Bromfenac (Ophthalmic)

Bromfenac (pronounced BROME fen ak) is an ophthalmic solution. It is used for the treatment of pain or swelling in patients' eyes after they have undergone cataract surgery.

Overview

Bromfenac ophthalmic (eye) solution is a medicine prescribed to patients as eye drops used for the treatment of swelling and/or pain that patients may experience in their eyes following cataract surgery. It is a non steroidal, topical and anti inflammatory drug (NSAID). (1) Aspirin and ibuprofen are two other commonly known NSAIDs. This medicine is known by the brand names Bromday and Prolensa, as well as several others. It was also previously known as Xibrom, which has since been discontinued. Bromfenac is intended for short term use.

Bromfenac works by blocking the effects of prostaglandins, which are naturally occurring lipid compounds that can cause pain and inflammation. (2) Studies have shown that prostaglandins can intervene effectively in particular cases of intraocular inflammation. It's been found in certain studies using animal eyes that prostaglandins were shown to have negative effects on the blood aqueous humor barrier, on their vasodilation, and to augment leukocytosis, vascular permeability, as well as to increase intraocular pressure. (4) Bromfenac comes as a liquid for use in the eyes via an eye dropper. It is usually prescribed to be used on the day before cataract surgery, on the day of the surgery, and for a two week postoperative period.

This article may not contain all information about the medication Bromfenac. If you have any further questions, consult with your doctor, healthcare professional or pharmacist. If you are experiencing serious side effects after having taken Bromfenac, seek medical care immediately.

Conditions Treated

  • Postoperative pain in the eye after cataract surgery
  • Inflammation of the eye after cataract surgery

Type of medicine

  • Non steroidal anti-inflammatory drug (NSAID)

Side Effects

When used correctly as prescribed, Bromfenac can be a great pain reliever for patients following cataract surgery. However, along with its intended effects, Bromfenac may cause some unwanted side effects. Fortunately, most people who take Bromfenac experience only mild side effects, but it is important to play close attention to any side effects that occur as you start using Bromfenac eye drops. So far, less than 1 in 100 people experience negative side effects. (6) Although not all of these side effects may occur, if they do you may require medical attention.

The most common side effects of Bromfenac are:

  • Temporary irritation, burning and/or stinging in the eyes
  • Temporarily blurred vision (You should not drive or operate heavy machinery until you know how this medication affects you)
  • Watery eyes
  • Headaches

Many people using Bromfenac do not experience any serious side effects. Tell your doctor or pharmacist immediately if you experience any of any of the following rare but serious side effects.
Less common side effects of Bromfenac are:

  • Severe pain in or around the eyes
  • Redness in or around the eyes
  • Itching around the eye area
  • Sensitivity to light (also called photophobia)
  • Unusual eye discharge
  • Blurred or abnormal vision that is not temporary
  • A feeling of something trapped in the eye
  • Slow or delayed healing of the eyes

If you are experiencing photophobia, you should avoid bright sunlight, wear sunglasses when outside, and should not use tanning sun beds while you are taking Bromfenac. Very serious allergic reactions to Bromfenac are rare, although some grave reactions have been reported. In particular, Bromfenac contains a sulfite that may cause  anaphylactic symptoms and severe asthmatic episodes. Use of Bromfenac may result in keratitis (inflammation of the eye). Long-term use of Bromfenac can result in eye damage which can lead to sight loss. If you experience any change in your eyesight, immediately discontinue the use of topical Bromfenac. (5)

You should also seek medical attention immediately if you notice any of the following symptoms, as they could be indications of a serious allergic reaction:

  • Loss of sight
  • Rash
  • Bleeding in the eye
  • Itching and/or swelling (particularly of the face, throat or tongue)
  • Blistered or peeling skin
  • Severe dizziness
  • Difficulty breathing, wheezing, or speaking
  • Tightness in the chest or throat

If any of these effects persist, become worse, or if you experience other side effects not listed here, contact your doctor or pharmacist right away. Not all side effects of Bromfenac are known. If you experience side effects not listed above, inform your doctor or pharmacist.

If you require medical advice about the side effects for this medication, call your pharmacist or doctor. If you need to contact the FDA to report side effects, you can reach them at 1-800-FDA-1088 or at www.fda.gov/medwatch.

Dosage

As with all medications, you should only take Bromfenac as prescribed by your physician. Your doctor or pharmacist may tell you to start using Bromfenac the day before or the day after your cataract surgery.
The usual method for applying Bromfenac is as follows:
When applying the eye drops, remember to always wash your hands first. To avoid any contamination, avoid touching the eye dropper tip with your hands, eyes or any other surface.

Do not apply Bromfenac while you are wearing contact lenses. If you do wear contact lenses, remove them before you apply the eye drops. Consult your doctor or pharmacist for more detail. Wait a minimum of 10 minutes after using Bromfenac to replace your lenses. The recommended usual adult dosage amounts are detailed in this article, but it is important to note that you should always follow the instruction and dosage amounts prescribed to your by your doctor and pharmacist. Personal factors about you and your treatment that you discuss with your doctor will determine your ideal dose size and frequency.

Usual adult dosage for Bromfenac:

If you have a 0.07% or 0.09% Bromfenac ophthalmic solution, you will apply 1 drop in the affected eyes once a day, starting 1 day before cataract surgery, and then continue treatment on surgery day itself and through the first 14 days afterwards.

If you have a 0.075% Bromfenac ophthalmic solution, you will apply 1 drop in the affected eyes twice a day (once in the morning and once in the evening) starting the day before cataract surgery, on the day of surgery itself, and then onwards through the first 14 days after the surgery.

