Xiaflex

Generic Name: collagenase clostridium histolyticum (KOL a JEN ase klos TRID ee um HIS toe LIT ik um)
Brand Names: Xiaflex

What is Xiaflex?

Xiaflex (collagenase clostridium histolyticum) is made from a mixture of proteins derived from a certain bacteria.

Xiaflex 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.

Xiaflex may also be used for purposes not listed in this medication guide.

Important information about Xiaflex

Before you receive Xiaflex, tell your doctor if you have a bleeding or blood clotting disorder, such as hemophilia.

The day after your Xiaflex injection, your doctor will need to examine your hand to see if your condition has improved. Avoid any strenuous activity using the treated hand until your doctor tells you to resume normal activities.

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Tell your caregiver at once if you have a serious side effect in the treated hand, such as bruising, bleeding, swelling, redness, warmth, numbness, tingling, or sudden pain or loss of movement. Call your doctor if you have fever, chills, body aches, flu symptoms, or swollen glands in your elbow or underarm.

Before receiving Xiaflex

You should not use Xiaflex if you are allergic to collagenase clostridium histolyticum.

To make sure you can safely receive Xiaflex, tell your doctor if you have a bleeding or blood clotting disorder, such as hemophilia.

FDA pregnancy category B. Xiaflex 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. Do not use Xiaflex without telling your doctor if you are breast-feeding a baby.

See also: Xiaflex pregnancy and breastfeeding warnings (in more detail)

How is Xiaflex given?

Xiaflex is injected directly into the "cord" of the affected hand. A healthcare provider will give you this injection.

After your Xiaflex 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.

The day after your Xiaflex injection, your doctor will need to examine your 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.

Xiaflex is usually given once every 4 weeks and you may receive more than one injection at a time. Follow your doctor's dosing instructions very carefully.

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.

Call your doctor if you have trouble bending the treated finger after the swelling goes down.

Prior to mixing, Xiaflex vials and diluent should be stored in a refrigerator at 2° to 8°C (36° to 46°F). Do not freeze. Once mixed, Xiaflex solution can be kept at room temperature (20° to 25°C/68° to 77°F) for up to one hour or refrigerated at 2° to 8°C (36° to 46°F) for up to 4 hours before it is injected.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Xiaflex injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid before and after receiving Xiaflex?

Until you visit your doctor the day after your injection, do not flex or extend the fingers of your treated hand. Doing so 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.

Xiaflex side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Xiaflex: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Tell your caregiver at once if you have a serious side effect such as:

• feeling like you might pass out (even while lying down);

• bruising or bleeding in the treated hand;

• severe pain, itching, redness, warmth, swelling, or other irritation in the treated hand;

• numbness or tingling in the treated hand;

• fever, chills, body aches, flu symptoms, swollen glands;

• swollen glands in your elbow or underarm; or

• sudden pain, snapping or popping sound, bruising, loss of movement, or swelling in the joints of your hand.

Less serious Xiaflex side effects may include:

• mild pain or tenderness in the treated hand;

• cracked skin; or

• underarm pain.

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: Xiaflex side effects (in more detail)

What other drugs can affect Xiaflex?

Before you receive Xiaflex, tell your doctor about all other medicines you have used within the past 7 days, especially medication used to prevent blood clots, such as:

• high doses of aspirin (more than 150 milligrams per day);

• a blood thinner such as warfarin (Coumadin);

• argatroban (Acova), bivalirudin (Angiomax), lepirudin (Refludan);

• dalteparin (Fragmin), enoxaparin (Lovenox), fondaparinux (Arixtra); or

• abciximab (ReoPro), anagrelide (Agrylin), cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine, Aggrenox), eptifibatide (Integrelin), prasugrel (Effient), ticlopidine (Ticlid), tirofiban (Aggrastat).

This list is not complete and other drugs may interact with Xiaflex. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist can provide more information about Xiaflex.

• Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2010 Cerner Multum, Inc. Version: 1.01. Revision Date: 08/09/2010 8:09:16 AM.