collagenase clostridium histolyticum
Generic Name: collagenase clostridium histolyticum (KOL a JEN ase klos TRID ee um HIS toe LIT ik um)
Brand Name: Xiaflex
What is collagenase clostridium histolyticum?
Collagenase clostridium histolyticum is made from a mixture of proteins derived from a certain bacteria.
Collagenase clostridium histolyticum is used to treat Dupuytren's contracture in adults. This condition causes an abnormal thickening of the tissue in the palm of the hand. This condition may get worse over time and form a "cord" in your palm, causing a permanent bend in your finger.
Collagenase clostridium histolyticum is also used to treat a related condition called Peyronie's disease in adult men. This condition causes scar tissue or "plaque" to develop under the skin of the penis, resulting in an abnormal curving of the penis during erection.
Collagenase clostridium histolyticum is available for Peyronie's disease only from a certified pharmacy under a special program called Xiaflex REMS. You must be registered in the program and understand the risks of taking this medicine.
Collagenase clostridium histolyticum may also be used for purposes not listed in this medication guide.
What is the most important information I should know about collagenase clostridium histolyticum?
Collagenase clostridium histolyticum can damage a nerve, tendon, or ligament in the hand the medicine is injected into. After the swelling from your injection goes down, call your doctor if you have numbness, tingling, increased pain, trouble bending your finger toward your wrist, or if you have new or worsened movement problems in your treated hand.
This medicine may also damage the erectile tissues inside a man's penis, which could require surgery to correct. Call your doctor right away if you have bruising and swelling of your penis, pain when you urinate, blood in the urine, sudden erection problems, or a "popping" sound or sensation in your penis during an erection.
What should I discuss with my health care provider before receiving collagenase clostridium histolyticum?
You should not use collagenase clostridium histolyticum if you are allergic to it. This medicine should not be used to treat Peyronie's disease that affects the urethra (the tube for passing urine out of your bladder).
To make sure collagenase clostridium histolyticum is safe for you, tell your doctor if you have:
a bleeding or blood clotting disorder, such as hemophilia; or
if you take a blood thinner such as warfarin (Coumadin, Jantoven).
FDA pregnancy category B. Collagenase clostridium histolyticum is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
It is not known whether collagenase clostridium histolyticum passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How is collagenase clostridium histolyticum given?
This medication is injected directly into the "cord" of the affected hand or into a "plaque" of the penis. A healthcare provider will give you this injection. Follow your doctor's dosing instructions very carefully.
For Dupuytren's contracture:
Collagenase clostridium histolyticum is usually given in a treatment cycle of 1 to 3 injections given 4 weeks apart.
After your injection, do not touch or put pressure on the treated area of the hand for the rest of the day. Keep the treated hand elevated until bedtime.
You may need to wear a splint on your hand for a short time to keep your fingers straight, especially at night. You may also need to perform daily finger exercises. Follow your doctor's instructions.
One to 3 days after injection into your hand, your doctor will need to examine the hand to see if your condition has improved.
If you still have the cord, your doctor may try to break it by extending your treated finger.
Call your doctor if you have trouble bending the treated finger after the swelling goes down.
For Peyronie's disease:
Collagenase clostridium histolyticum is usually given in a treatment cycle of 2 injections given 1 to 3 days apart.
Your penis may need to be wrapped in a bandage for a short time after each injection. Follow your doctor's instructions about how long to wear the bandage.
One to 3 days after your second injection, your doctor will perform a stretching procedure to help straighten the curve in your penis.
You may also need to perform gentle exercises to stretch and straighten the penis at home every day for 6 weeks. Carefully follow all directions about how to perform these exercises.
You should not have any sexual activity for at least 2 weeks after your second injection if the first injection caused any pain or swelling in your penis.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your collagenase clostridium histolyticum injection.
What happens if I overdose?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid before and after receiving collagenase clostridium histolyticum?
