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Enzyme — Hyaluronic Acid Filler Reversal Agent

Hyaluronidase

Brand names: Hyalase

Hyaluronidase is an enzyme used to increase the dispersion and absorption of co-administered fluids and drugs, to aid subcutaneous fluid administration, and in plastic and aesthetic practice to dissolve hyaluronic acid dermal filler.

Dosing — not shown for this use

The product information we hold does not support a dose for this page's specific use, route or population, so none is shown. Follow your local or national guideline, and confirm against the product SmPC.

Clinical monograph

How it works

It temporarily depolymerises hyaluronic acid, a component of interstitial ground substance, reducing tissue viscosity and increasing the permeability and spread of injected substances through connective tissue.

Prescribing in practice

  • Do not inject into or around an infected or acutely inflamed area, as enhanced spread of the enzyme may disseminate infection.
  • Hypersensitivity reactions, including anaphylaxis, can occur, so administer where resuscitation facilities are available and have anaphylaxis management to hand.
  • When used to manage filler complications, confirm the product and indication and follow current prescribing references and specialist guidance.

Monitoring

Observe for immediate local and systemic hypersensitivity reactions and review the treated area for the intended clinical effect.

Counselling the patient

  • Explain that this enzyme helps spread or, in aesthetic use, dissolve injected material.
  • Advise the patient to report swelling, rash, breathlessness or other signs of an allergic reaction urgently.
  • Note that more than one treatment may be required when reversing dermal filler.

Evidence & guidelines

Use is supported by established pharmacology and the product SPC; refer to current prescribing references and specialist aesthetic guidance for filler-related indications.

Reference: BCAM Filler Emergency Guidelines 2022; JCCP (Joint Council for Cosmetic Practitioners) Vascular Occlusion Protocol; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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