Nexobrid (Concentrate Of Proteolytic Enzymes Enriched In Bromelain)

Nexobrid acts on burn‑related eschar to enable enzymatic debridement.

• Eschar removal in superficial partial‑thickness burns: facilitates removal of necrotic tissue to prepare the wound for healing.
• Topical debridement of burn wounds: accelerates the debridement process and reduces the need for surgical intervention.
• Burn wound management: supports clinicians in achieving a clean wound bed for subsequent dressings or grafting.

• The bromelain‑rich proteolytic enzyme mixture hydrolyzes peptide bonds in denatured proteins, selectively digesting necrotic eschar while sparing viable dermal tissue. This enzymatic action softens and loosens the dead tissue, allowing it to be removed without mechanical trauma, thereby preparing the wound for optimal healing.

Local reactions are the most frequently reported adverse events.

Common Side Effects

• Local pain at the application site.
• Erythema or redness of the treated area.
• Mild edema or swelling.
• Itching or mild burning sensation.
• Transient hyperemia.

Serious or Rare Side Effects

• Severe allergic reaction or anaphylaxis.
• Extensive skin necrosis beyond the intended area.
• Significant bleeding, especially in patients on anticoagulants.
• Systemic hypersensitivity reactions.
• Secondary wound infection.
• Uncontrolled scarring or hypertrophic scar formation.

Before using Nexobrid, clinicians should consider the following precautions.

• Allergy assessment: verify no known bromelain or pineapple allergy.
• Wound assessment: ensure eschar depth is appropriate for topical enzymatic debridement.
• Concurrent therapy: avoid applying other proteolytic agents to the same area.
• Monitoring: observe for signs of local irritation or systemic reaction during and after treatment.
• Pregnancy and lactation: use only if the potential benefit outweighs any theoretical risk and after professional consultation.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Enzymatic activity may be influenced by other medications or topical agents.

Major Interactions (Avoid)

• Concurrent systemic proteolytic enzymes: may increase risk of bleeding.
• Anticoagulants or antiplatelet agents: potential potentiation of hemorrhagic events.
• Immunosuppressants: possible alteration of wound healing dynamics.

Moderate Interactions (Monitor Closely)

• Topical antibiotics: may affect local microbiome and enzyme activity.
• Dressings containing silver or other metal ions: could inhibit enzymatic action.
• Chemotherapeutic agents applied to the wound: monitor healing response and possible toxicity.