Nexobrid (Concentrate Of Proteolytic Enzymes Enriched In Bromelain)

• Nexobrid is indicated for enzymatic debridement of deep partial‑thickness burn injuries.
• Deep partial‑thickness burns: enzymatic debridement that removes necrotic tissue while preserving viable dermis, preparing the wound for definitive closure.

• The bromelain‑rich proteolytic enzyme concentrate contains a mixture of cysteine‑proteinases that hydrolyze peptide bonds in denatured collagen and other extracellular matrix proteins. By selectively targeting necrotic tissue, the preparation dissolves eschar without damaging viable cells, thereby accelerating wound cleaning and promoting a favorable environment for subsequent grafting or healing.

Topical application of Nexobrid may be associated with local and systemic adverse reactions.

Common Side Effects

• Pain at the application site: transient discomfort during enzymatic activity.
• Erythema: mild redness surrounding the treated area.
• Edema: localized swelling that usually resolves within days.
• Increased wound exudate: temporary rise in fluid discharge.

Serious or Rare Side Effects

• Severe allergic reaction: anaphylaxis or angioedema requiring immediate medical attention.
• Deep tissue necrosis beyond intended area: excessive enzymatic activity causing unintended tissue loss.
• Infection: secondary bacterial infection of the debrided wound.

When using Nexobrid, clinicians should observe the following precautions to minimize complications.

• Assess burn depth: confirm that the injury is deep partial‑thickness before application.
• Avoid full‑thickness burns: the enzyme is not intended for burns with no viable dermis.
• Do not apply to infected wounds: bacterial colonization may alter enzyme activity.
• Monitor for hypersensitivity: discontinue if signs of allergic reaction appear.
• Pregnancy and lactation: safety not established; use only if benefit outweighs risk.
• Store at room temperature: keep in the original container, protect from moisture and direct light.

Nexobrid can interact with certain systemic and topical agents; awareness of these interactions helps ensure safe use.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin, heparin): increased risk of bleeding at the wound site.
• Systemic proteolytic enzyme supplements: additive proteolysis may exacerbate tissue breakdown.

Moderate Interactions (Monitor Closely)

• Topical antibiotics (e.g., silver sulfadiazine): may reduce enzymatic activity.
• Moisture‑retaining dressings: could alter absorption and efficacy of the enzyme.
• Topical corticosteroids: might interfere with wound healing dynamics.