Application method:

To apply the Bromfenac drops tilt your head back, look upward, and then gently pull down your lower eyelid to form a pouch. Hold the eye dropper (tip down) with your other hand, as close to your eye as possible without touching it. The best way to deliver the dose is to gently squeeze the dropper whilst looking up. Ensure that a single drop falls into your lower eyelid, then, after removing your index finger, close your eyes for between one and three minutes whilst looking down. Place one finger in the inner corner of your eye (next to the nose) and apply pressure gently to prevent the medication from leaking out. It's important that you make sure not to blink too much, and do not rub your eyes. Do not rinse the eye dropper. Replace the eye dropper cap after each use. (1)

If you are currently using an alternative eye medication (such as concomitant topical ophthalmic medication, ointments or drops), it's best to wait for between 5 to 10 minutes before administering other medications. It is also important to ensure that any eye ointments are used after eye drops, as otherwise the drops will not be able to enter the eye properly. Take Bromfenac for the amount of time advised by your physician.
If you miss a dose of Bromfenac, apply the drops as soon as you remember. If it is almost time for your next application, do not take it twice; just take your next planned dose on time.

There are no recommended dosage amounts for the use of Bromfenac on children. If your child has been prescribed Bromfenac, follow the instructions given to you by your doctor or pharmacist. Special care may be necessary.

Major Drug Interactions

Certain medications or drugs will interact with other drugs you may be taking. Before using Bromfenac, tell your doctor or pharmacist if you are taking any other prescriptions or herbal supplements you are currently using, especially any of the following:

  • Anti-platelet medications (such as clopidogrel)
  • Other anti-inflammatory NSAID medications (such as aspirin or ibuprofen)
  • Blood thinners (such as wafarin or heparin)
  • Other eye medications

There are hundreds of medications, particularly NSAIDs, not listed here, that may interact with Bromfenac ophthalmic solution, so it is important to disclose all drugs you may be taking to your doctor.

Warnings

Be careful not to apply Bromfenac more often than prescribed or continue to use it for longer than the period directed by your doctor or healthcare professional. Prolonged use of Bromfenac eye drops may increase the risk of serious negative side effects on the eye. (2)
You should not take Bromfenac if you have certain medical conditions. Before taking this medicine, consult your doctor or pharmacist in particular:

  • If you have aspirin sensitive asthma or a history of worsening breathing with a runny or stuffy nose after taking other NSAIDs such as aspirin or ibuprofen
  • If you have eye defects or have recently had eye surgery
  • If you have dry eye syndrome
  • If you have rheumatoid arthritis or diabetes
  • If you are taking blood thinners
  • If you have any bleeding disorders, particularly any condition that causes you to bleed easily
  • If you have growths in your nose
  • If you are currently pregnant or breastfeeding. (5)

You should also inform your doctor or healthcare professional if you have any allergies, especially to:

  • Bromfenac
  • Aspirin or other non steroidal anti-inflammatory NSAIDs (such as naproxen or celecoxib)
  • Anticoagulants
  • To steroid products that are used for the eyes (for example, dexamethasone)
  • Fluorometholone (such as Flarex and FML)
  • Difluprednate (Durezol)
  • Loteprednol (such as Alrex, Zylet, Lotemax)
  • Prednisolone (such as Omnipred, Pred-G, Pred Mild, Pred Forte and in Blephamide)

If you suspect you may have overdosed after applying or swallowing Bromfenac (you are experiencing an unusually slow or fast pulse, difficulty breathing, unconsciousness, seizures, poor coordination, hot or flushed skin) call 911 or the poison control center (1-800-222-1222) or get medical care right away. Be ready to tell or show what you have taken, how much, and when it happened. Bring the container with you.

This medication is intended for use in your eyes only. If you or someone else swallows or ingests it, seek medical care immediately. Bring the container with you. Do not share your prescription with others, even if they have a similar condition to you. Talk to your pharmacist for more details.

Storage

You should store Bromfenac in a dry, room temperature place that is between 59-77 degrees Fahrenheit (15-25 degrees Celsius) away from heat and light. Do not store it in the bathroom or anywhere humid. You should keep all medicines out of reach of children and pets.

To keep from contaminating the eye dropper tip or solution, care should be taken not to touch your eyelids, surrounding eye area or any other surfaces with the eye dropper tip. Always wash your hands before applying Bromfenac or any other medication to your eyes. (3)

Unless you have been instructed to do so by your pharmacist, make sure not to pour Bromfenac down your drain, or flush down the toilet. When the product is no longer needed due to improvements in your condition or a change to alternative medication, or if the medication has expired, it's crucial to dispose of this product properly. For more information on how to safely discard Bromfenac, talk to your local waste disposal or company or your pharmacist.

Summary

Bromfenac is a prescription medication used to treat inflammation and pain in patients who have recently undergone cataract surgery. It comes as a liquid solution for use in the eyes via an eye dropper. Although serious side effects are rare, this drug can lead to grave side effects for some who take it, so it is important to discuss any pre-existing medical conditions, medications or herbal supplements that you are taking with your physician before you commence using Bromfenac on your eyes. You should remove contact lenses before administering Bromfenac ophthalmic drops.

By blocking the effects of naturally occurring lipid compounds (sometimes called prostaglandins) after cataract surgery, Bromfenac can relieve pain and inflammation in patients' eyes. It is usually prescribed to be used the day before cataract surgery, on the day of the surgery, and for a two week postoperative period. To achieve the best results from the use of this medication and all medicines, you should work together with your healthcare professional to determine the right dose and frequency for your particular needs.

This article may not contain all information about Bromfenac ophthalmic (eye) solution. If you have any further questions or concerns, you should consult with your doctor, healthcare professional or pharmacist. If you are currently experiencing serious side effects after having applied Bromfenac, seek medical care immediately.