• Miscellaneous dermatological conditions

Nexobrid Generic Name & Formulations

General Description

Anacaulase-bcdb 8.8%; gel; preservative-free.

Pharmacological Class

Proteolytic enzyme.

How Supplied

Gel (lyophilized pwd + gel vehicle)—2g, 5g


Generic Availability


Mechanism of Action

The mixture of proteolytic enzymes in Nexobrid dissolves burn wound eschar. The specific components responsible for this effect have not been identified.

Nexobrid Indications


Eschar removal in deep partial thickness (DPT) and/or full thickness (FT) thermal burns. 

Limitations of Use

Not established for treating: chemical or electrical burns; burns on the face, perineum, genitalia; burns on the feet of patients with diabetes mellits or occlusive vascular disease; circumferential burns; burns in patients with significant cardiopulmonary disease, including inhalation injury. Not for wounds contaminated with radioactive and other hazardous substances.

Nexobrid Dosage and Administration


Must be administrated by healthcare provider. Prepare and mix lyophilized pwd in gel vehicle prior to administration. Apply 3mm thick layer to an area up to 15% body surface area (BSA) in one session; leave in place for 4hrs. If area is >15% BSA, apply in 2 sessions separated by 24hrs. Total treatment area: max 20% BSA (40g of pwd) across 2 sessions. Wound treatment area preparation, pain management, application, product removal, others: see full labeling. 


Not established.

Nexobrid Contraindications


Hypersensitivity to bromelain, pineapples, papayas, papain. 

Nexobrid Boxed Warnings

Not Applicable

Nexobrid Warnings/Precautions


Monitor for serious hypersensitivity reactions; remove Nexobrid and treat if occurs. Avoid exposure when preparing and handling product. Not for treatment of burn wounds where medical devices or vital structures could be exposed. Protect open wounds (eg, laceration, abraded skin, escharotomy incision) with protectant ointments or gauze. Avoid in uncontrolled coagulation disorders. Patients taking anticoagulants, on drugs affecting coagulation, low platelet counts, increased risk of bleeding (eg, peptic ulcers, sepsis): monitor for coagulation abnormalities and bleeding. Elderly. Pregnancy. Nursing mothers.

Nexobrid Pharmacokinetics


Half-life: 12 ± 4.4 hours.

Nexobrid Interactions

Not Applicable

Nexobrid Adverse Reactions

Adverse Reactions

Pruritus, pyrexia; hypersensitivity reactions.

Nexobrid Clinical Trials

See Literature

Nexobrid Note

Not Applicable

Nexobrid Patient Counseling

See Literature