What is Collagenase Clostridium Histolyticum Injection: Uses, Dosage, Side Effects and More

Collagenase clostridium histolyticum injection is a specialized enzyme treatment that breaks down collagen buildup in your body. This medication helps treat conditions where excess collagen creates painful lumps or bands of tissue, offering a non-surgical option for people dealing with these challenging conditions.

What is Collagenase Clostridium Histolyticum?

Collagenase clostridium histolyticum is an enzyme derived from bacteria that specifically targets and breaks down collagen. Think of collagen as the body's natural scaffolding protein that normally helps hold tissues together, but sometimes it builds up in places where it shouldn't.

This medication works by dissolving excess collagen that forms tough, fibrous bands or nodules. The enzyme comes from a specific type of bacteria called Clostridium histolyticum, which naturally produces this collagen-breaking protein.

Your doctor administers this treatment through direct injection into the affected area. The medication is available under brand names like Xiaflex in the United States and has been specifically developed for targeted collagen disorders.

What is Collagenase Clostridium Histolyticum Used For?

This injection treats two main conditions where collagen buildup causes problems. Both conditions involve excess collagen formation that creates physical limitations and discomfort.

The primary use is for Dupuytren's contracture, a condition where thick bands of tissue form in your palm and fingers. These bands gradually pull your fingers toward your palm, making it difficult to straighten them fully. The condition typically affects the ring finger and pinky finger most severely.

The second approved use is for Peyronie's disease, which affects men and involves the formation of fibrous plaques in the penis. These plaques can cause curvature, pain, and difficulties with sexual function. The injection helps break down these collagen deposits to reduce curvature and improve function.

Your doctor might also consider this treatment for other conditions involving excess collagen formation, though these uses are less common. The medication specifically targets areas where collagen has formed abnormal bands or nodules that interfere with normal function.

How Does Collagenase Clostridium Histolyticum Work?

This enzyme works by specifically targeting and breaking down collagen fibers that have formed abnormal bands or nodules. The medication acts like molecular scissors, cutting through the collagen structure that's causing your symptoms.

When injected directly into the affected tissue, the enzyme begins working within hours to dissolve the problematic collagen. This process is gradual and targeted, affecting only the excess collagen buildup rather than healthy surrounding tissue.

The medication is considered moderately strong for its intended purpose. It effectively breaks down tough collagen bands that have been resistant to other treatments, but it works in a controlled, localized manner.

Over the following days and weeks after injection, your body naturally processes the broken-down collagen. This allows the affected area to gradually return to a more normal position and function.

How Should I Take Collagenase Clostridium Histolyticum?

You don't take this medication yourself - it must be administered by a healthcare professional in a clinical setting. Your doctor will inject the medication directly into the affected collagen band or nodule using a fine needle.

Before your injection, you don't need to avoid food or drink, but your doctor may recommend avoiding certain medications that increase bleeding risk. These might include aspirin, blood thinners, or anti-inflammatory medications for several days before treatment.

The injection process typically takes just a few minutes. Your doctor will locate the exact spot where the collagen band is thickest and inject the medication directly into that area. You may receive a local anesthetic to minimize discomfort during the procedure.

After the injection, you'll need to return to your doctor's office within a few days for a follow-up procedure. During this visit, your doctor will manipulate the treated area to help break apart the softened collagen bands.

How Long Should I Take Collagenase Clostridium Histolyticum For?

The treatment duration depends on your specific condition and how well you respond to the initial injection. Most people need multiple injection sessions spaced several weeks apart to achieve the best results.

For Dupuytren's contracture, you might need 1-3 injections per affected finger, with each injection given about 4 weeks apart. Your doctor will assess your progress after each injection to determine if additional treatments are needed.

For Peyronie's disease, the typical treatment course involves 2 injections per treatment cycle, with injections given about 6 weeks apart. You may need multiple treatment cycles depending on the severity of your condition.

Your doctor will monitor your progress throughout the treatment process. The goal is to achieve significant improvement in function and symptoms while using the minimum number of injections necessary.

What Are the Side Effects of Collagenase Clostridium Histolyticum?

