Nexobrid is now approved for pediatric patients

Precision in
Eschar Removal1,2

NexoBrid® (anacaulase-bcdb) is an effective and selective enzymatic agent that removes eschar in adults while preserving viable tissue1–3

NexoBrid Is a first-line bromelain-based enzymatic agent for eschar removal3,4

Help adult patients with deep partial thickness and/or full thickness burn wounds start towards a path to healing with effective, selective eschar removal1–3

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Watch The ABCs of NexoBrid: Advancing Burn Care with Steven A. Kahn, MD
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See How NexoBrid Works: Watch the Product Video

Product illustration

NexoBrid powder and gel

NexoBrid is available as 5 g lyophilized powder (containing 4.85 g of anacaulase-bcdb) mixed in 50 g gel vehicle per 2.5% BSA3

  • For topical use only

Studies showed NexoBrid dissolves eschar and can be3:

  • Applied as a 4-hour application within hours of patient presentation for earlier and more informed medical planning for healing and care1,3,5
    • Remove NexoBrid after 4 hours
  • Used at bedside, in the ICU, or in the OR with appropriate monitoring5,6
  • Administered by burn surgeons and/or burn care professionals5

Precautions should be taken to avoid exposure during preparation and handling (e.g., gloves, surgical masks, other protective coverings, as needed). In the event of inadvertent skin exposure, rinse NexoBrid off with water to reduce the likelihood of skin sensitization.

This information provided is not intended to provide medical advice or direction. Healthcare professionals should assess each situation and consider their own procedures, including treatment and pain management, for their patients as each patient’s situation will vary.

Please see Full Prescribing Information for guidance on preparation and application.

Learn How to Use NexoBrid 

NexoBrid may provide an alternative option to surgical excision that4

  • Removes eschar in adults while preserving viable tissue1–3
  • Dissolves eschar within a 4-hour application period3
    • Remove NexoBrid after 4 hours
  • May lead to more precise wound depth determination1,2
  • Achieved ≥95% eschar removal in 93% of patients with DPT and FT thermal burns in a clinical study3
  • Lowered the incidence of excision for eschar removal in clinical studies3

See Study Design 

Review the Clinical Data 

Unveiling the NexoBrid wound bed

Selective eschar removal with NexoBrid may reveal a clear view of the extent of the original injury.2,6

Before

After

Before removing eschar After removing eschar

Images are from a real NexoBrid patient

See More Before and After Pictures 
NexoBrid About icon

About NexoBrid

NexoBrid is a mixture of proteolytic enzymes extracted from the stems of pineapple plants that dissolves burn wound eschar while preserving viable tissue.1–3

Learn More About This Alternative to Surgical Excision 

How to use NexoBrid

How to use NexoBrid

Find out more about the preparation, application, and removal of NexoBrid.

Learn How to Use NexoBrid 

Important Safety Information

Indication

NEXOBRID® (anacaulase-bcdb) is indicated for eschar removal in adults and pediatric patients with deep partial thickness (DPT) and/or full thickness (FT) thermal burns.

Limitations of Use

The safety and effectiveness of NEXOBRID have not been established for treatment of:

  • Chemical or electrical burns
  • Burns on the face, perineum, or genitalia
  • Burns on the feet of patients with diabetes mellitus or on the feet of patients with occlusive vascular disease
  • Circumferential burns
  • Burns in patients with significant cardiopulmonary disease, including inhalation injury

NEXOBRID is not recommended for:

  • Wounds contaminated with radioactive and other hazardous substances to avoid unforeseeable reactions with the product and an increased risk of spreading the noxious substance
  • Treatment of burn wounds where medical devices (e.g., implants, pacemakers, shunts) or vital structures (e.g., large vessels) could become exposed during eschar removal

Important Safety Information

Contraindications

NEXOBRID is contraindicated in patients with: known hypersensitivity to anacaulase-bcdb, bromelain, pineapples, or to any other components; known hypersensitivity to papayas or papain because of the risk of cross-sensitivity.

