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collagenase, combinations

D03BA52

Forms & Strengths

Ointment: collagenase (Clostridiopeptidase A) 250 units/g combined with chloramphenicol 10 mg/g

Adult Dosing

Apply a thin layer of ointment (approx. 2 mm thickness) to the lesion once daily
Gently remove necrotic debris before each new application
Moisten dry wound beds with saline or Ringer's solution prior to application to optimize enzymatic activity

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established; use not routinely recommended

Indications

Enzymatic debridement of necrotic tissue in dermal ulcers, severe burns, pressure sores, and surgical wounds

Mechanism of Action

Collagenase specifically attacks native and denatured collagen in necrotic tissue, cleaving the peptide bond and allowing safe debridement without harming granulation tissue
Chloramphenicol provides broad-spectrum antibacterial coverage to prevent or treat local wound infections during debridement

Contraindications

Hypersensitivity to collagenase, chloramphenicol, or any excipients
Exposed deep tissues where systemic absorption through large surface areas could pose severe toxicity risks

Adverse Reactions

Transient local burning, pain, or erythema at the application site
Allergic contact dermatitis or hypersensitivity reactions secondary to chloramphenicol
Systemic toxicity (e.g., bone marrow suppression) if absorbed extensively through severely compromised skin (rare)

Drug Interactions

Heavy metal ions (e.g., silver, mercury, iodine) inactivate collagenase enzymatic activity and should not be used concurrently
Soaps, detergents, and acidic solutions may inactivate collagenase; cleanse wounds thoroughly with neutral saline before application
Systemic adverse effects may theoretically potentiate with other bone marrow suppressants due to systemic absorption of chloramphenicol

Curated Content: Needs Vetting Before Put to Clinical Use