If you’ve been diagnosed with Peyronie’s disease or Dupuytren’s contracture, your doctor might suggest Xiaflex as a treatment option for you. It’s a prescription drug used in adults to treat these conditions.
The active ingredient* in Xiaflex is collagenase clostridium histolyticum. This is an enzyme that helps break down collagen.
Xiaflex is a brand-name biologic drug, which means it’s made from living cells. It’s not available in a biosimilar version. (Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.)
Xiaflex comes as a single-dose vial of powder. The powder is mixed with a sterile liquid to make a solution that’s given as an injection by a healthcare professional.
This article describes the dosages of Xiaflex, as well as its strength and how it’s given. To learn more about Xiaflex, see this in-depth article.
Note: This article covers the usual dosages of Xiaflex, which are provided by the drugmaker. But your doctor will prescribe the dosage that’s right for you.
*An active ingredient is what makes a drug work.
Below you’ll find common dosage information for Xiaflex.
What is Xiaflex’s form?
Xiaflex comes as a single-dose vial of powder. The powder is mixed with a sterile liquid to make a solution that’s given as an injection by a healthcare professional.
What strength does Xiaflex come in?
Xiaflex comes in one strength of 0.9 milligrams (mg) per single-dose vial.
What are the usual dosages of Xiaflex?
Your doctor will prescribe you a set dosage of Xiaflex. You’ll then follow a treatment plan based on the condition the drug is being used to treat.
The information below describes dosages that are commonly used or recommended. But your doctor will determine the best dosage to fit your needs.
Dosage for Peyronie’s disease
The dosage of Xiaflex for Peyronie’s disease is based on dosing cycles. Depending on the severity of your condition, you may receive up to four cycles of Xiaflex treatment. Each cycle is about 6 weeks apart. In each cycle, you’ll receive two injections (0.58 mg* each) about 1 to 3 days apart.
You’ll visit your doctor 1 to 3 days after your second injection dose. They’ll try to stretch the plaque to straighten the bend in your penis. If the angle of the bend in your penis is less than 15 degrees after a treatment cycle, you won’t need further Xiaflex treatments.
Dosage for Dupuytren’s contracture
The dosage of Xiaflex for Dupuytren’s contracture is based on treatment cycles. The dosage is one 0.58-mg injection directly into the cord of the affected area. You may get up to two injections in the same hand during a treatment appointment, depending on the area(s) involved. Your doctor will try to straighten the affected area 1 to 3 days after your injection.
You may receive up to three treatments for each cord area, with each appointment being 4 weeks apart. The number of treatments will depend on the severity of your condition and how your body responds to the drug.
* The powder only comes in 0.9-mg strength vials, but the concentration (mg per milliliter) of the drug changes once the powder is mixed with liquid to make a solution.
Is Xiaflex used long term?
No, Xiaflex is usually prescribed as short-term treatment for Peyronie’s disease and Dupuytren’s contracture.
Depending on the severity of your condition and how your body responds to treatment, you may receive injections for a set number of cycles.
For Peyronie’s disease, you may receive up to four cycles of treatment about every 6 weeks, as needed.
For Dupuytren’s contracture, you may receive up to three treatments for each cord area, with each appointment being 4 weeks apart.
Only certain doctors may prescribe Xiaflex through a
These precautions are due to the serious risk of penile injury when the drug is used for Peyronie’s disease.
Administration for Peyronie’s disease
A trained healthcare professional will inject Xiaflex directly into the plaque that’s causing your penis to bend. You may receive a local anesthetic before your Xiaflex injection to numb the area first.
You may receive up to two injections about 1 to 3 days apart in each treatment cycle. And you may receive up to four cycles of treatments 6 weeks apart.
Your doctor may wrap your penis in a bandage after each injection. Do not try to remove the bandage until your doctor instructs you that it’s safe to do so. They’ll try to gently straighten your penis after the second injection in each cycle by stretching the plaque area. They’ll also show you how to do this up to three times per day for 6 weeks after each treatment cycle.
Do not engage in sexual activity:
- between the first and second injection in each treatment cycle
- for at least 4 weeks after the second injection of each treatment cycle
Your doctor will provide you with more detailed information on the injection procedure, risks, and post-procedure care.
Administration for Dupuytren’s contracture
Your doctor or another healthcare professional will inject Xiaflex directly into the cord of the hand that’s causing it to bend. You may receive up to two injections in the same hand during a treatment appointment, based on the affected areas.
Your doctor will bandage your hand after the procedure. Do not remove the bandage until they say it’s safe to do so. It’s important to keep the treated area still. Do not try to bend or straighten your finger, and keep your hand elevated until bedtime.
You’ll make another appointment with the doctor 1 to 3 days after your first injection. They’ll check the condition of the cord and try to gradually straighten the finger by breaking up the cord. They’ll usually administer a local anesthetic during this process to numb the area.
Your doctor may do another round of injections after 4 weeks if your finger isn’t straight. You can receive treatments for each affected cord up to three times, 4 weeks apart.
If Xiaflex is effective in straightening your finger, your doctor may have you wear a splint at bedtime for about 4 months. They’ll also show you exercises to perform several times a day for several months after treatment.
You’ll receive detailed information about the procedure, risks, and how to care for your hand after each treatment.
Xiaflex is given by a healthcare professional in a doctor’s office or clinic. Your doctor’s office will schedule your doses. If you miss a dose, call your doctor’s office as soon as you remember. They’ll discuss your options.
If you need help remembering your Xiaflex appointments, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Xiaflex for you, they’ll prescribe the dosage that’s right for you. Talk with them if you have questions or concerns about your current dosage. Here are some examples of questions you may want to ask:
- Does the cost of Xiaflex treatment depend on the dosage I’m prescribed?
- Would you change my Xiaflex dosage if my condition is not improving?
- Can you adjust my Xiaflex dosage cycle if I’m experiencing side effects?
To learn more about Xiaflex, see these articles:
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Disclaimer: Healthline 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.
