Dissolving filler with hyaluronidase: what the label says, what reviews found and the risks

Hyaluronidase is an enzyme used to break down hyaluronic acid filler. That use is not on the label we read. The Amphadase label lists it as an adjuvant for subcutaneous fluids, to increase the absorption and dispersion of other injected drugs, and in subcutaneous urography.¹

Here is what the label says, what reviews found about using it for filler complications and what to ask. It gives no dose and no technique. Whether to dissolve filler is for you and a clinician.

What the label says

Amphadase is an enzyme the label calls an endoglycosidase. The label lists three uses, none of them for filler.¹ Using an approved drug for something its label doesn't list is called off-label use. Doctors may do this, but the label doesn't describe the use, so ask what the plan is based on.

The label says hyaluronidase must not be used by anyone with hypersensitivity to it or to anything in the formulation. It warns against injecting it into or around an infected or acutely inflamed area, because of the danger of spreading a localized infection, against applying it directly to the cornea, and against intravenous injection, because the enzyme is rapidly inactivated.¹

What reviews found

A 2024 review says hyaluronidase can reverse complications of hyaluronic acid fillers. It finds limited controlled data but increasing clinical experience, and that the hyaluronidases in use give good results with an acceptable safety profile. It notes differing opinions on dosing, and that for inflammatory nodules hyaluronidase should be considered alongside oral antibiotics.²

A 2025 review of filler complications around the eyes found that the most reported were redness, swelling and bruising right after injection, followed by early contour irregularities and blue discoloration. These were mainly minor and reversible through conservative management or hyaluronidase.³ It covers loss of vision as a complication too. Our page on under-eye filler covers that area.

Side effects

The label says the most frequently reported reactions are at the injection site. It says hyaluronidase has been reported to enhance the adverse reactions of drugs injected with it, that allergic reactions such as hives and swelling have been reported in under 0.1% of patients, and that anaphylactic-like reactions, mostly with injections around the eye (a retrobulbar block) or into a vein, have occurred rarely.¹

Only hyaluronic acid

Hyaluronidase is used for hyaluronic acid filler. The FDA says reducing or removing filler may need injections, surgery or other procedures, which carry their own risks, and that it may be difficult or impossible to remove some filler materials, especially permanent ones or those not made of hyaluronic acid.⁴ Ask which filler you have had and whether it can be dissolved.

Which licensed professionals may inject depends on your state. See our guide to who may inject, and our overview of dermal fillers.

Here is what to bring to a consultation.

Cost

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Common questions