Santyl (collagenase) dosing, indications, interactions, adverse effects, and more

Sections

Sections collagenase
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ointment

250 units/g

Dermal Ulcers

Apply qDay directly to wound or to sterile gauze pad, which is then applied to wound and properly secured; apply more frequently if dressing becomes soiled; terminate use of collagenase ointment when debridement of necrotic tissue is completed and granulation tissue well established

Administration

When clinically indicated, crosshatching thick eschar with a #10 blade allows ointment more surface contact with necrotic debris

Remove as much loosened detritus as can be done readily with forceps & scissors

Clean wound of debris & digested material by gently rubbing with a gauze pad saturated with NS (or other desired cleansing agent compatible with Santyl), follow with a NS rinse

If an antibiotic powder is used in case of infection, it should be applied prior to the application of Santyl.

If infection remains, discontinue Santyl until remission of infection

May be applied directly to the wound or to a sterile gauze pad which is then applied to the wound & properly secured

Terminate treatment when debridement of necrotic tissue is complete & granulation tissue is well established

Safety & efficacy not established

Interaction Checker

Enter a drug name and collagenase

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Interactions Found

Contraindicated

Serious - Use Alternative

Significant - Monitor Closely

Minor

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Contraindicated (0)

Serious - Use Alternative (1)

povidone iodine
povidone iodine decreases effects of collagenase by increasing metabolism. Avoid or Use Alternate Drug.

Monitor Closely (3)

silver nitrate
silver nitrate decreases effects of collagenase by Other (see comment). Use Caution/Monitor. Comment: Heavy metal ions inactivate enzymes.
silver sulfadiazine
silver sulfadiazine decreases effects of collagenase by Other (see comment). Use Caution/Monitor. Comment: Heavy metal ions inactivate enzymes.
urea topical
urea topical decreases effects of collagenase by increasing metabolism. Use Caution/Monitor.

Minor (1)

silver sulfadiazine
collagenase decreases effects of silver sulfadiazine by pharmacodynamic antagonism. Minor/Significance Unknown.

Frequency Not Defined

Irritation

Burning sensation at site of application

Hypersensitivity disorder

Contraindications

Hypersensitivity

Cautions

Efficacy will be adversely affected by detergents, denaturants, extreme pH & certain heavy metal ions

May cause slight transient erythema in surrounding tissues

Monitor patients for the possibility of systemic bacterial infections; debriding enzymes may increase risk of bacteremia

For external use only; avoid contact with eyes

Pregnancy & Lactation

Pregnancy Category: C

Lactation: Excretion in milk unknown

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Collagen-degrading enzyme; has high specificity for native and denatured collagen; digests collagen in necrotic tissue but not in healthy tissue; does not act on fibrin, fat, keratin or muscle

Images

No images available for this drug.

Patient Handout

A Patient Handout is not currently available for this monograph.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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