Bromsite Drug Information
Generic name: BROMFENAC
Uses of Bromsite
BromSite (bromfenac ophthalmic solution) 0.075% is indicated for the treatment of postoperative inflammation and prevention of ocular pain in patients undergoing cataract surgery. BromSite is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the treatment of postoperative inflammation and prevention of ocular pain in patients undergoing cataract surgery.
Dosage & Administration of Bromsite
Recommended Dosing One drop of BromSite should be applied to the affected
eye twice daily (morning and evening) 1 day prior to surgery, the day of surgery, and 14 days postsurgery.
Use with Other Topical Ophthalmic Medications BromSite should be administered at least
5 minutes after instillation of other topical medications. BromSite may be administered in conjunction with other topical ophthalmic medications such as alpha-agonists, beta-blockers, carbonic anhydrase inhibitors, cycloplegics, and mydriatics.
Side Effects of Bromsite
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. The most commonly reported adverse reactions in 1 to 8% of patients were: anterior chamber inflammation, headache, vitreous floaters, iritis, eye pain and ocular hypertension.
Warnings & Cautions for Bromsite
Slow or Delayed Healing All topical nonsteroidal anti-inflammatory drugs (NSAIDs), including BromSite
(bromfenac ophthalmic solution) 0.075%, may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems.
Potential for Cross-Sensitivity
There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs, including BromSite (bromfenac ophthalmic solution) 0.075%. Therefore, caution should be used when treating individuals who have previously exhibited sensitivities to these drugs.
Increased Bleeding Time of Ocular Tissue With some
NSAIDs, including BromSite (bromfenac ophthalmic solution) 0.075%, there exists the potential for increased bleeding time due to interference with platelet aggregation. There have been reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery. It is recommended that BromSite be used with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time.
Keratitis and Corneal Reactions Use of topical
NSAIDs may result in keratitis. In some susceptible patients, continued use of topical NSAIDs may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration or corneal perforation. These events may be sight threatening.
Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs, including BromSite (bromfenac ophthalmic solution) 0.075%, and should be closely monitored for corneal health. Postmarketing experience with topical NSAIDs suggests that patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (e.g., dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk for corneal adverse events which may become sight threatening. Topical NSAIDs should be used with caution in these patients.
Postmarketing experience with topical NSAIDs also suggests that use more than 24 hours prior to surgery or use beyond 14 days postsurgery may increase patient risk for the occurrence and severity of corneal adverse events.
Contact Lens Wear BromSite should not be administered while wearing contact lenses.
The preservative in BromSite, benzalkonium chloride, may be absorbed by soft contact lenses.
Pregnancy Safety for Bromsite
Pregnancy Risk Summary There are no adequate and well-controlled studies in pregnant women to inform any drug associated risks. Treatment of pregnant rats and rabbits with oral bromfenac did not produce teratogenic effects at clinically relevant doses. Clinical Considerations Because of the known effects of prostaglandin biosynthesis-inhibiting drugs on the fetal cardiovascular system (closure of ductus arteriosus), the use of BromSite during late pregnancy should be avoided.
Data Animal Data Treatment of rats with bromfenac at oral doses up to 0.9 mg/kg/day (195 times a unilateral daily human ophthalmic dose on a mg/m 2 basis, assuming 100% absorbed) and rabbits at oral doses up to 7.5 mg/kg/day (3243 times a unilateral daily dose on a mg/m 2 basis) produced no structural teratogenicity in reproduction studies. However, embryo-fetal lethality, neonatal mortality and reduced postnatal growth were produced in rats at 0.9 mg/kg/day, and embryo-fetal lethality was produced in rabbits at 7.5 mg/kg/day. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Pediatric Use of Bromsite
Pediatric Use Safety and efficacy in pediatric patients below the age of 18 years have not been established.
Clinical Studies of Bromsite
Ocular Inflammation and Pain Clinical efficacy was evaluated in 2 multi-centered, randomized
double-masked, parallel group, placebo-controlled US trials in which subjects requiring cataract surgery were assigned to receive BromSite or vehicle. Patients undergoing cataract surgery self-administered BromSite or vehicle twice daily, beginning 1 day prior to surgery, continuing the day of surgery and for 14 days after surgery. Clearance of ocular inflammation was assessed on Days 1, 8, 15, and 29 using slit lamp biomicroscopy.
The primary efficacy endpoint was the proportion of subjects with anterior chamber cell (ACC) grade 0 at Day 15. The secondary efficacy endpoint was the proportion of subjects who were pain free after cataract surgery as assessed using a Visual Analog Scale. Proportion of Subjects with Cleared Ocular Inflammation, ACC Grade 0 Visit BromSite Vehicle Treatment Difference (95% CI) Study 1 Day 8 54/168 (32.1%) 7/85 (8.2%) 23.9% (14.7%, 33.1%) Day 15 96/168 (57.1%) 16/85 (18.8%) 38.3% (27.1%, 49.5%) Study 2 Day 8 40/168 (23.8%) 8/85 (9.4%) 1 4.4% (5.5%, 23.3%) Day 15 64/168 (38.1%) 19/85 (22.4%) 1 5.7% (4.2%, 27.3%) Proportion of Subjects who were Pain Free Study 1 Day 1 129/168 (76.8%) 41/85 (48.2%) 28.6% (16.2%, 40.9%) Study 2 Day 1 138/168 (82.1%) 53/85 (62.4%) 19.8% (8.0%, 31.6%)
Drug information sourced from the FDA. This content is for informational purposes only and does not constitute medical advice. Consult a healthcare professional before making any medication decisions.
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