Collagenase Clostridium Histolyticum Injection
Brand Name(s):
  • Xiaflex®
WHY is this medicine prescribed?
Collagenase clostridium histolyticum injection is used to treat Dupuytren's contracture (a painless thickening and tightening of tissue [cord] beneath the skin in the palm of the hand, which may make it difficult to straighten one or more fingers) when a cord of tissue can be felt upon examination. Collagenase clostridium histolyticum injection is in a class of medications called enzymes. It works by helping to break down the cord of thickened tissue and allows the finger(s) to be straightened.

HOW should this medicine be used?
Collagenase clostridium histolyticum injection comes as a powder to be mixed with a liquid and injected into a cord just under the skin in the affected hand by a doctor. Your doctor will choose the best place to inject the medication into the cord.

Do not bend or straighten the fingers of the injected hand or put pressure on the injected area after your injection. Keep the injected hand elevated until bedtime. You must return to your doctor's office on the day after your injection. Your doctor will check your hand, and possibly move and extend the finger to help break up the cord. Ask your doctor when you can expect to see improvement, and call your doctor if your condition does not improve during the expected time.

Do not perform strenuous activity with the injected hand until your doctor tells you that you can do so. Your doctor will probably tell you to wear a splint every night (at bedtime) for up to 4 months after the injection. Your doctor may also tell you to do finger exercises each day. Follow the directions of your doctor carefully and ask the doctor to explain any part you do not understand.

Your doctor may need to give you one or two additional injections, not more often than once every 4 weeks. You may receive up to three injections per cord.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with collagenase clostridium histolyticum injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( Web Site) to obtain the Medication Guide.

Are there OTHER USES for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?
Before receiving collagenase clostridium histolyticum injection,

  • tell your doctor and pharmacist if you are allergic to collagenase clostridium histolyticum injection, any other medications, or any of the ingredients in collagenase clostridium histolyticum injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin), aspirin (more than 150 mg per day), clopidogrel (Plavix), and prasugrel (Effient). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had a bleeding condition.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving collagenase clostridium histolyticum injection, call your doctor.
What SPECIAL DIETARY instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?
Collagenase clostridium histolyticum injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • redness, swelling, tenderness, bruising, or bleeding around the injected area
  • itching of the treated hand
  • pain in the treated hand
  • painful and swollen glands in the elbow or underarm area

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:
  • hives
  • rash
  • difficulty breathing or swallowing
  • hoarseness
  • chest pain
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • fever, sore throat, chills, cough and other signs of infection
  • numbness, tingling, or increased pain in your treated finger or hand (after your injection or after your follow-up visit)

Collagenase clostridium histolyticum injection can cause injury to the hand that may require surgical treatment or can be permanent. Call your doctor right away if you have trouble bending your injected finger towards the wrist after the swelling goes away, or if you have problems using your treated hand after your follow-up visit. Talk to your doctor about the risks of receiving this medication.

Collagenase clostridium histolyticum injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at Web Site] or by phone [1-800-332-1088].

What OTHER INFORMATION should I know?
Keep all appointments with your doctor.

Ask your doctor or pharmacist any questions you have about collagenase clostridium histolyticum injection.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: September 15, 2012.







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