Xiaflex (collagenase clostridium histolyticum) is a brand-name drug that’s prescribed to treat Dupuytren’s contracture and Peyronie’s disease in adults. Xiaflex comes as an injection that’s given by a healthcare professional.

Xiaflex is a biologic and belongs to a drug class called class I Clostridium histolyticum collagenases. Xiaflex is not available in a biosimilar version. 

Keep reading for specific information about the dosage of Xiaflex, including its strength and how the medication is given. For a comprehensive look at Xiaflex, see this article.

Note: This article describes typical dosages for Xiaflex provided by the drug’s manufacturer. However, your doctor will prescribe the Xiaflex dosage that’s right for you.

Xiaflex dosage

Read below for details about Xiaflex’s dosages for its approved uses.

Xiaflex form

Xiaflex comes as a powder in a single-use vial. The powder is mixed with a liquid to form a solution for injection. It’s always given by a healthcare professional in their office or clinic.

Xiaflex strength

Xiaflex comes in one strength. Each vial contains 0.9 milligrams (mg) of the drug.

Each vial can be used for only one injection. If you need more than one injection, your doctor will use one vial for each injection they give. Your doctor will withdraw the necessary dose from the vial and discard any medication that’s left.

Typical dosages

The following information describes recommended dosages depending on what condition is being treated. Your doctor will determine the best dosage to fit your needs.

Dosage for Dupuytren’s contracture

Doctors may prescribe Xiaflex to treat Dupuytren’s contracture.

If your doctor prescribes Xiaflex for your Dupuytren’s contracture, the recommended dosage is one injection of 0.58 mg directly into the cord in your hand that’s causing your finger to bend. You may receive an injection in each cord up to three times. Typically, the injections will be at least 4 weeks apart.

Your doctor will always give you the injection in their office or clinic. You can receive up to two injections in your hand at each appointment.

Dosage for Peyronie’s disease

Xiaflex is also approved to treat Peyronie’s disease. Your doctor will inject Xiaflex directly into the plaque (fibrous scar tissue) that’s causing your penis to bend. The recommended dosage for each injection is 0.58 mg.

Xiaflex is given in treatment cycles. For each treatment cycle, you’ll receive two injections 1–3 days apart. You’ll see your doctor for a follow-up visit 1–3 days after the second injection.

Each plaque can have up to four treatment cycles. If you have more than one treatment cycle, they will typically be scheduled 6 weeks apart.

Talk with your doctor if you have questions about the dose of Xiaflex used to treat your condition.

Short-term treatment

Xiaflex is used short term for the treatment of Dupuytren’s contracture and Peyronie’s disease. There is a maximum number of doses you can receive. Your doctor can recommend the number of doses you will need based on your condition.

Factors that can affect your dosage

The Xiaflex dosage your doctor prescribes will depend on several factors. These include:

  • the condition you’re using Xiaflex to treat
  • how your body responds to Xiaflex

How Xiaflex is given

Your doctor will give you the Xiaflex injection in their office or clinic. How Xiaflex is given depends on the condition you’re receiving the drug to treat.

For Dupuytren’s contracture

For Dupuytren’s contracture, your doctor will inject Xiaflex into the cord in your hand that is causing your finger to bend. If you have more than one cord, you may receive up to two injections in your hand at the same appointment.

After giving you the injection, your doctor will wrap your hand in a bandage. You will need to limit the movement of your treated hand. It’s important that you try not to bend or straighten your fingers. You will also need to keep your treated hand elevated until bedtime.

You’ll typically have a follow-up appointment 1–3 days after your injection to check whether the cord has dissolved. If it hasn’t, your doctor may try to break the cord by slowly trying to straighten your finger. A local anesthetic will usually be used to numb your hand before your doctor does this.

If your finger has straightened, your doctor will give you a splint to use at bedtime. You’ll use the splint for about 4 months. This helps keep your finger straight. Your doctor will also show you finger exercises that you should do several times per day. You’ll need to keep doing the finger exercises for several months.

For Peyronie’s disease

For Peyronie’s disease, your doctor will inject Xiaflex directly into the plaque (fibrous scar tissue) that’s causing your penis to bend.

Treatment with Xiaflex for Peyronie’s disease is done in cycles. You may receive up to four treatment cycles. The cycles should be about 6 weeks apart.

During each treatment cycle, you’ll receive two injections 1–3 days apart. Your doctor may apply a bandage after your injection. You’ll see your doctor again 1–3 days after your second injection. At this appointment, your doctor will try to stretch the plaque and straighten your penis.

After your treatment with Xiaflex, you should try to gently stretch your penis three times per day for 6 weeks. Your doctor will show you how to do this. The medication guide for Xiaflex also includes instructions for these stretches. If you get an erection without sexual activity, your doctor will ask you to do additional stretches in this time to straighten the penis. They can show you the correct way to do this.

It is recommended that you don’t engage in sexual activity for at least 4 weeks after each treatment cycle.

Missed dose

If you miss your appointment for a Xiaflex injection, call your doctor’s office as soon as possible to reschedule. They’ll adjust your dosing schedule as needed.

If you need help remembering your appointments, try setting an alarm or downloading a reminder app on your phone.

Frequently asked questions

Below are some frequently asked questions about Xiaflex.

How long does it take for Xiaflex to start working?

It can depend on the condition Xiaflex is being used to treat.

For Dupuytren’s contracture, it’s possible that Xiaflex could dissolve the cord within 1–3 days. If the cord has not broken down within 1–3 days after your injection, your doctor may try to break the cord by slowly stretching your fingers. If the first injection doesn’t work, your doctor may recommend a second injection in 4 weeks.

Xiaflex may take longer to work for Peyronie’s disease. The plaque may start to dissolve during the first treatment cycle, but most people will need more than one treatment cycle. One cycle consists of two injections 1–3 days apart, a penis-straightening procedure 1–3 days later in your doctor’s office, and 6 weeks of gentle penis straightening and stretching. You may receive up to four treatment cycles given 6 weeks apart.

Talk with your doctor if you have questions about what to expect with Xiaflex treatment.

What is the recommended maximum dosage of Xiaflex?

The maximum dosage of Xiaflex for Dupuytren’s contracture is three injections 4 weeks apart. The maximum dosage for Peyronie’s disease is four treatment cycles given 6 weeks apart.

If you have questions or concerns about your injections of Xiaflex, talk with your doctor.

Takeaway and helpful resources

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Xiaflex for you, they will prescribe the dosage that’s right for you.

Besides learning about dosage, you may want other information about Xiaflex. These additional articles might be helpful:

  • More about Xiaflex: For information about other aspects of Xiaflex, refer to this article.
  • Side effects: To learn about side effects of Xiaflex, see the Xiaflex prescribing information
  • Cost: If you’d like to learn about Xiaflex and cost, see this article.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.