title: Subcutaneous Injection Volume of Biopharmaceuticals-Pushing the Boundaries.
abstract: Administration into the subcutaneous (SC) tissue is a typical route of delivery for therapeutic proteins, especially for frequent treatments, long-term regimens, or self-administration. It is currently believed that the maximum volume for SC injections is approximately 1.5 mL. Larger SC injection volumes are considered to be associated with injection pain and adverse events at the injection site. However, no controlled clinical studies and actual evidence exist to support this assumption. In this review, we discuss current and publically available data related to SC administration volumes. We conclude that injection volumes higher than 3.5 mL are worth exploring if required for the development of efficacious drug treatments. Studying tissue back pressure, injection site leakage, local tolerability, and injection-related adverse events, such as injection pain, should be considered for the development of higher SC injection volumes.
authors.affiliation: Drug Product Services, Lonza AG, Basel, Switzerland.
authors.forename: Roman
authors.initials: R
authors.lastname: Mathaes
authors.affiliation: Drug Product Services, Lonza AG, Basel, Switzerland.
authors.forename: Atanas
authors.initials: A
authors.lastname: Koulov
authors.affiliation: Drug Product Services, Lonza AG, Basel, Switzerland.
authors.forename: Susanne
authors.initials: S
authors.lastname: Joerg
authors.affiliation: Drug Product Services, Lonza AG, Basel, Switzerland. Electronic address: Hanns-Christian.Mahler@Lonza.com.
authors.forename: Hanns-Christian
authors.initials: HC
authors.lastname: Mahler
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000502:physiology; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000737:chemistry; D006801:Humans; D000075662:Injection Site Reaction / Q000517:prevention & control; D007279:Injections, Subcutaneous / Q000009:adverse effects / Q000379:methods*; D020714:Maximum Tolerated Dose; D010146:Pain / Q000517:prevention & control; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000737:chemistry; D012867:Skin / Q000187:drug effects; D012879:Skin Physiological Phenomena / Q000187:drug effects; D040521:Subcutaneous Tissue / Q000187:drug effects / Q000502:physiology
chemical_list: D000911:Antibodies, Monoclonal; D004364:Pharmaceutical Preparations
keywords: combination products; health care; hypodermis; injection pain; injection volume; subcutaneous injection