in accordance with the principle of similarity, optimizing the synthesis and functioning of a substance similar to itself.
Thus, for homeopathic hyaluronidase, the point of application of the therapeutic action will be endogenous hyaluronidase, and for homeopathic HA - endogenous HA. It is quite obvious that the optimal way to deliver these substances will be the mesotherapy method, since in this case the needle is a conductor of drugs to the place of their influence - the connective tissue matrix. This type of therapy is called biological mesotherapy, or homeomesotherapy. Considering the fact that the matrix is ​​an integral system of the body, then by acting on the matrix of the dermis, we can achieve therapeutic effect at the level of the organism as a whole.

The founder of mesotherapy, M. Pistor, wrote: “The effect of mesodermal origin on tissue is so significant that this method of therapy should be given a general name - mesotherapy” (La Presse medicale, 1958).
Ultra-small (homeopathic) doses of substances help to activate the body’s own reserves, that is, to carry out regulatory therapy rather than replacement therapy. It is much more physiological than substitutive and suppressive, since it does not contradict the basic biological processes, but supports them. Moreover, regulation physiological processes in the matrix - this and good preparation, and a complement to the use of classical allopathic techniques for the injection of HA. There are complex methods of biorevitalization that have been developed, including homeomesotherapy with ultra-low doses of HA and hyaluronidase, classical mesotherapy with allopathic doses of non-animal hyaluronic acid of biotechnological origin.

Homeomesotherapy is carried out at the beginning of the course of therapy in the amount of 1-2 sessions, this is enough to start the processes of sanogenesis and regulate the aggressiveness of hyaluronidase, then these procedures are alternated with the introduction of allopathic forms of HA. The effect is like this combination therapy is as stable and long-lasting as possible, allowing you to reduce the number of sessions of classical allopathic biorevitalization. This, on the one hand, saves the patient’s expenses, since drugs for classical birevitalization are quite expensive, on the other hand, it saves emotional health, because the procedures are quite traumatic and painful.
And, of course, we should not forget that skin aging is not an independent process, but a reflection of the general aging of the body, therefore, lifestyle and nutrition correction should be an obligatory component of any therapy.

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Hyaluronic acid is used as a base in a variety of anti-aging products of varying strengths, as well as in a number of procedures to restore skin condition.

There are cases when the body may reject the injected hyaluronic acid and cause side effects, and also during the bioreinforcement procedure, uneven administration of the drug is possible, due to which one area of ​​the skin will become fuller than another.

The most problems and complications occur on the lips after contouring. But even without that, there are unpleasant consequences, which you need to get rid of as quickly as possible, because you have to wait until the fillers dissolve and come out naturally no possibility.

To eliminate such side effects and unwanted effects and accelerating the biodegradation of hyaluronic acid and the enzyme hyaluronidase was removed.

Initially it was used in medicine (Longidaza), but then it was found wide application and in cosmetology. This is practically the only method for eliminating and resolving hyaluronic acid.

Hyaluronidase is a group of enzymes that are capable of breaking down hyaluronic acid into low molecular weight fragments.

Lidaza and fillers

A reaction to fillers can occur both in the first weeks and after a year, and in some cases and after several years, when, theoretically, hyaluronic acid should have been absorbed.
In such cases, to speed up the processes of resorption and excretion an indispensable tool becomes hyaluronidase.

In addition, it is used to eliminate the consequences incorrect insertion fillers, namely:

• uneven amount of gel;
• some infectious diseases;
• unnatural skin tone;
• complications on blood vessels due to their blockage during injections;
• insufficiently deep or excessive needle insertion;
• discrepancy between the density of the drug and the injection area;
• gel migration.

The time interval between the administration of the anti-aging drug and hyaluronidase does not matter; the emphasis should be placed only on the volume of the injected solution, its density and concentration.
It should be noted that some fillers are more sensitive to hyaluronidase than others due to their composition.

The area of ​​drug administration also requires an individual approach. For example, when papules of abnormal size appear, the drug should be injected in a minimum volume into the center of the papule.

Longidaza and the Tyndall effect

Besides unpleasant consequences Excessive administration of hyaluronic acid may result in the Tyndall effect, which is especially common in patients with thin, “transparent” or sensitive skin.

Fillers are introduced not only to rejuvenate the skin, but also to return it to a healthy color. With superficial administration, a change in shade from blue to burgundy, red or yellowish may be observed. It changes both above the area of ​​filler injection and in neighboring areas.
In this case, the drug can be administered several times, but not more often than once every 2-3 weeks. A repeat course may be necessary if serious damage skin that cannot be eliminated in one go.

Hyaluronidase only acts on biodegradable fillers, which are mostly used in cosmetology. Fillers based on silicone or polyacrylamide gel cannot be removed from the body in this way, but only through surgery or similar intervention.

When using lidase, it must be taken into account that in individual cases side effects may also occur. Therefore, it is necessary to conduct an allergy test and consult a cosmetologist.

TO side effects relate:

• 1. Allergic reaction may arise both from the drug itself and from its interaction with the injected fillers.
• 2. There may be a risk of decreased production of natural hyaluronic acid.
• 3. The entire filler can be completely dissolved, which will even destroy positive effect from its introduction. Therefore, when making local correction, one should take into account the subsequent need to contact specialists for repeat procedure based on hyaluronic acid.
• 4. B in rare cases Infectious diseases associated with the insertion of a needle into the layers of the skin are possible.

