Summary
Commonly reported side effects of collagenase clostridium histolyticum include: bleeding at injection site, pruritus, bruise, and ecchymoses. Continue reading for a comprehensive list of adverse effects.
Applies to collagenase clostridium histolyticum: injection powder for solution.
Warning
Injection route (Powder for Solution)
Warning: Corporal rupture (penile fracture) or other serious penile injury in the treatment of Peyronie's diseaseCorporal rupture (penile fracture) was reported as an adverse reaction in 5 of 1044 (0.5%) collagenase clostridium histolyticum-treated patients in clinical studies. In other collagenase clostridium histolyticum-treated patients (9 of 1044; 0.9%), a combination of penile ecchymoses or hematoma, sudden penile detumescence, and/or penile "popping" sound or sensation was reported, in these cases, a diagnosis of corporal rupture cannot be excluded. Severe penile hematoma was also reported as an adverse reaction in 39 of 1044 (3.7%) collagenase clostridium histolyticum-treated patients.Signs or symptoms that may reflect serious penile injury should be promptly evaluated to assess for corporal rupture or severe penile hematoma which may require surgical intervention.Because of the risks of corporal rupture or other serious penile injury, collagenase clostridium histolyticum is available for the treatment of Peyronie's disease only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the collagenase clostridium histolyticum REMS program.
Serious side effects
Along with its needed effects, collagenase clostridium histolyticum may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking collagenase clostridium histolyticum:
More common—Dupuytren's contracture
- Bruising or bleeding at the injection site
- swelling of the hands
- tearing of the skin
More common—Peyronie's disease
- Itching, pain, redness, swelling, or bruise of the penis
- popping sound or sensation in an erect penis
Less common—Peyronie's disease
- Decreased interest in sexual intercourse
- inability to have or keep an erection
- loss in sexual ability, desire, drive, or performance
- painful sexual intercourse
Incidence not known—Dupuytren's contracture
- Bone pain
- dizziness
- fainting
- lower back or side pain
- painful, swollen joints
Incidence not known—Peyronie's disease
- Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain or tightness
- difficult or labored breathing
- dizziness
- fainting
- lower back pain, possibly radiating to the legs, feet, arms, or chest
- muscle spasms
Other side effects
Some side effects of collagenase clostridium histolyticum may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common—Dupuytren's contracture
- Blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, lumps, numbness, rash, scarring, stinging, tingling, or ulceration at the injection site
- bruise
- flushing, redness of the skin or unusually warm skin at the injection site
- itching, pain, swelling, or tenderness at the injection site
- swollen, painful, or tender lymph glands in the neck or armpit
For Healthcare Professionals
Applies to collagenase clostridium histolyticum: injectable powder for injection.
Musculoskeletal
Very common (10% or more): Pain in extremity (35%), arthralgia (11%)
Common (1% to 10%): Shoulder pain
Uncommon (0.1% to 1%): Axillary mass, chest wall pain, groin pain, joint crepitation, joint stiffness, limb discomfort, muscle spasms, muscular weakness, musculoskeletal stiffness, neck pain, tendon rupture[Ref]
Local
Very common (10% or more): Injection site hemorrhage (38%), injection site reaction (erythema, inflammation, irritation, pain, warmth) (35%), injection site swelling and edema (24%), pruritus (15%), blood blister (13%)
Common (1% to 10%): Ecchymosis, hyperhidrosis, rash, skin laceration
Uncommon (0.1% to 1%): Eczema, swelling face, pain of skin, skin exfoliation, skin lesion, scab, skin discoloration, skin tightness[Ref]
Cardiovascular
Very common (10% or more): Peripheral edema (most cases were swelling of the injected hand) (73%)
Frequency not reported: Vasovagal syncope (after finger extension procedures)[Ref]
Other
Very common (10% or more): Contusion (any body system) and ecchymosis (70%), tenderness (24%)
Common (1% to 10%): Axillary pain
Uncommon (0.1% to 1%): Breast tenderness, hypertrophy breast[Ref]
Dermatologic
Common (1% to 10%): Lymphadenopathy, lymph node pain
Uncommon (0.1% to 1%): Thrombocytopenia[Ref]
Gastrointestinal
Common (1% to 10%): Nausea
Uncommon (0.1% to 1%): Diarrhea, vomiting, abdominal pain upper[Ref]
Genitourinary
Patients with Peyronie's disease:
Very common (10% or more): Penile hematoma (65.5%), penile swelling (55%), penile pain (45.4%), penile ecchymoses (14.5%), a popping noise or popping sensation in the penis, sometimes described as "snapping" or "cracking", and sometimes accompanied by detumescence, hematoma, and/or pain (13.2%)
Common (1% to 10%): blood blister (4.5%), penile blister (3.3%), genital pruritus (3.1%), painful erection (2.9%), erectile dysfunction (1.8%), procedural pain (1.6%), injection site vesicles (1.3%), localized edema (1.3%), dyspareunia (1.1%), injection site pruritus (1.1%), nodule (1.1%), suprapubic pain (1.1%)
Uncommon (0.1% to 1%): Corporal rupture (penile fracture) (0.5%)[Ref]
Hematologic
Very common (10% or more): Lymphadenopathy (13%)
Common (1% to 10%): Lymph node pain
Uncommon (0.1% to 1%): Thrombocytopenia[Ref]
Hypersensitivity
Uncommon (0.1% to 1%): Hypersensitivity[Ref]
Immunologic
Uncommon (0.1% to 1%): Injection site cellulitis, lymphangitis[Ref]
Nervous system
Common (1% to 10%): Burning sensation, dizziness, headache, hypoesthesia, paresthesia
Uncommon (0.1% to 1%): Disorientation, agitation, insomnia, irritability,
restlessness[Ref]
Ocular
Uncommon (0.1% to 1%): Eyelid edema[Ref]
Respiratory
Uncommon (0.1% to 1%): Dyspnea, hyperventilation[Ref]