Drug updated on 4/18/2024

Dosage FormGel (topical; 8.8%)
Drug ClassProteolytic enzymes
Ongoing and
Completed Studies


  • Indicated for eschar removal in adults with deep partial thickness and/or full thickness thermal burns.

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  • Anacaulase (NexoBrid) is indicated for eschar removal in adults with deep partial thickness and/or full thickness thermal burns. It has been associated with positive effects on debridement outcomes, functional and cosmetic results, scarring, and quality of life improvements.
  • The efficacy and safety profile of NexoBrid, including comparisons to other debridement methods, were analyzed in two systematic reviews/meta-analyses.
  • When compared to other treatments for burn wound debridement, such as surgical excision or collagenase-based agents, NexoBrid has not been linked with significant adverse events like coagulopathy or burn wound infection, suggesting it is a safe option for patients requiring debridement.
  • Key benefits of NexoBrid include quicker healing times due to the Bromelain-based approach. This reduces the need for surgical interventions, leading to shorter hospital stays and a lower risk of complications such as sepsis or compartment syndrome.
  • Unlike collagenase, which is effective for burns covering less than 25% total body surface area (TBSA) and is usually used in outpatient settings, NexoBrid is beneficial even in treating deep burns that might require more intensive treatments.
  • Although the benefits of NexoBrid are recognized, especially when used in conjunction with protocols that include analgosedation/locoregional anesthesia, further research with larger sample sizes and no conflicts of interest is necessary to fully understand bromelain’s effectiveness in treating various types of burns.

Product Monograph / Prescribing Information

Document TitleYearSource
NexoBrid (anacaulase-bcdb) Prescribing Information. 2023Vericel Corporation, Cambridge, MA

Systematic Reviews / Meta-Analyses