It is necessary to carry out contour plastic surgery and biorevitalization only in trusted clinics with well-known specialists, observing all precautions. The same applies to eliminating the unpleasant consequences of correction with hyaluronic acid.
It is not recommended to use hyaluronidase on your own, so it is better to consult a doctor.

Hyaluronidase INN

Pharmachologic effect:

Enzyme preparation isolated from the testes of large cattle. Breaks down the main component of the interstitial substance of connective tissue - hyaluronic acid (mucopolysaccharide, which includes acetylglucosamine and glucuronic acid, is a cementing substance of connective tissue), reduces its viscosity, increases tissue and vascular permeability, facilitates the movement of fluids in the interstitial spaces; reduces tissue swelling, softens and flattens scars, increases range of motion in joints, reduces contractures and prevents their formation. Hyaluronidase causes the breakdown of hyaluronic acid into glucosamine and glucuric acid. Duration of action when administered intradermally is up to 48 hours.

Indications:

Burns, traumatic, postoperative scars; long-term non-healing ulcers (including radiation); Dupuytren's contracture; joint stiffness, joint contractures (after inflammatory processes, injuries), osteoarthritis, ankylosing spondylitis, serious illnesses lumbar discs; chronic tendovaginitis, scleroderma ( skin manifestations), soft tissue hematoma of superficial localization; preparation for skin plastic surgery for scar tissue. Myocardial infarction, hydrocephalus. Pulmonary tuberculosis (complicated by nonspecific lesions of the bronchi), inflammatory processes in the upper respiratory tract and bronchi with symptoms of obstruction. Complex therapy of allergic rhinitis, rheumatoid arthritis, arachnoiditis. Traumatic lesions nerve plexuses and peripheral nerves (plexitis, neuritis). To improve the absorption of drugs administered subcutaneously and intramuscularly. Keratitis (for finer scarring of the affected areas of the cornea).

Contraindications:

Hypersensitivity, acute infectious and inflammatory diseases, recent hemorrhages. For inhalation administration- pulmonary tuberculosis with severe respiratory failure; pulmonary hemorrhage, hemoptysis; acute intercurrent diseases; malignant neoplasms, fresh hemorrhage into the vitreous body. Concomitant use of estrogens. With caution - pregnancy, lactation period.

Dosage regimen:

For scar lesions, 64 IU (1 ml) is administered subcutaneously (under the scarred tissue) or intramuscularly (near the site of the lesion) daily or every other day (10-20 injections in total). For traumatic lesions of the nerve plexuses and peripheral nerves, a subcutaneous injection is administered into the area of ​​the affected nerve (64 UE in novocaine solution) every other day; per course - 12-15 injections. The course of treatment is repeated if necessary. When used in ophthalmic practice, a 0.1% solution is instilled simultaneously with application antibacterial drugs(sulfonamides, antibiotics). For retinopathy, it is also injected under the skin of the temple; for hemorrhages into the vitreous body - under the conjunctiva and/or retrobulbar. Patients with pulmonary tuberculosis with a productive nature of inflammation are prescribed in complex therapy to increase the concentration of antibacterial substances in the lesions in the form of injections and/or inhalations. Inhalations are carried out once daily using 5 ml of solution (320 CU). The course of treatment consists of 20-25 inhalations. If necessary, repeat courses are carried out at intervals of 1.5-2 months. Externally, in the form of bandages soaked in a solution of the drug. To prepare the solution, every 64 IU is dissolved in 10 ml of sterile isotonic sodium chloride solution or boiled water room temperature. A sterile bandage folded in 4-5 layers is moistened with this solution, applied to the affected area, covered with wax paper and fixed. soft bandage. The dose depends on the area of ​​the lesion (20-60 IU/sq.cm), on average - 300 IU per bandage. The bandage is applied daily for 15-18 hours for 15-60 days. At long-term use Every 2 weeks they take a break for 3-4 days. When used by electrophoresis, 300 IU is dissolved in 60 ml of distilled water, add 2-3 drops of a 0.1% solution of hydrochloric acid and injected from the anode onto the affected area for 20-30 minutes. The course of treatment is 15-20 sessions. The application dosing regimen can be alternated with electrophoresis. The prepared solution must be used within 24 hours.

Side effects:

Allergic reactions; with long-term use - local irritating effect. Overdose. Symptoms: chills, nausea, vomiting, dizziness, tachycardia, decreased blood pressure, local edema, urticaria, erythema. Treatment: administration of epinephrine, corticosteroids; antihistamines.

Special instructions:

The solution should not be administered through a catheter into which solutions containing cations have previously been injected. Solutions for injection are prepared using isotonic sodium choride solution or 0.5% procaine solution, for inhalation - using isotonic sodium chloride solution, for electrophoresis - using distilled water. Before starting treatment, it is advisable to conduct a test with intradermal injection of 20 μl of hyaluronidase. Should not be introduced into areas infectious inflammation and tumors.

Interaction:

Improves the absorption of drugs administered subcutaneously or intramuscularly, enhances the effect of local anesthetics.