Important Safety Information

Indication

NEXOBRID® (anacaulase-bcdb) is indicated for eschar removal in adults and pediatric patients with deep partial thickness (DPT) and/or full thickness (FT) thermal burns.

Limitations of Use

The safety and effectiveness of NEXOBRID have not been established for treatment of:

  • Chemical or electrical burns
  • Burns on the face, perineum, or genitalia
  • Burns on the feet of patients with diabetes mellitus or on the feet of patients with occlusive vascular disease
  • Circumferential burns
  • Burns in patients with significant cardiopulmonary disease, including inhalation injury

NEXOBRID is not recommended for:

  • Wounds contaminated with radioactive and other hazardous substances to avoid unforeseeable reactions with the product and an increased risk of spreading the noxious substance
  • Treatment of burn wounds where medical devices (e.g., implants, pacemakers, shunts) or vital structures (e.g., large vessels) could become exposed during eschar removal

Important Safety Information

Contraindications

NEXOBRID is contraindicated in patients with: known hypersensitivity to anacaulase-bcdb, bromelain, pineapples, or to any other components; known hypersensitivity to papayas or papain because of the risk of cross-sensitivity.

Warnings and Precautions

Hypersensitivity Reactions

Serious hypersensitivity reactions, including anaphylaxis, have been reported with postmarketing use of anacaulase-bcdb. If a hypersensitivity reaction occurs, remove NEXOBRID (if applicable) and initiate appropriate therapy.

Healthcare personnel should take appropriate precautions to avoid exposure when preparing and handling NEXOBRID (e.g., gloves, surgical masks, other protective coverings, as needed).

Coagulopathy

Avoid use of NEXOBRID in patients with uncontrolled disorders of coagulation. Use with caution in patients on anticoagulant therapy or other drugs affecting coagulation, and in patients with low platelet counts and increased risk of bleeding from other causes. Monitor patients for possible signs of coagulation abnormalities and signs of bleeding.

Adverse Reactions

The most common adverse reactions (>5%) in adults were pruritus, pyrexia, wound complication, anemia, vomiting and insomnia. The most common adverse reactions (>5%) in pediatric patients were pruritus, pyrexia and vomiting.

Use in Special Populations
Geriatric Use

Clinical studies of NEXOBRID did not include sufficient numbers of subjects 65 years of age and older to determine whether they respond differently from younger adult subjects.

To report negative side effects contact Vericel Corporation at 888-454-BURN (888-454-2876) or FDA at 1-800-FDA-1088 (1-800-332-1088) or www.fda.gov/medwatch.

Please see Full Prescribing Information.

References: 1. Krieger Y, Bogdanov-Berezovsky A, Gurfinkel R, et al. Efficacy of enzymatic debridement of deeply burned hands. Burns. 2012;38:108-112. 2. Palao R, Aguilera-Saez J, Collado JM, et al. Use of a selective enzymatic debridement agent (Nexobrid) for wound management: Learning curve. World J Dermatol. 2017;2;6(2):32-41. 3. NexoBrid Prescribing Information. Cambridge, MA. Vericel Corporation; 2023. 4. Muhammad ZA, Ahmad T. Therapeutic uses of pineapple-extracted bromelain in surgical care. J Pak Med Assoc. 2017;67(1):121-125. 5. Singer AJ, Taira BR, Anderson R, et al. The effects of rapid enzymatic debridement of deep partial-thickness burns with Debrase on wound repithelialization in swine. J Burn Care Res. 2010;31(5):795-802. doi: 10.1097/BCR.0b013e3181eed48e 6. Korzeniowski T, Struzyna J, Torres K. Evaluation of bromelain-based enzymatic debridement combined with laser doppler imaging and healing of burn wounds. Med Sci Monit. 2022;28:e936713.