Comprehensive medication guide to Santyl including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$50 copay with prior authorization approved on most commercial plans; specialty tier or high-deductible plans may still result in $100+ out-of-pocket. Santyl Copay Assistance Card can reduce commercial insurance copay to $20–$50. Medicare and Medicaid cover with prior auth but copay card is not applicable.
Estimated Cash Pricing
$333–$450+ retail for a 30g tube (no generic available); as low as $346 with a GoodRx coupon or $328 with SingleCare at participating pharmacies.
Medfinder Findability Score
68/100
Summarize with AI
On this page
Santyl is the brand name for collagenase ointment, a prescription topical medication used to remove dead tissue from chronic wounds and severe burns. It is manufactured by Smith & Nephew, Inc. and is the only FDA-approved enzymatic debriding ointment in the United States. Healthcare professionals have prescribed Santyl for more than 50 years.
Santyl is FDA-approved for two indications: debriding chronic dermal ulcers (including diabetic foot ulcers, pressure ulcers, and venous leg ulcers) and debriding severely burned areas (second- and third-degree burns). It is available as a topical ointment containing 250 collagenase units per gram of white petrolatum, in 30-gram and 90-gram tubes.
Because no generic version of Santyl exists — and patents extend to at least 2030 — every prescription must be filled with the brand-name product. This makes pharmacy availability a more significant concern than for most medications.
We have a 99% success rate finding medications, even during nationwide shortages.
Need this medication?
Santyl contains collagenase, an enzyme derived from the fermentation of Clostridium histolyticum bacteria. Collagen accounts for approximately 75% of the dry weight of skin tissue. When tissue dies, the collagen denatures (loses its normal triple-helix structure) and becomes vulnerable to enzymatic attack. Collagenase specifically targets and cleaves the peptide bonds of this denatured collagen in necrotic tissue, breaking down the structural scaffold of dead tissue so it can be cleared from the wound.
Critically, collagenase is selective — it attacks denatured collagen in dead tissue but does not damage native collagen in healthy, living tissue or newly forming granulation tissue. This selectivity makes Santyl gentler than mechanical debridement methods that can damage surrounding healthy tissue.
Once necrotic tissue is removed, the wound bed is clean and granulation tissue can form, followed by epithelialization (new skin cell growth) that closes the wound. Santyl works optimally in a pH range of 6–8 and is inactivated by heavy metal ions (silver, mercury) and detergents, which is why these products must not be used on Santyl-treated wounds.
250 units/gram — ointment (30g tube)
Standard tube size for individual or short-term use
250 units/gram — ointment (90g tube)
Larger tube for extended treatment or larger wounds
Finding Santyl at a pharmacy can be more challenging than most prescription medications. The ASHP documented a formal drug shortage for collagenase ointment from August 2023, which was formally resolved as of October 2024 when Smith & Nephew reported both the 30-gram and 90-gram tubes available. However, even with the national shortage resolved, individual pharmacy stock varies significantly.
Santyl is a specialty wound care product not routinely stocked at most retail chain pharmacies. Specialty pharmacies, wound care center pharmacies, and hospital outpatient pharmacies are the most reliable sources. Mail-order specialty pharmacies through insurance plans often provide the most consistent supply. Some areas may still have limited local availability even as national supply has improved.
If you're having trouble filling a Santyl prescription, medfinder calls pharmacies near you to find which ones can fill your prescription — so you don't have to spend hours on hold.
Santyl is not a controlled substance, so any licensed prescriber can write a prescription without special DEA registration. However, many insurance plans require that the prescription be written by, or in consultation with, a wound care specialist as a condition of prior authorization. Common prescribers include:
Wound care specialists and wound care center clinicians
Podiatrists (especially for diabetic foot ulcers and lower extremity wounds)
Surgeons (plastic, vascular, general)
Dermatologists
Primary care physicians (PCPs) and internal medicine physicians
Nurse practitioners (NPs) and physician assistants (PAs)
Infectious disease specialists (for infected chronic wounds)
Santyl is generally not prescribed via telehealth, as wound assessment requires in-person evaluation of wound size, tissue type, and infection status. Most patients are initially evaluated and prescribed Santyl at a wound care center, podiatry clinic, burn center, or surgery practice, with ongoing prescriptions sometimes managed by primary care.
