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This medication, used for treating Peyronie's disease, carries potential risks and requires careful adherence to safety guidelines. Below are key safety warnings and instructions for its use:

• Serious Penile Injury (Peyronie's Disease): Rarely, this medication can cause significant injury to the penis, such as fractures or hematomas, which may require surgical intervention. Symptoms of serious injury include severe pain, bruising, swelling, difficulty maintaining an erection, trouble urinating, blood in urine, or a popping sensation in an erect penis. Immediate medical attention is advised if these symptoms occur.

• REMS Program Requirement (U.S. only): In the United States, patients must agree to and follow the REMS Program protocols when receiving treatment for Peyronie's disease. In other countries, consult your healthcare provider for relevant regulations.

• Injection Precautions: Only a trained healthcare provider should administer this medication to avoid injecting into sensitive areas such as the urethra, nerves, or blood vessels, which can cause severe injury.

• Tendon and Hand Injury (Dupuytren's Contracture): Similar precautions apply when treating Dupuytren’s contracture to prevent tendon rupture or severe injury to the hand.

• Allergic Reactions: Some patients may experience mild to severe allergic reactions, including anaphylaxis. Seek immediate medical attention if symptoms like itching, dizziness, fainting, hives, chest pain, breathing difficulties, or facial swelling occur.

• Bleeding Risk: Patients with a history of blood clotting issues or those taking blood thinners may experience bruising or bleeding at the injection site. Discuss these risks with your healthcare provider.

• Sudden Back Pain: Some individuals with Peyronie's disease may experience sudden back pain shortly after injections. This pain usually subsides in about 30 minutes without additional medication. Notify your healthcare provider if this occurs.

• Lightheadedness and Fainting: These symptoms can occur, particularly related to injection pain. It is advisable to lie down if you feel faint to prevent injury.

• Contraindications: This medication should not be used in cases of Peyronie’s plaques involving the penile urethra or if there is an allergy to collagenase products.

Patients and healthcare providers should discuss these risks and precautions to ensure safe use of the medication. If any concerns arise, consult a healthcare professional promptly.

When using this medication, some common side effects may occur, which are generally mild and should not cause alarm unless they persist or worsen. These include pain, swelling, bruising, bleeding, and redness at or around the injection site. Itching may also occur in these areas. Specifically, for injections in the hand, swelling and pain in the elbow and underarm due to swollen lymph nodes could be experienced. For those treating Peyronie's disease, there may be swelling, bruising, and pain in the penis, along with possible tenderness or bleeding.

More serious side effects, though rare, require immediate medical attention. For Dupuytren's contracture, watch for signs of infection such as fever and chills, or symptoms indicating nerve injury, like numbness or tingling in the treated hand. Serious injury to the hand's tendons or ligaments is possible, potentially needing surgical intervention if you experience difficulty moving your fingers or hand. For Peyronie's disease, sudden lower back pain that may spread to other areas and cause muscle spasms should be reported promptly.

A very serious allergic reaction, although rare, can occur, characterized by rash, itching or swelling, severe dizziness, and breathing difficulties. Immediate medical help is crucial in such cases. Additionally, some users have reported painful erections, pain during intercourse, and erectile dysfunction, which also necessitate urgent attention. Always consult your healthcare provider if you notice any side effects, especially if they are severe or persistent.