Chloroprocaine and Hyaluronidase: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Chloroprocaine
No brand names on recordHyaluronidase
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased incidence of a systemic reaction to the anesthetic
Interaction Deep Dive
Hyaluronidase will effectively increase the diffusion of local anesthetics5678. It hastens the onset of anesthesia, tends to reduce swelling caused by local infiltration 1, and prevents the onset of hematoma, due to the action of the spreading factor 4, but the wider spread of the local anesthetic solution increases its absorption. This shortens its duration of action and tends to increase the incidence of systemic reaction 1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) One case of temporary blindness has been reported following retrobulbar injection of an anesthetic to which hyaluronidase had been added 2. Cardiopulmonary arrest was reported immediately after retrobulbar block with a mixture of 2 ml of 0.5% BUPivacaine, 2% mepivacaine, and hyaluronidase 3. The authors speculated it was precipitated by the local anesthetic being transported through the ophthalmic artery to the carotid artery and the other midbrain structures. In addition, hypersensitivity reactions and anaphylaxis have occurred following the use of hyaluronidase 2. Hyaluronidase also shortens the duration of anesthesia. The addition of EPINEPHrine prolongs the duration of anesthesia, but does not affect the diffusion facilitated by the hyaluronidase 4.
Common questions
Can I take Chloroprocaine and Hyaluronidase together?
An increased incidence of a systemic reaction to the anesthetic Always confirm with your pharmacist or prescriber before making any change.
How serious is the Chloroprocaine and Hyaluronidase interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Chloroprocaine or Hyaluronidase need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (8)
- Product Information: AMPHADASE(R) subcutaneous injection, hyaluronidase subcutaneous injection. Amphastar Pharmaceuticals, Inc. (per FDA), Rancho Cucamonga, CA, 2024. DailyMed
- Meyler LMeyler L (Ed): Side Effects of Drugs, 1, Excerpta Medica Fdn, New York, 1971.
- Rosenblatt RM, May DR, & Barsoumian K: Cardiopulmonary arrest after retrobulbar block. Am J Ophthalmol 1980; 90:425-427.
- Ghoneim MM: Drug interactions in anesthesia - a review. Can Anaesth Soc J 1971; 18:353-375.
- Smith RB & Linn JG Jr: Retrobulbar injection of bupivacaine (Marcaine(R)) for anesthesia and akinesia. Invest Ophthal 1974; 13:157.
- Steinberg MD: Therapy of osteoarthritis of the great toe and hallux rigidus. JAMA 1971; 217:215. DOI
- AMA Council on DrugsAMA Council on Drugs: AMA Drug Evaluations, 6th. American Medical Association, Chicago, 1986.
- Reynolds JEFReynolds JEF (Ed): Martindale: The Extra Pharmacopoeia, 28th. The Pharmaceutical Press, London, England, 1982.
Keep reading about Chloroprocaine
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