Description
Lidase Pharmacodynamics
Enzyme preparation isolated from the testes of cattle. It splits the main component of connective tissue interstitial substance – hyaluronic acid (mucopolysaccharide containing acetylglucosamine and glucuronic acid, which is the cementing substance of connective tissue), reduces its viscosity, increases tissue and vascular permeability, facilitates movement of fluids in interstitial spaces; reduces tissue swelling, softens and flattens scars, increases the amount of movement in joints, reduces contractures and prevents their formation. Hyaluronidase causes breakdown of hyaluronic acid to glucosamine and glucuronic acid and thus reduces its viscosity. Duration of action after intradermal injection – up to 48 h
Indications
– Burn, traumatic, post-operative scars.
– Non-healing ulcers (including radiation ulcers).
– Dupuytren’s contracture.
– Joint stiffness, joint contractures (after inflammation, trauma), osteoarthritis, ankylosing spondylitis, severe lumbar disc disease.
– Chronic tendovaginitis, scleroderma (skin manifestations), soft tissue hematoma of superficial localization.
– Preparation for skin-plastic surgeries for scar stitches.
– Pulmonary tuberculosis (complicated by non-specific bronchial lesions), inflammatory processes in the upper airways and bronchi with the phenomena of obstruction.
– Traumatic lesions of nerve plexuses and peripheral nerves (plexitis, neuritis).
– Hyphema, hemophthalmia, retinopathies of various etiologies.
Contraindications
Hypersensitivity, acute infectious and inflammatory diseases, recent bleeding, pregnancy, breast-feeding, children under 18 years of age.
For inhalational administration – pulmonary tuberculosis with marked respiratory insufficiency; pulmonary bleeding, hemoptysis; malignant neoplasms, fresh vitreous hemorrhage. Concomitant administration of estrogens.
Caution
Chronic renal insufficiency (use no more than once a week).
Administration during pregnancy and lactation
The drug is contraindicated in pregnancy and during breastfeeding.
Dosage and administration
- 1280 ME of lidase (hyaluronidase) corresponds to 64 U of lidase (hyaluronidase).
- In cicatricial lesions the drug is injected subcutaneously (under the scar tissue) or intramuscularly (near the lesion) 1280 ME daily or every other day (10-20 injections in total). To prepare the solution for injection in case of scar lesions, the contents of the ampoule is dissolved in 1 ml of 0.9% sodium chloride.
- In traumatic lesions of nerve plexuses and peripheral nerves are injected subcutaneously in the affected nerve area (1280 ME) every other day; 12-15 injections per course. The course of treatment is repeated if necessary. To prepare a solution for injection in traumatic lesions, the contents of one ampoule is dissolved in 1 ml of 0.5% procaine.
When used in ophthalmologic practice the drug is administered subconjunctival – 0.3 ml, parabulbar – 0.5 ml as well as by electrophoresis. For use in ophthalmology the contents of one ampoule is dissolved in 1 ml of 0.9% sodium chloride solution. - Patients with pulmonary tuberculosis with productive character of inflammation are prescribed as part of complex therapy to increase concentration of antibacterial drugs in the lesion as injections and/or inhalations. Inhalations are carried out once daily. For one inhalation the contents of an ampoule (1280 ME) are dissolved in 5 ml of 0.9% sodium chloride solution. A course of treatment consists of 20-25 inhalations. If necessary, repeat courses at intervals of 1.5-2 months.
- Externally, in the form of dressings soaked in the drug solution. To prepare the solution, every 1,280 ME is dissolved in 10 ml of sterile 0.9% sodium chloride solution or boiled water at room temperature. A sterile dressing folded in 4-5 layers is moistened with this solution, applied to the affected area, covered with wax paper and fixed with a soft dressing. The dose depends on the area of the lesion (640-1280 ME per sq cm), averaging 6400 ME per bandage. The dressing is applied daily for 15-18 hours for 15-60 days. In case of long-term use a break is taken every 2 weeks for 3-4 days.
- When administered by electrophoresis, one ampoule of the drug (1280 ME) is dissolved in 60 ml of distilled water, 2-3 drops of 0.1% hydrochloric acid solution is added and injected onto the affected area for 20-30 minutes using an anode. The course of treatment is 15-20 sessions. Applicative dosing mode can be alternated with electrophoresis. The prepared solution should be used within 24 h.
