Bromfenac is a potent, non-steroidal anti-inflammatory drug (NSAID) formulated as an ophthalmic solution. It is a phenylacetic acid derivative that selectively inhibits cyclooxygenase-2 (COX-2) more than COX-1. In the Indian market, it is a leading topical NSAID for managing postoperative ocular inflammation and pain following cataract surgery, effectively reducing prostaglandin-mediated responses without the side effects associated with corticosteroids.
Adult: One drop (approximately 0.04-0.05 mL) instilled into the affected eye(s) once daily (for 0.09% formulation) or twice daily, beginning 24 hours after cataract surgery and continuing through the first 2 weeks of the postoperative period. Duration may be extended up to 4 weeks as per surgeon's discretion.
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid down to form a pouch. 4. Instill one drop without touching the tip to eye, eyelid, or any surface. 5. Close eyes gently and apply gentle pressure to the inner corner of the eye (nasolacrimal occlusion) for 1-2 minutes to reduce systemic absorption. 6. Wait at least 5-10 minutes before instilling any other eye drops. 7. Replace cap tightly.
Bromfenac is a non-selective, but preferential, inhibitor of cyclooxygenase (COX), the enzyme responsible for the biosynthesis of prostaglandins (PGs) from arachidonic acid. It demonstrates a higher inhibitory potency for the inducible COX-2 isoform over the constitutive COX-1 isoform. By blocking PG synthesis in the anterior segment of the eye (iris, ciliary body, conjunctiva), it reduces the vasodilation, increased vascular permeability, leukocyte migration, and pain sensation associated with ocular inflammation and surgical trauma.
Pregnancy: Category C (US FDA). Animal studies have shown fetal abnormalities. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy, especially in the third trimester, may cause premature closure of the fetal ductus arteriosus. Use only if the potential benefit justifies the potential risk to the fetus. Avoid use in late pregnancy.
Driving: May cause transient blurred vision immediately after instillation. Patients should not drive or operate machinery until vision clears.
| Other Topical NSAIDs (e.g., Ketorolac, Nepafenac) | Increased risk of additive corneal toxicity and side effects. Avoid concomitant use. | Major |
| Topical Corticosteroids (e.g., Dexamethasone, Prednisolone) | May be used together for enhanced anti-inflammatory effect, but also may increase risk of infection, elevated IOP, and cataract formation. Monitor closely. | Moderate |
| Oral Anticoagulants (Warfarin) or Antiplatelets (Clopidogrel, Aspirin) | Potential increased risk of ocular bleeding (hyphema) due to additive antiplatelet effect. Use with caution. | Moderate |
| Topical Miotics (e.g., Pilocarpine) | May increase ocular irritation. Separate administration by at least 10 minutes. | Minor |
Same composition (Bromfenac (0.09% w/v)), different brands: