Manufacturer : Merz Pharmaceuticals

Active Substance(s) : Hyaluronic acid, mannitol

Strength : 23mg/ml

Pack Size : 2-1ml prefilled syringes

Accessories : Package insert, 4-27G 1/2" needles, 4 traceability labels

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ETERMIS 2 - 20 mg/ml - 2 x 1 ml


Main Benefits

  • Helps correct the appearance of mild and superficial wrinkles.
  • The antioxidant mannitol helps thyaluronic acid last longer.
  • Hyaluronic acid helps hydrate and restore volume and stimulates collagen.
  • Good tolerability, low rate of adverse events, and low extrusion force.


Hyaluronic acid 20 mg/ml, sodium phosphate buffer pH 7.1 q.s. for 1 g, and mannitol.

Ingredients Information

  • Hyaluronic acid: holds moisture within skin to restore hydration and volume while stimulating collagen growth.
  • Mannitol: an antioxidant to trap free radicals and reduce hyaluronic acid degradation.

Use Instructions

  1. Ensure filler is at room temperature.
  2. Inspect package for damage and check expiry date. Do not use if damaged or expired.
  3. Inform patient of product indications, contraindications, incompatibilities, and potential undesirable effects. Discuss risks with patient and ensure they are aware of signs and symptoms of potential complications.
  4. Gently unscrew cap from syringe.
  5. Screw needle onto luer lock connection by gently turning until it is in place. The manufacturer recommends using the supplied needles. If you choose to use a cannula, depending on injection technique and area injected, ensure it has an inner diameter at least as big as the diameter of the supplied needles.
  6. Pull needle protective cap horizontally to remove.
  7. Thoroughly disinfect treatment area.
  8. Slowly inject filler into the upper dermis, at about a 15 degree angle between the needle and skin's surface. Use injection techniques such as linear threading, fanning, cross-hatching, serial puncture, or sandwich. The quantity you inject depends on the area you are correcting.
  9. If needle is blocked, do not force the syringe plunger. Stop injecting and replace needle.
  10. Stop the injection if patient exhibits symptoms including vision changes, signs of stroke, skin blanching, or unusual pain during or shortly after the injection. Patient should receive prompt medical attention and possibly evaluation by an appropriate health care practitioner if there is intravascular injection.
  11. After injection, massage the treated area, which helps ensure the filler gel is evenly distributed.
  12. Properly dispose of all used or open needles and syringes.


  • Not for use in patients using medications such as NSAIDs, antiplatelet agents, anticoagulants, or immunomodulators.
  • Not for use in patients with allergic disease, autoimmune disease, sarcoid-like granulomatous disease, or subacute bacterial endocarditis.
  • Not for use in patients with acne or other skin inflammation or infection.
  • Not for use in patients with a known sensitivity to products containing hyaluronic acid.
  • Not for use in patients prone to skin inflammation or with a tendency to develop hypertrophic scars or keloids.
  • Not for use in pregnant mothers.
  • Not for use in nursing mothers.
  • Not for use in children or adolescents.
  • Not for injection into the nose or glabellar area. Injection into glabellar wrinkles carries a risk of necrosis (tissue death).
  • Not for injection into tendon, muscle, or bone.
  • Not for increasing breast volume.
  • Not for intravascular injection. Injecting into blood vessels may cause embolization (blockage), vessel occlusion (blockage), ischemia (inadequate blood supply), or infarction (lack of blood supply causing tissue death). Use care, including injecting slowly and using least amount of pressure necessary.
  • Avoid overcorrection.
  • Avoid injecting into an area with a non-resorbable filler or that has been treated recently.
  • Not for concomitant injection with botulinum toxins in the same area.
  • Patient should not apply makeup for twelve hours after injection.
  • Patient should avoid exposure to sun, UV rays, cold temperatures, and heat, including sauna and steam rooms, for two weeks after injection.
  • Not for immediate association with laser treatment, chemical peeling, or dermabrasion.
  • Only for use by trained health care professionals with appropriate experience and anatomy knowledge at and around the treatment site.
  • Do not inject more than 20 ml of reticulated hyaluronic acid per person per year.
  • Do not re-use since sterility cannot be guaranteed.
  • Do not re-sterilize.

