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Collagenase (Topical)

Medically reviewed by Drugs.com. Last updated on Jul 16, 2020.

Pronunciation

(KOL la je nase)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, External:

Santyl: 250 units/g (30 g, 90 g)

Brand Names: U.S.

  • Santyl

Pharmacologic Category

  • Enzyme, Topical Debridement

Pharmacology

Collagenase is an enzyme derived from the fermentation by Clostridium histolyticum and differs from other proteolytic enzymes in that its enzymatic action has a high specificity for native and denatured collagen in necrotic tissue; collagenase will not attack collagen in healthy tissue or newly formed granulation tissue. Therefore, collagenase is effective for the removal of detritus, formation of granulation tissue, and subsequent epithelization of dermal ulcers and severely burned areas.

Absorption

Topical: Unknown

Use: Labeled Indications

Dermal ulcers: Debriding chronic dermal ulcers and severely burned areas.

Contraindications

Local or systemic hypersensitivity to collagenase or any component of the formulation.

Dosing: Adult

Dermal ulcers: Topical: Apply once daily (or more frequently if the dressing becomes soiled) until debridement of necrotic tissue is complete and granulation tissue is well established. If infection is present, apply an appropriate topical antibiotic prior to the application of collagenase. If the infection persists despite treatment, discontinue use of collagenase until remission of the infection.

Dosing: Geriatric

Refer to adult dosing.

Administration

Prior to application, cleanse the wound of debris and digested material by gently rubbing with a gauze pad saturated with normal saline or another compatible cleansing solution (eg, Dakin’s solution) followed by a normal saline rinse; detergents and antiseptics or soaks containing heavy metal ions (eg, mercury, silver) may decrease the enzymatic activity of collagenase and should be avoided. The enzymatic activity is optimal at a pH range of 6 to 8; precautions should be taken to ensure optimal pH at the application site.

Apply collagenase directly to the wound or to a sterile gauze pad and then apply to the wound and secure. If a thick eschar is present, consider crosshatching with a #10 blade prior to application to allow for more surface contact with necrotic debris; remove as much loosened detritus as can be done readily with forceps and scissors. Application should be carefully confined to the area of the wound; transient erythema may occur in surrounding tissue when application is not confined to the wound.

Storage

Do not store above 25°C (77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined.

Local: Application site burning, application site irritation, application site pain

<1%, postmarketing and/or case reports: Hypersensitivity reaction

Warnings/Precautions

Concerns related to adverse effects:

• Local effects: A slight transient erythema has been noted occasionally in the surrounding tissue, particularly when application was not confined to the wound.

Special populations:

• Debilitated patients: Debriding enzymes may increase the risk of bacteremia; monitor debilitated patients for systemic bacterial infections.

Monitoring Parameters

Signs and symptoms of systemic bacterial infection

Pregnancy Considerations

It is not known if collagenase is absorbed systemically following topical application.

Patient Education

What is this drug used for?

• It is used to promote healing of skin ulcers and wounds.

• It is used to treat burns.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Infection

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.