Bromfenac

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Bromfenac

Bromfenac is a sterile, topical nonsteroidal anti-inflammatory drug (NSAID) eye drop for ophthalmic use.

Introduction

Bromfenac is a sterile, topical nonsteroidal anti-inflammatory drug (NSAID) eye drop for ophthalmic use. It is used for the management of ocular pain and inflammation because of its anti-inflammatory and analgesic properties. It blocks prostaglandin synthesis (a substance that causes inflammation (e.g., redness, swelling, irritation) by inhibiting cyclooxygenase 1 and 2.

Pharmacological class: NSIAD

Indications

  • Eye pain
  • Eye swelling
  • Cataract surgery
  • Postoperative inflammation 
  • Reduction of ocular pain

Pharamcological Action

It works by its ability to block prostaglandin synthesis (a substance that causes inflammation (e.g., redness, swelling, irritation) by inhibiting cyclooxygenase 1 and 2. Prostaglandins are the mediators of certain kind of intraocular inflammation and they have shown to produce disruption of the blood-aqueous humor barrier, vasodilation, increased vascular permeability, leukocytosis, and increased intraocular pressure.

Dosage

Cataract surgery: One drop twice daily, to be administered 24 hours’ post-surgery continuing through the first 2 weeks of the postoperative period.

Pharmacokinetics

The plasma concentration of bromfenac following ocular administration of bromfenac ophthalmic solution in humans is unknown. Based on the maximum proposed dose of one drop to the eye (0.09 mg) twice a day and pharmacokinetics information from other routes of administration, the systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans.

Contraindications

  • In patients with known hypersensitivity to bromfenac.
  • In patients with active epithelial keratopathy, red eyes, rheumatoid arthritis and diabetes

Drug Interactions

Using bromfenac ophthalmic together with abciximab may cause dizziness, lightheadedness and also increases the risk of bleeding.

Side effects

Common (affecting between 1 in10 to 1 in 100)

  • Eye burning
  • Irritation
  • Itching
  • Pain
  • Redness
  • Stinging
  • Swelling
  • Headache
  • Unusual feeling in the eye
  • Conjuctivital hyperemia
  • Eye pruritus
  • Iritis

Uncommon (affecting 1 in 100 to 1 in 1000)

  • Allergic reactions
  • Swelling of the mouth, face, lips, or tongue

Very rare (affecting less than 1 in 10,000)

  • Difficulty breathing
  • Tightness in the chest
  • Unusual bleeding of the eye
  • Vision changes

Precautions

  • Avoid in patients who have previously exhibited sensitivity to this drug.
  • Avoid in patients who have known bleeding tendencies
  • Avoid its use in asthma patients as it may cause severe allergic reactions.

Clinic Evidence

  • Efficacy of bromfenac was evaluated in two randomized, double-masked, trials in which subjects with a summed ocular inflammation score ≥ 3 after cataract surgery were assigned to bromfenac or vehicle in a 2:1 ratio following surgery.
  • One drop of bromfenac or vehicle was self-instilled in the study eye twice a day for 14 days, beginning the day after surgery. The primary endpoint was reduction of ocular inflammation (to trace inflammation or clearing) assessed 14 days’ post-surgery. Overall, only 20% of the patients undergoing cataract surgery in these trials had pain on the first day after surgery. In these patients, the bromfenac group demonstrated a statistically significant difference in median time to resolution of ocular pain of 2 days compared to 4 days for patients receiving vehicle.1

References

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