Bromfenac

PROLENSA

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Pronunciation: BROEM-fen-ak

Bromfenac ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Bromfenac ballicule

What it isTopical ophthalmic NSAID; post-operative inflammation and cystoid macular edema.

Why this oneOnce- or twice-daily dosing, and it controls inflammation without the pressure rise a steroid causes.

What limits itCorneal melting with prolonged use or in a compromised surface, so courses are short and supervised.

Bromfenac molecular structure (skeletal formula) — Molecular structure: Bromfenac

FDA-approved for

postoperative ocular inflammation and pain after cataract surgery (2005)

FDA label

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FDA dosing	Population	Start	Target	Max
Postoperative inflammation and ocular pain after cataract surgery	Adults	1 drop QD	1 drop QD

Renal Undefined

Hepatic Undefined

Instructions

Begin 1 day before cataract surgery, continue day of surgery and through 14 days postoperatively
Space other topical ophthalmic drugs at least 5 minutes apart
Remove contact lenses before instillation; reinsert 10 minutes after
Avoid use >24 h before surgery or >14 days postoperatively (corneal risk)

Available strengths

drops 0.07, 0.075, 0.09 %
sol 0.9 mg/mL

Cautions

Sulfite allergic reactions (contains sodium sulfite; anaphylaxis/asthmatic episodes)
Slow or delayed healing; more so with concomitant topical steroids
Cross-sensitivity to acetylsalicylic acid and other NSAIDs
Increased ocular bleeding time
Keratitis and corneal reactions (epithelial breakdown, thinning, ulceration, perforation)

Adverse reactions

Anterior chamber inflammation
Foreign body sensation
Eye pain
Photophobia
Blurred vision

Pregnancy No human data; avoid in late pregnancy (NSAID risk of premature ductus arteriosus closure)

Lactation No data; minimal systemic exposure expected after topical ocular use

Cost

Bromfenac (PROLENSA)

Strength		#/mo	CostPlus
0.07 %	drops	per unit	not offered
0.075 %	drops	per unit	not offered
0.09 %	drops	per unit	not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Bromfenac is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2011

NO BOXED WARNINGS

Principal riskCorneal melting with prolonged use

Classes and tags

Clinical profile

Therapeutic safety burden0 / 4

Overdose danger0 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryC

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.

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