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Uses

What is Xiaflex used for?

Xiaflex (collagenase clostridium histolyticum) is commonly used for Dupuytren’s contracture, a condition involving the hands where the fingers may become permanently bent. Thick cords of collagen form under the skin and restrict movement.

Xiaflex is also commonly used for Peyronie’s disease. In this condition, scar tissue forms in the penis, which may cause the penis to curve and can affect sexual function.

Learn more about Xiaflex for for Dupuytren's Contracture and Peyronie’s Disease.

Xiaflex may also be used for other conditions as determined by your healthcare provider.

How does Xiaflex work (mechanism of action)?

Xiaflex dissolves collagen plaques and lesions.

How is Xiaflex supplied (dosage forms)?

Xiaflex is available in an injectable form that is given by a healthcare provider.

How should I store Xiaflex?

Xiaflex is usually given by a healthcare provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Xiaflex?

The most common side effects of Xiaflex are listed below, which vary depending on why Xiaflex is being used. Tell your healthcare provider if you have any of these side effects that bother you.

Dupuytren’s Contracture.

  • Swelling of the hand or injection site
  • Bleeding or bruising at the injection site
  • Pain or tenderness of the hand or at the injection site
  • Swelling of the lymph nodes of the elbow or armpit
  • Itching
  • Breaks in the skin
  • Warmth or redness of the skin
  • Pain in the armpit

Peyronie’s Disease.

  • A small collection of blood at the injection site under the skin (hematoma)
  • Swelling at the injection site or along the penis
  • Pain or tenderness at the injection site or along the penis
  • Bruising
  • Itching of the penis or scrotum
  • Painful erection
  • Change in color of penis skin
  • Blisters at the injection site
  • Pain during sex
  • Lump at the injection site

There may be other side effects of Xiaflex that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Xiaflex?

While less common, the most serious side effects of Xiaflex are described below, along with what to do if they happen.

Severe Allergic Reactions. Xiaflex may cause allergic reactions, which can be serious. Stop using Xiaflex and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Tendon or Ligament Problems. Tendons are the connectors between your bones and muscles. Ligaments are the connectors between two different bones. If Xiaflex is used for Dupuytren’s contracture and accidentally injected into these areas, problems with tendons and ligaments can happen. This could cause tendon rupture or ligament damage that may be permanent. Surgery may be required. Call your healthcare provider right away if you have trouble bending the affected finger after the swelling goes away, or if you have problems using the affected hand after your follow-up visit. 

Nerve Injury or Other Serious Injury. Injecting Xiaflex into a nerve can cause serious injury to the hands and fingers. Xiaflex can cause cuts or tears in the skin. This could cause the skin tissue to die and may require surgery or amputation. Call your healthcare provider right away if you develop any of the following symptoms of a serious injury.

  • Numbness or tingling
  • Increased pain
  • Cuts or tears in the skin after an injection or follow-up visit

Severe Penis Injury. Injecting Xiaflex into certain areas of the penis can cause severe damage. When the penis is erect, the inner tubes may rupture, causing a penile fracture. This is an emergency and may require surgery. The injection may also cause blood to pool under the skin and form a hematoma. This could cause the skin tissue to die and may require surgery. Call your healthcare provider right away if you develop any of the following symptoms of serious injury to the penis.

  • A popping sound or sensation when your penis is erect
  • Severe pain in the penis
  • Purple bruising and swelling of the penis
  • Trouble peeing or blood in your pee
  • Unable to maintain an erection

Severe Back Pain. Severe back pain can occur in people receiving Xiaflex for Peyronie’s disease. You may have severe pain in your back, legs, feet, chest, and arms. You may be temporarily unable to walk. Most of these symptoms will go away within 15 minutes after the injection. Tell your healthcare provider if you have sudden pain or are unable to walk. 

Fainting. Fainting or passing out can occur after receiving Xiaflex. Pain is the most common reason for fainting, including injection pain, pain from erections, pain while peeing, and finger extension pain. If you feel dizzy or as though you may faint, you should lie down until you feel better. 

Risk of Bleeding. People using Xiaflex may have an increased risk of bleeding or bruising. You may be at higher risk if you are also taking aspirin (other than low-dose aspirin), a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen, or a blood thinner such as warfarin (Coumadin, Jantoven), apixaban (Eliquis), or rivaroxaban (Xarelto). If your healthcare provider tells you to stop taking a medicine before treatment, ask them when to restart that medicine.

Warnings & Precautions

Who should not use Xiaflex?

Allergies to Ingredients. People who are allergic to any of the following should not use Xiaflex.

  • Collagenase clostridium histolyticum
  • Xiaflex
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Xiaflex.

Urethra Involvement. If you have Peyronie’s disease and you have a plaque that involves the urethra (the tube you pee out of), you should not receive Xiaflex. 

What should I know about Xiaflex before using it?

Xiaflex is usually given by a healthcare provider in a hospital or clinic.  

If you are using Xiaflex for Dupuytren’s contracture, your provider will give you a splint to wear. You will also have to do finger exercises daily. Ask your healthcare provider for more information.

If you are using Xiaflex for Peyronie’s disease, you will have to perform gentle stretching and straightening exercises daily after each treatment. Ask your healthcare provider for more information.

If you are using Xiaflex for Peyronie’s disease, your healthcare provider will tell you when you are able to have sex. You should not have sex between the first and second injections of a treatment cycle. You should also avoid sex for at least 4 weeks after the second injection of a treatment cycle and until the pain and swelling have gone away. You should not use a vacuum erection device (penis pump) during treatment. 

What should I tell my healthcare provider before using Xiaflex?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Xiaflex is right for you.

In particular, make sure that you discuss any of the following.

Bleeding Problems. Xiaflex can cause bleeding and bruising. People with bleeding or clotting disorders are at a higher risk of bleeding.

Other Medicines and Supplements. Xiaflex may interact with other medicines and supplements. Before using Xiaflex, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how Xiaflex could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if Xiaflex passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Xiaflex?

For more information about Xiaflex, you can visit the manufacturer’s website at www.xiaflex.com or call them at 800-462-3636.

Interactions

Does Xiaflex interact with foods or drinks?

There are no known interactions between Xiaflex and foods or drinks.

There are no known interactions between Xiaflex and alcohol.

Does Xiaflex interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Xiaflex.

  • An anticoagulant medicine, such as warfarin or rivaroxaban (Xarelto), which thins the blood to prevent blood clots
  • An antiplatelet medicine, such as clopidogrel or aspirin, which prevents blood clots

This may not be a complete list of medicines that can interact with Xiaflex. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Xiaflex?

If you or someone else has used too much Xiaflex, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Xiaflex?

If you miss an appointment to get your Xiaflex dose, call to make another appointment as soon as possible.

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