Side Effects

  • Inflammation, including redness, erythema, edema, swelling, pain, and hyperthermia.
  • Itching or burning sensation.
  • Irritation, tenderness, or paraesthesia (tingling).
  • Bleeding, bruising, hematoma, or telangiectasia (spider veins).
  • Vascular occlusion (blood vessel blockage).
  • Formation of non-inflammatory or inflammatory nodules, induration (hardening), or asymmetry.
  • Skin discoloration. Generally this is a bluish discoloration, known as the Tyndall Effect, caused by superficial injection. This could also be redness caused by ischemia (inadequate blood supply) or whiteness or blanching caused by an occluded (blocked) artery.
  • Hyperpigmenation, especially in Fitzpatrick phototyping scale IV to VI skin types.
  • Immediate or delayed hypersensitivity or allergic reactions, including urticaria, anaphylaxis, or Quincke's edema.
  • Conjunctival infection, corneal edema (swelling), hyphema (bleeding eye), ptosis (drooping), ophthalmoplegia (muscle weakness), haemolacria (blood in tears), or other ocular and periorbital complications.
  • Delayed injection-related inflammation, including persistent erythema (redness), formation of acne papules, or ecchymosis (bruising).
  • Delayed infection, abscess, biofilm formation, or recurrent herpetic lesions.
  • Delayed product migration, displacement, or dislocation.
  • Delayed non-inflammatory or inflammatory granuloma formation (foreign body reactions).
  • Delayed dermal fibrosis, ulcer, scarring, or cellulitis (bacterial infection).
  • Lack of efficacy or reduced effect.
  • Rarely, necrosis (tissue death).
  • Rarely, ocular or periorbital complications, including temporary or permanent vision impairment, blindness, diplopia, or xanthelasma.
  • Rarely, headache, dizziness, nausea, or vomiting due to retinal or cerebral artery occlusion (blockage) or stroke.
  • Rarely, non-thrombotic pulmonary embolism, alveolar hemorrhage, or ground glass opacities including dyspnoe (difficulty breathing) or cough.
  • Rarely, in patients with hepatitis C and interferon treatment, formation of sarcoid granulomas.
  • Rarely, osteitis (bone inflammation).
  • Rarely, cerebral ischemia (inadequate blood supply) and cerebral hemorrhage or stroke.
  • Rarely, hypopigmentation, especially in those with Fitzpatrick phototyping scale IV to VI skin types.

Adverse reactions may be immediate or delayed. If any side effect lasts longer than a week, your patient should report to a physician as soon as possible. These may not be all the possible side effects.

Frequently Asked Questions


What is ETERMIS 2?

This dermal filler helps correct the appearance of mild and superficial wrinkles. The monophasic, cohesive gel is made of hyaluronic acid and mannitol, helping restore moisture and volume with antioxidant protection. The low extrusion force helps make treatment more comfortable, and the filler has good tolerability and a low rate of adverse events.

When should I use this dermal filler?

  • The results of this dermal filler usually last about twelve months, depending on factors such as patient age, gender, skin quality, lifestyle, and injection area.
  • Your patients should receive injections about once a year to maintain their results.

Why do doctors use this dermal filler?

Dermatologists, plastic surgeons, and other doctors use this dermal filler to correct the appearance of mild and superficial wrinkles, including the perioral lines that appear around the mouth with age. This dermal filler can also help contour lips.

How does ETERMIS 2 work?

The monophasic and cohesive texture of this hyaluronic acid gel helps give it smooth, natural-looking and long-lasting results. After you inject the hyaluronic acid into the upper dermis, the particles hold moisture, restoring lost volume to the dermis. This supports and stretches the skin to reduce the appearance of wrinkles. Hyaluronic acid can also stimulate collagen growth, which can improve skin thickness and texture. The mannitol in this filler is an antioxidant, which helps trap free radicals, reducing hyaluronic acid degradation for longer-lasting results.

When and how do I use ETERMIS 2?


How do I use this dermal filler?

You should inject this filler about once a year to maintain treatment results. Inject the dermal filler into the upper dermis of the wrinkled area using a needle. After the injection, gently massage the treated area to ensure the filler gel is distributed evenly within the dermis.

  1. Administer these injections about once a year.
  2. Use a needle to inject the filler into the upper dermis at the site of the wrinkle.
  3. Gently massage the treated area to ensure uniform distribution.

Can this dermal filler be combined with other treatments?

Never inject this filler into an area containing a permanent filler. Do not inject at the same time and location as botulinum toxins, and do not combine these treatments with laser, chemical peel, or dermabrasion.

How do I store ETERMIS 2?

Store between 2° C and 25° C (35.6° and 77° F). Do not freeze and do not expose to heat or frost. Keep away from light. Avoid impacts.

Where can I buy ETERMIS 2?

You can buy ETERMIS 2 online at Doctor Media by choosing a quantity and adding to cart. You can also phone a helpful customer service associate to order this dermal filler or other cosmetic and medical supplies.

Additional Information

ETERMIS 2 Website
Merz Aesthetics Corporate Website
More Antioxidant Information

Through, cosmetic and orthopaedic products are offered wholesale to licensed practitioners, clinics and hospitals. Go to, call 1-866-343-2413, or e-mail for more information.

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