What is collagenase clostridium histolyticum, and what is it used for?

Xiaflex is an injectable formulation of purified collagenase derived from the bacterium, clostridium histolyticum. It is used for treating Dupuytren’s contracture. A Dupuytren’s contraction is caused by an abnormal accumulation of collagen (scar) in the tissue beneath the skin of the palm of the hand. The collagen binds the tissue to the skin of the palm, limiting the movement of the skin over the underlying tissues and preventing extension of the fingers. Collagenase is an enzyme that breaks down collagen. Xiaflex breaks down excessive collagen by disrupting its chemical structure. Reducing the accumulation of collagen improves movement of the affected fingers. The FDA approved Xiaflex in February 2010.

What brand names are available for collagenase clostridium histolyticum?


Is collagenase clostridium histolyticum available as a generic drug?


Do I need a prescription for collagenase clostridium histolyticum?


What are the side effects of collagenase clostridium histolyticum?

The most common adverse reactions of Xiaflex are:

  • fluid retention (swelling of the injected hand),
  • contusion (bruising),
  • injection site bleeding,
  • injection site swelling,
  • pain in the treated hand, and
  • tenderness.

Tendon rupture or other serious injury to the injected hand may occur. Allergic reactions and development of antibodies to Xiaflex also may occur.

What is the dosage for collagenase clostridium histolyticum?

The recommended dose is 0.58 mg per injection into a palpable cord. Re-injection may occur 4 weeks after the initial injection if the contracture remains. Injections may be repeated up to 3 times per cord at 4 week intervals.

Which drugs or supplements interact with collagenase clostridium histolyticum?

In clinical trials many patients treated with Xiaflex developed bruising or bleeding at the injection site. Therefore, Xiaflex should be used with caution in patients with an abnormal tendency to bleed or who are taking drugs that cause bleeding. Except for low dose aspirin, Xiaflex has not been tested in patients receiving drugs that reduce the ability of blood to clot.

Is collagenase clostridium histolyticum safe to take if I’m pregnant or breastfeeding?

Use in pregnant women has not been adequately evaluated. It should be used only if it is clearly needed.

Xiaflex has not been studied in women who are breastfeeding.

What else should I know about collagenase clostridium histolyticum?

What preparations of collagenase clostridium histolyticum are available?

Powder for Injection: Single use vial, 0.9 mg

How should I keep collagenase clostridium histolyticum stored?

Vials should be refrigerate at 2-8 C (36-46 F) prior to mixing with diluents but should not be frozen After diluting, it should be kept at room temperature for one hour at 20-25 C (68-77 F) or refrigerated for up to 4 hours at 2-8 C (36-46 F).

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Medically Reviewed on 10/22/2019


Medically reviewed by John P. Cunha, DO, FACOEP


FDA Prescribing Information