Topical NSAID (post-operative) Pregnancy: SPC §4.6: no adequate data in pregnant women; animal studies have shown reproductive toxicity. Systemic exposure is negligible so the risk during pregnancy could be considered low, but use during the third trimester should be avoided (prostaglandin biosynthesis inhibition — closure of ductus arteriosus); in general not recommended during pregnancy unless the benefit outweighs the potential risk. Breast-feeding: bromfenac can be used during breast-feeding (systemic exposure negligible; no effects on the breastfed infant anticipated).

Bromfenac

Brand names: Yellox

Bromfenac is a topical non-steroidal anti-inflammatory drug (NSAID) eye drop used to treat postoperative ocular inflammation following cataract surgery.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One drop in the affected eye(s)

Route: Topical ocular (bromfenac 0.9 mg/ml eye drops, solution)

Frequency: Twice daily, beginning the day after cataract surgery and continuing through the first 2 weeks of the postoperative period

SPC §4.2 'Use in adults, including the elderly': one drop in the affected eye(s) twice daily, beginning the next day after cataract surgery and continuing through the first 2 weeks of the postoperative period. Treatment should not exceed 2 weeks, as safety data beyond this is not available. If more than one topical ophthalmic medicinal product is used, administer each at least 5 minutes apart. Paediatric: safety and efficacy in paediatric patients has not been established; no data available. Contains benzalkonium chloride (0.00155 mg per drop, 0.05 mg/ml) — remove contact lenses before use and reinsert 15 minutes afterwards; in general contact lens wear is not recommended during the postoperative period following cataract surgery (§4.4). NOTE — US/UK divergence: the US bromfenac 0.09% ophthalmic solution label states one drop into the affected eye once daily beginning 1 day prior to cataract surgery, continued on the day of surgery and through the first 14 days postoperatively; the UK SPC regimen above has been used.

Dose adjustments

Renal

SPC §4.2: bromfenac has not been studied in patients with hepatic disease or renal impairment. No dose adjustment is stated.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to bromfenac or to any of the excipients, or to other non-steroidal anti-inflammatory medicinal products (NSAIDs)
Patients in whom attacks of asthma, urticaria or acute rhinitis are precipitated by acetylsalicylic acid or by other medicinal products with prostaglandin synthetase inhibiting activity

Side effects

Abnormal sensation in eye (0.5%)
Corneal erosion, mild or moderate (0.4%)
Eye pruritus (0.4%)
Eye pain (0.3%)
Eye redness / conjunctival hyperaemia (0.3%)
Rare but serious (post-marketing): corneal perforation, corneal ulcer, serious corneal erosion, corneal infiltrates, corneal scar, scleromalacia — discontinue immediately if corneal epithelial breakdown occurs

Interactions

Topical corticosteroids — concomitant use of NSAIDs and topical steroids may increase the potential for healing problems, and in at-risk patients may lead to a higher risk of corneal adverse events (SPC §4.4)
Medicinal products which may prolong bleeding time — use bromfenac with caution, as ophthalmic NSAIDs may cause increased bleeding of ocular tissues (including hyphaema) in conjunction with ocular surgery (SPC §4.4)
Other topical ophthalmic medicinal products — administer at least 5 minutes apart (SPC §4.2)

Clinical monograph

How it works

It inhibits cyclo-oxygenase, reducing prostaglandin synthesis and thereby controlling ocular inflammation and associated pain after surgery.

Prescribing in practice

Topical ocular NSAIDs can cause corneal complications including epithelial breakdown, thinning, ulceration and, rarely, perforation, particularly with prolonged use or in at-risk eyes.
Use with caution in patients with known hypersensitivity to aspirin or other NSAIDs and in those with bleeding tendencies.
Caution is advised in diabetes, ocular surface disease, rheumatoid arthritis and repeat ocular surgery, which increase the risk of corneal adverse effects.

Monitoring

Monitor the cornea for signs of epithelial breakdown or thinning, especially with extended use or in eyes with predisposing surface disease.

Counselling the patient

Report any worsening eye pain, redness or deterioration in vision promptly.
Remove soft contact lenses before instilling and wait before reinserting them.
Do not exceed the prescribed treatment duration without ophthalmology review.

Evidence & guidelines

Topical NSAIDs are an established treatment for postoperative ocular inflammation and for prophylaxis of cystoid macular oedema after cataract surgery.

Reference: RCOphth; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways