Bromfenac

PROLENSA

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.

FDA-approved for

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

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)

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)

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

NO BOXED WARNINGS

Principal riskCorneal melting with prolonged use

Cost, est. cash$10–$400/month

Generic entry2011

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.