After your injection for Dupuytren's contracture, do not flex or extend the fingers of your treated hand until you visit your doctor again. Extending your fingers may cause the medicine to spread away from the treatment area, making it less effective. Avoid any strenuous activity using the treated hand until your doctor tells you to resume normal activities.
Avoid sexual activity during your treatment for Peyronie's disease. Your doctor will tell you when it is safe to resume sexual activity.
Collagenase clostridium histolyticum side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; chest pain, difficult breathing; feeling like you might pass out; swelling of your face, lips, tongue, or throat.
Collagenase clostridium histolyticum can damage a nerve, tendon, or ligament in the hand the medicine is injected into. After the swelling from your injection goes down, call your doctor if you have:
numbness, tingling, increased pain;
trouble bending your finger toward your wrist; or
new or worsened movement problems in your treated hand.
Collagenase clostridium histolyticum may also damage the erectile tissues inside a man's penis, which could require surgery to correct. Call your doctor right away if you have:
bruising and swelling of your penis;
pain when you urinate, blood in the urine;
sudden erection problems; or
a "popping" sound or sensation in your penis during an erection.
Also call your doctor at once if you have:
signs of infection such as fever, chills, redness or swelling;
severe pain, itching, or other irritation; or
feeling like you might pass out (even while lying down).
Common side effects may include:
swelling, bruising, bleeding, pain, or tenderness where the medicine was injected;
swollen glands in your elbow or underarm;
itching, redness, or warmth of the skin;
mild pain or tenderness in your treated hand;
bruising of the penis or scrotum, erection problems; or
discoloration of the skin on your penis, bruising or blisters where the medicine was injected.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Collagenase clostridium histolyticum dosing information
Usual Adult Dose for Dupuytren's Contracture:
0.58 mg as a single injection into a palpable cord with a contracture of a metacarpophalangeal (MP) joint or a proximal interphalangeal (PIP) joint
-This drug should be administered by a healthcare provider experienced in injection procedures of the hand and in the treatment of patients with Dupuytren's contracture.
-Up to 2 joints in the same hand may be treated during a treatment visit.
-Approximately 24 to 72 hours following an injection, a finger extension procedure should be performed if a contracture persists. Consult manufacturer product information or local protocol for information on the finger extension procedure.
-Injections and finger extension procedures may be administered up to 3 times per cord at approximately 4-week intervals.
-Up to 2 cords in the same hand may be injected at a treatment visit. If a patient has other cords with contractures, those cords should be injected at another treatment visit.
-Vital signs should be monitored and appropriate equipment should be available to address any severe local or systemic reactions including the potential for anaphylaxis that may occur following injection.
Use: The treatment of adult patients with Dupuytren's contracture with a palpable cord
Usual Adult Dose for Peyronie's Disease:
0.58 mg as a single injection into the target plaque once on each of two days, 1 to 3 days apart
-This drug should be administered by a healthcare provider experienced in the treatment of male urological diseases, who has completed required training for use of this drug in the treatment of Peyronie's disease.
-A treatment cycle consists of 2 injection procedures and a penile modeling procedure.
-For each plaque causing the curvature deformity, up to 4 treatment cycles may be administered. Each treatment cycle may be repeated at approximately 6 week intervals. If the curvature deformity is less than 15 degrees after the first, second or third treatment cycle, or if further treatment is not indicated, then subsequent treatment cycles should not be administered.
Use: The treatment of adult men with Peyronie's disease with a palpable plaque and curvature deformity of at least 30 degrees at the start of therapy
What other drugs can affect collagenase clostridium histolyticum?
Other drugs may interact with collagenase clostridium histolyticum, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
More about collagenase clostridium histolyticum
- Collagenase clostridium histolyticum
- Collagenase clostridium histolyticum Injection (Advanced Reading)
- Other brands: Xiaflex
- Collagenase Clostridium Histolyticum (AHFS Monograph)
- Collagenase Clostridium Histolyticum (Wolters Kluwer)
Related treatment guides
Where can I get more information?
- Your doctor or pharmacist can provide more information about collagenase clostridium histolyticum.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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