Bromfenac

Pronunciation: brome-fen-ACK
Class: NSAID

Trade Names

Xibrom
- Solution 0.09%

Pharmacology

Decreases inflammation by blocking prostaglandin synthesis through inhibition of cyclooxygenase 1 and 2.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Pharmacokinetics

Absorption

Based on the recommended ophthalmic dose, systemic plasma concentration is estimated to be below the limit of quantification (50 ng/mL).

Indications and Usage

Treatment of postoperative inflammation in patients who have undergone cataract extraction.

Contraindications

Standard considerations.

Dosage and Administration

Adults

Ophthalmic 1 drop to affected eye(s) twice daily beginning 24 h after cataract surgery and continuing postoperatively through the first 2 wk.

Storage/Stability

Store ophthalmic solution between 59° and 77°F. Keep tightly capped.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Headache (2% to 7%).

EENT

Abnormal sensation in eye, conjunctival hyperemia, eye irritation (including burning/stinging), eye pain, eye pruritus, eye redness, iritis (2% to 7%); corneal erosion, corneal perforation, corneal thinning, epithelial breakdown (postmarketing).

Precautions

Pregnancy

Category C .

Lactation

Use with caution.

Children

Safety and efficacy not established.

Hypersensitivity

Because of potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs, use with caution in patients who previously have exhibited sensitivity to these drugs.

Bleeding

There is a potential for increased bleeding time because of interference with platelet aggregation. Use with caution in patients with known bleeding tendencies or who are receiving other medications that prolong bleeding time

Healing

May slow or delay healing.

Keratitis

Continued use may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation, which may threaten sight.

Special risk patients

Because of increased risk of corneal adverse reactions, use with caution in patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (eg, dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time. Risk of corneal adverse reactions also may be increased if topical NSAIDs are used more than 24 h prior to surgery or beyond 14 days postsurgery.

Sulfite

Contains sodium sulfite, which may cause allergic-type reactions including asthmatic episodes and life-threatening anaphylaxis.

Patient Information

  • Remind patient that eye drops are for use in the eye only.
  • Teach patient proper technique for instilling eye drops: Wash hands; do not allow dropper to touch eye. Tilt head back, look up; pull lower eyelid down; instill prescribed number of drops. Close eye(s) for 2 to 3 min and apply gentle pressure to bridge of nose for 1 to 2 min. Do not rub eye.
  • Caution patient not to touch top of dropper bottle to eye, fingers, or any other surface.
  • Advise patient that if more than 1 topical ophthalmic medication is being used, separate each medication by at least 5 min. Instill ophthalmic ointment last.
  • Inform patient that eye redness, eye irritation, burning or stinging, eye pain, and headaches are the most common side effects and to contact health care provider if they occur and are bothersome.
  • Advise patient to contact eye doctor if eye or eyelid inflammation is noted or if eye symptoms do not improve or worsen.
  • Instruct patient wearing contact lenses to remove lenses when instilling eye drops and, if wearing soft contact lenses, to wait at least 10 min after instilling drops before inserting their lenses.
  • Caution patient wearing contact lenses not to wear lenses if eyes are red.

Copyright © 2009 Wolters Kluwer Health.

Hide
(web3)