No. Santyl (collagenase topical ointment) is not a controlled substance. It has no abuse potential, is not habit-forming, and is not scheduled by the Drug Enforcement Administration (DEA). There are no special DEA prescribing restrictions, and prescriptions can be called in or faxed to a pharmacy without the additional requirements that apply to controlled substances.
Any licensed prescriber — including physicians, nurse practitioners, physician assistants, and others — can prescribe Santyl without special DEA registration. However, some insurance plans require that Santyl be prescribed by or in consultation with a wound care specialist, podiatrist, or surgeon as part of the prior authorization process.
Santyl has a well-established safety profile after more than 50 years of clinical use. Side effects are uncommon. The most frequently reported effect is:
Slight transient erythema (redness) in healthy skin surrounding the wound — occurs when Santyl contacts skin outside the wound bed; temporary and avoidable by careful application
Systemic bacterial infection (bacteremia): Theoretical risk in debilitated patients. Call your doctor immediately for fever, chills, rapid heartbeat, nausea, vomiting, confusion, or lightheadedness.
Hypersensitivity/allergic reaction: Rare. Seek emergency care for hives, difficulty breathing, or facial/lip/tongue/throat swelling.
Worsening wound condition: Call your provider if the wound gets significantly worse or shows new signs of infection.
Know what you need? Skip the search.
Medihoney
Medical-grade Manuka honey; FDA-cleared for wound management; promotes autolytic and osmotic debridement with antimicrobial properties; available OTC; generally less expensive than Santyl
Hydrogel Dressings (Intrasite Gel, SoloSite)
Water-based gels that promote autolytic debridement by maintaining moist wound environment; significantly cheaper than Santyl; best for dry wounds with thin necrotic tissue
Sharp/Surgical Debridement
Physical removal of necrotic tissue by a healthcare provider; fastest debridement method; billed as a procedure; requires provider visit; no medication cost
EscharEx (Bromelain-based)
Bromelain enzyme-based debriding agent; alternative enzymatic option with limited US availability
Prefer Santyl? We can find it.
Povidone-iodine (Betadine)
majorInactivates the collagenase enzyme, rendering Santyl ineffective. Avoid concurrent use. If previously used, cleanse wound thoroughly with normal saline before applying Santyl.
Silver sulfadiazine (Silvadene/SSD)
majorHeavy metal silver ions inactivate the collagenase enzyme. Do not use silver sulfadiazine on the same wound as Santyl.
Mercury-containing antiseptics
majorHeavy metal mercury ions inactivate the collagenase enzyme. Avoid on Santyl-treated wounds.
Silver nitrate
moderateHeavy metal ions from silver nitrate reduce collagenase activity. Avoid concurrent use on the same wound.
Detergents and soaps
moderateCan denature (destroy) the collagenase enzyme. Do not cleanse the wound with soap or detergent-based products before applying Santyl.
Hydrogen peroxide
moderateCan inactivate the collagenase enzyme. Do not use hydrogen peroxide on Santyl-treated wounds.
Urea topical
moderateMay increase metabolism of collagenase, reducing its effectiveness. Use with caution on Santyl-treated wounds.
Santyl (collagenase ointment) is a well-established, FDA-approved wound care medication that has been helping chronic wounds heal for over 50 years. It offers a unique combination of selectivity, ease of home application, and proven efficacy for chronic dermal ulcers and severe burns. The biggest challenges with Santyl tend to be cost and pharmacy availability rather than the medication itself.
For cost, the Santyl Copay Assistance Card can bring commercially insured patients' out-of-pocket cost to $20–$50 per fill, and the Smith & Nephew Patient Assistance Program provides Santyl at no cost to eligible uninsured or underinsured patients. GoodRx and SingleCare coupons offer another avenue for reducing costs.
For pharmacy availability, specialty pharmacies, wound care center pharmacies, and mail-order options are the most reliable channels. If you're having trouble locating Santyl, medfinder calls pharmacies near you to find which ones can fill your prescription — so you can spend less time on hold and more time focused on healing.
Medfinder Editorial Standards
Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
ChatGPT
Claude
Perplexity
Grok
Gemini