What Is Collagenase? Uses, Dosage, and What You Need to Know in 2026

Collagenase Is an Enzymatic Debriding Agent Used to Remove Dead Tissue From Chronic Wounds and Burns

If you or someone you care for has a wound that isn't healing, your doctor may prescribe Collagenase. This guide covers everything you need to know — from what it is and how it's used to what it costs and who shouldn't take it.

What Is Collagenase?

Collagenase is a prescription topical ointment that helps clean wounds by breaking down and removing dead tissue. Here are the key facts:

• Brand name: Santyl
• Generic name: Collagenase (Clostridium Histolyticum-derived)
• Drug class: Enzymatic debriding agent
• Manufacturer: Smith+Nephew
• FDA-approved: Yes, for debriding chronic dermal ulcers and severely burned areas
• Controlled substance: No — Collagenase is not a scheduled medication
• Generic available: No — patents extend to at least 2030

The active enzyme in Collagenase comes from Clostridium histolyticum bacteria. It's specifically designed to break down denatured collagen — the protein scaffolding found in dead tissue — while leaving healthy tissue intact.

What Is Collagenase Used For?

FDA-Approved Uses

• Chronic dermal ulcers — Including diabetic foot ulcers, venous leg ulcers, and pressure ulcers that have dead tissue preventing healing
• Severely burned areas — Helping remove dead tissue from burn wounds to prepare them for healing or skin grafting

Off-Label Uses

Doctors also prescribe Collagenase for conditions not listed on the official label, including:

• Stage III and IV pressure ulcers (bedsores)
• Diabetic foot ulcers
• Venous leg ulcers
• Post-surgical wound debridement

The concept behind all these uses is the same: dead tissue in a wound acts like a roadblock to healing. Collagenase clears that roadblock so new, healthy tissue can grow. For a deeper explanation, see our guide on how Collagenase works.

How Is Collagenase Taken?

Collagenase is not a pill — it's a topical ointment applied directly to wounds. Here's how it's used:

Dosage Form

• Topical ointment, 250 units/gram
• Available in 30g tubes and 90g tubes

How to Apply

1. Clean the wound. Gently remove any loose debris from the wound. Do not use harsh antiseptics — they can inactivate the enzyme.
2. Apply the ointment. Apply Collagenase directly to the wound bed, or apply it to a sterile gauze pad first, then place the pad on the wound.
3. Secure with a dressing. Cover the wound with an appropriate sterile dressing as directed by your healthcare provider.
4. Repeat once daily. The typical dose is 250 units/gram applied once daily.

How Long Do You Use It?

Continue using Collagenase until your doctor tells you to stop — typically when debridement is complete and healthy granulation tissue is well established. This can take anywhere from a few weeks to several months depending on the size and severity of the wound.

Important Application Tips

• Do not apply Collagenase to surrounding healthy skin — only to the wound bed.
• Protect surrounding skin with zinc oxide paste or petroleum jelly before applying.
• Do not use Betadine (Povidone-Iodine), silver products, or detergents on the wound while using Santyl. These will destroy the enzyme.

Who Should Not Use Collagenase?

Collagenase has very few contraindications, but there are some important considerations:

Contraindications

• Allergy to Collagenase — If you've had a hypersensitivity reaction to Collagenase or any ingredient in the ointment, do not use it.

Use With Caution

• Debilitated patients — Those who are very ill, malnourished, or bedridden should be closely monitored for signs of systemic infection, including bacteremia.
• Immunocompromised patients — People with weakened immune systems may be at higher risk for wound infections.
• Pediatric patients — Safety and efficacy haven't been established through controlled trials in children, though it has been studied in pediatric burn patients.

For a full rundown of side effects and risks, read our Collagenase side effects guide.

How Much Does Collagenase Cost?

Collagenase is an expensive medication, and there's currently no generic available. Here's what you can expect to pay:

Cash Prices (Without Insurance)

• 30g tube: $333 to $450+
• 90g tube: $800 to $1,200+

With Insurance

Most insurance plans cover Santyl, but typically require prior authorization. Approval is usually granted for 3-month periods for documented chronic wounds or burns. Medicare Part D and Medicaid generally cover it with prior auth. Some plans may require step therapy — meaning you may need to try other debridement methods first.

Ways to Save

• Santyl Copay Assistance Card — Eligible patients pay the first $50, and Smith+Nephew covers up to the next $250 per fill. Available for up to 6 fills per year ($1,000 annual maximum). Not valid for Medicare, Medicaid, TRICARE, or other government insurance.
• Smith+Nephew Patient Assistance Program (PAP) — Provides Santyl at no cost to eligible low-income, uninsured, or underinsured patients. Apply through santyl.com or by contacting Smith+Nephew directly.
• For more options, check our complete guide to saving money on Collagenase.

Final Thoughts

Collagenase (Santyl) is a well-established wound care medication that helps chronic wounds heal by removing dead tissue enzymatically. It's applied once daily, has relatively few side effects, and is covered by most insurance plans with prior authorization.

The biggest challenges with Collagenase tend to be cost and availability rather than the medication itself. If you need help finding it at a pharmacy near you, Medfinder can help you locate Collagenase in stock. And if cost is a concern, the manufacturer's savings programs can make a real difference.