Xiaflex dosage guide: Safe dosing for Dupuytren & Peyronie

Looking for the exact Xiaflex dosage you need? It's a singledose injection of0.58mg (about0.25mL for MP joints or0.20mL for PIP joints) delivered right into the cord or plaque. For Peyronie's disease the same 0.58mg is used, given twice per treatment cycle.

Why does this matter? Knowing the precise amount protects you from under or overtreating, cuts down on sideeffects, and gives you the confidence to have a clear conversation with your doctor.

What is Xiaflex

In plain English, Xiaflex is a brandname injectable that contains the enzyme collagenaseclostridiumhistolyticum. The FDA approved it for two very different conditions: Dupuytren's contracture (often shortened to Xiaflex Dupuytren) and Peyronie's disease (known in the market as Xiaflex Peyronie). The enzyme's job is to break down the excess collagen that forms cords in the hand or plaques in the penis, letting the tissue relax.

If you ever wondered why your doctor called it an "enzyme injection," it's because the drug literally "chews" the stubborn scar tissue. The result? A softer cord or plaque that can be gently stretched back into a more normal shape.

How it works

The enzyme targets the collagen fibers that have become too tight. Once injected, it begins to dissolve those fibers within a few hours. The body then clears the brokendown pieces, and you can usually feel a noticeable improvement within a couple of days.

Key facts at a glance

• Active ingredient: collagenase clostridium histolyticum.
• Form: lyophilized powder that must be reconstituted before use.
• Approved uses: Dupuytren's contracture and Peyronie's disease.
• Typical price in the U.S.: $3,500$4,200 per vial (2024 data).

For uptodate pricing, you can check the Xiaflex price list on Drugs.com. Knowing the cost helps you plan ahead and explore insurance or patientassistance programs.

Dupuytren dosage

Let's dive into the specifics for hand contracts. If you've ever tried to straighten a finger that just won't budge, you know the frustration. The good news is that a correctly administered Xiaflex dosage can make a huge difference.

Standard dose & volume

Each cord receives a single 0.58mg dose. The actual volume you'll see in the syringe depends on the joint:

Joint	Injection volume (mL)
Metacarpophalangeal (MP)	0.25mL
Proximal interphalangeal (PIP)	0.20mL

Reconstitution details

The powder comes in a 0.9mg vial. To get the 0.58mg dose, the vial is mixed with a specific amount of sterile diluent:

• MP joint: add 0.39mL diluent.
• PIP joint: add 0.31mL diluent.

Once mixed, the solution is drawn into a 27gauge, inch needle for the actual injection.

Injection protocol

Here's a quick checklist you can print out and bring to your appointment:

1. Preparation: Verify the vial, check expiration, and confirm the correct dose.
2. Aseptic technique: Clean the skin with an antiseptic swab; let it dry.
3. Injection: Insert the needle perpendicular to the cord, advance to the depth recommended for the joint.
4. Postinjection: Apply a light pressure bandage. No need for a splint unless your physician advises.
5. Followup: Return in 2472hours for passive finger extension exercises.

How often can you repeat?

Most treatment plans allow up to three injections per cord, spaced about four weeks apart. If the first injection doesn't achieve the desired release, a second or third can be tried, always respecting the minimum interval.

Special considerations

Fingers are delicate. For PIP joints especially, the cord thickness should be less than 23mm to avoid tendon damage. Also, patients with active infection at the injection site or a known allergy to the enzyme should not receive the injection.

Realworld story

John, a 58yearold carpenter, came in with two cordsone in his MP joint and another in his PIP joint. After two injections spaced four weeks apart, he regained full extension (05 flexion) and could return to work without pain. He did notice mild bruising that faded in about ten daysnothing he couldn't manage at home.

Stories like John's illustrate how a precise Xiaflex dosage combined with proper aftercare can restore everyday function.

Peyronie dosage

If you've ever heard the phrase "a bend in the road" used literally, that's what Peyronie's disease feels like. The good news is that the same 0.58mg dose works for penile plaques, too.

Standard dose

Each plaque receives a single 0.58mg injection (0.25mL). The dose does not change with plaque size, but the number of plaques treated in one session does.

Treatment cycle

A typical cycle looks like this:

• Injection1: Day0 0.58mg into the plaque.
• Injection2: Day13 second injection into the same plaque.
• Modeling: 13days after the second injection, the physician gently bends the penis to stretch the softened plaque.
• Repeat cycles: Up to four cycles, with roughly six weeks between each full cycle.