Most people experience some side effects after receiving this injection, but these are typically mild and temporary. Understanding what to expect can help you prepare for the treatment process.

Common side effects that many people experience include swelling, bruising, and pain at the injection site. These symptoms usually develop within hours of the injection and can last several days to a week.

Here are the most frequently reported side effects you might notice:

• Swelling and tenderness at the injection site
• Bruising that may spread beyond the injection area
• Pain or discomfort that may worsen before it improves
• Itching or mild skin irritation
• Small bumps or lumps under the skin
• Temporary stiffness in the treated area

These common reactions are actually signs that the medication is working to break down the collagen bands. Most people find these symptoms manageable with over-the-counter pain relievers and ice packs.

More serious side effects are less common but require immediate medical attention. These include severe allergic reactions, signs of infection at the injection site, or unusual bleeding or bruising that doesn't improve.

Rare but serious complications can include tendon rupture, nerve injury, or blood vessel damage. Your doctor will discuss these risks with you and monitor you carefully during treatment to minimize these possibilities.

Who Should Not Take Collagenase Clostridium Histolyticum?

Several groups of people should avoid this treatment due to increased risks or reduced effectiveness. Your doctor will carefully evaluate whether this medication is safe for your specific situation.

You should not receive this injection if you have a known allergy to collagenase or any components of the medication. People with bleeding disorders or those taking blood-thinning medications may also need to avoid this treatment.

Certain medical conditions make this treatment inadvisable, and your doctor will need to know about your complete medical history before proceeding.

Here are the main conditions that may prevent you from receiving this treatment:

• Active infection at or near the injection site
• Severe bleeding disorders or uncontrolled blood clotting problems
• Pregnancy or breastfeeding (safety not established)
• Recent surgery in the area to be treated
• Severe liver or kidney disease
• Autoimmune conditions affecting connective tissue

Your doctor will also consider other factors like your age, overall health, and other medications you're taking. This careful evaluation helps ensure the treatment is both safe and likely to be effective for your specific situation.

Collagenase Clostridium Histolyticum Brand Names

The most common brand name for this medication is Xiaflex, which is available in the United States. This is the brand name most doctors and patients will recognize when discussing treatment options.

In some other countries, the same medication may be available under different brand names, though the active ingredient remains the same. Your doctor will prescribe the specific brand that's available in your area.

When researching this treatment or discussing it with your healthcare team, you might see it referred to by its generic name or various brand names. All versions contain the same active enzyme and work in the same way.

Collagenase Clostridium Histolyticum Alternatives

Several other treatment options exist for the conditions this medication treats. Your doctor might recommend these alternatives if you're not a good candidate for enzyme injection or if you prefer different approaches.

For Dupuytren's contracture, surgical options include needle aponeurotomy, where a needle is used to break up the collagen bands, or fasciectomy, where the affected tissue is surgically removed. Physical therapy and splinting can also help in early stages.

For Peyronie's disease, alternatives include other injectable medications like verapamil or interferon, oral medications, shock wave therapy, or surgical correction. Vacuum devices and penile traction therapy are also sometimes recommended.

Non-surgical options tend to be less invasive but may be less effective for severe cases. Surgical treatments are often more definitive but carry higher risks and longer recovery times.

Is Collagenase Clostridium Histolyticum Better Than Surgery?

This medication offers several advantages over surgical treatment, but the best choice depends on your specific situation and preferences. Both approaches have their place in treating collagen-related conditions.

The enzyme injection is less invasive than surgery, typically requiring only local anesthesia and allowing you to return to normal activities more quickly. There's no surgical incision, which means less risk of infection and scarring.

However, surgery may be more effective for severe cases or when the collagen bands are very thick and extensive. Surgical treatment can also provide more predictable results, especially for advanced conditions.

Recovery from enzyme injection is generally faster, with most people able to use their hands or return to normal activities within a few days to weeks. Surgical recovery typically takes longer and may require more extensive rehabilitation.

Your doctor will help you weigh these factors based on the severity of your condition, your overall health, and your personal preferences for treatment approach.