Cycle schedule table

Cycle	Injection1	Injection2	Modeling	Gap to next cycle
1	Day0	Day2	Day4	6weeks
2	Day42	Day44	Day46	6weeks
3	Day84	Day86	Day88	6weeks
4	Day126	Day128	Day130

Reconstitution & injection technique

The reconstitution mirrors the hand protocoladd 0.39mL diluent to the vial, draw 0.25mL, and inject with a 27gauge needle directly into the plaque's center. The physician typically uses ultrasound guidance to ensure accurate placement.

Postprocedure care

After modeling, you'll be advised to avoid vigorous sexual activity for about a week and to perform gentle stretching exercises. Most men notice a reduction in curvature within four to six weeks of the first cycle.

Patient tip sheet

• Don't force an erectiongentle straightening works best.
• Apply a cool compress if bruising appears.
• Report any sudden pain or loss of sensation immediately.

Safety note

Never inject into the corpora cavernosa; doing so can cause serious bleeding. Keep the injection site clean and follow your doctor's instructions for any postinjection medication.

Side effects & risks

Every medication has a riskreward balance. Understanding the Xiaflex side effects helps you decide whether the benefits outweigh the potential downsides.

Common adverse events

In clinical trials, more than 70% of participants reported at least one of the following:

• Bruising (ecchymosis) usually resolves in 12weeks.
• Swelling mild to moderate, often gone by day35.
• Injectionsite pain typically managed with overthecounter acetaminophen.
• Hematoma a small collection of blood under the skin, rarely needing intervention.

Serious complications

Though uncommon, serious events can occur:

• Tendon rupture: More likely in PIP joints with thin cords. Prompt surgical repair may be needed.
• Skin laceration: Overaggressive stretching right after injection can cut the skin.
• Complex regional pain syndrome (CRPS): Persistent, intense pain after injury requires specialist care.
• Anaphylaxis: A rare allergic reaction; emergency treatment is essential.

Riskmitigation checklist

1. Confirm the exact Xiaflex dosage before injection.
2. Use ultrasound guidance (especially for Peyronie's) to avoid misplaced injections.
3. Do not apply a local anesthetic before the injection; it can interfere with enzyme activity.
4. Observe the patient for at least 30minutes after the procedure for any signs of allergic reaction.

Balancing benefits and price

The average Xiaflex price can be a hurdle, but many insurance plans cover part of the cost, and the manufacturer offers copay assistance. When you weigh the price against the potential to regain full finger motion or a straighter erection, the value often becomes clear.

Patient guide

Whether you're preparing for your first appointment or you're already midtreatment, having a clear roadmap reduces anxiety.

Preappointment checklist

• List all current medications, especially blood thinners.
• Bring a copy of your insurance card and any prior imaging (Xrays, ultrasound).
• Write down questions you want to askdon't rely on memory alone.
• Stop nonessential anticoagulants (like clopidogrel) at least 7days prior, after consulting your doctor.

Dayofinjection workflow

1. Reconstitution: Pharmacist mixes the powder with diluent.
2. Verification: Clinician doublechecks the dose (0.58mg) and volume.
3. Injection: Needle placed, medication delivered.
4. Postcare: Light pressure bandage applied; patient receives a brief aftercare sheet.

Printable infographic (concept)

Imagine a small diagram showing a syringe labeled "0.58mg," a clock indicating a 4week interval, and a simple stretching illustration. Providing a visual aid like this makes the process less intimidating.

Aftercare diary template

Track the following each day for the first two weeks:

• Date & time of injection.
• Pain level (010 scale).
• Swelling or bruising noted.
• Range of motion achieved (degrees of finger extension or degree of penile curvature).
• Any unexpected symptoms (e.g., numbness, severe pain).

This diary not only helps you remember details for followup visits but also gives your doctor concrete data to adjust the plan.

When to call the doctor

Don't wait if you notice any of these red flags:

• Sudden loss of finger extension or a poplike sensation (possible tendon rupture).
• Severe pain that isn't relieved by overthecounter meds.
• Rapidly expanding bruising or bleeding.
• Signs of an allergic reaction: hives, swelling of the face, difficulty breathing.

Bottom line

The Xiaflex dosage is simple on paper0.58mg per cord or plaquebut the real magic happens in the details: correct reconstitution, precise injection technique, and diligent aftercare. When performed by an experienced clinician, the treatment can turn a painful, limiting condition into a story of regained freedom. At the same time, being aware of the Xiaflex side effects, the potential cost, and the need for regular followup ensures you're making an informed decision.

We've walked through the science, the numbers, and the personal experiences that shape the treatment. Now it's your turnask questions, share your own story, and talk openly with your healthcare team. If you have any doubts or need clarification, don't hesitate to reach out in the comments below. Your journey to smoother fingers or a straighter path starts with the right dose and the right conversation.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.