Prolensa dosage, forms, and strengths

Prolensa (Bromfenac 0.07%) eye drops are a prescription drug that reduces eye swelling and pain after cataract surgery. Most importantly, Prolensa helps prevent retinal swelling, a rare complication of cataract surgery that could result in permanent vision loss. The active ingredient in Prolensa is bromfenac, a nonsteroidal anti-inflammatory drug (NSAID) similar to ibuprofen or diclofenac. It works by blocking the production of chemicals called prostaglandins that cause swelling and pain. Prolensa treatment starts one day before surgery and continues on the day of surgery and for the next 14 days following surgery. 

Prolensa forms and strengths

Prolensa is an ophthalmic solution, so it is taken as eye drops.

• Ophthalmic solution: 0.07% 

Prolensa dosage for adults

Prolensa is only used to treat eye pain, swelling, and pupil constriction due to cataract surgery and to prevent retinal swelling. Although eye pain, swelling, and pupil constriction may last for only a few days, people need Prolensa eye drops for at least 14 days following cataract surgery because of the risk of CME. 

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Prolensa dosage for cataract surgery

Cataract surgery involves the removal of a clouded lens from the eye and its replacement with an artificial lens. It’s usually done as an outpatient procedure with topical anesthesia and minimal sedation. The eye will hurt and swell for a few days from the surgery. Most importantly, there’s a risk of swelling (fluid buildup) in the macula, the central area of the eye’s retina. Called cystoid macular edema (CME), this condition is very serious and can cause permanent vision loss. Because of this risk, ophthalmologists usually prescribe topical NSAIDs such as diclofenac, ketorolac, nepafenac, or bromfenac eye drops to prevent CME, reduce swelling, relieve eye pain, and keep pupils from getting too narrow. Prolensa is just one eye drop medicine taken after cataract surgery. Most people will also use topical corticosteroid eye drops, antibiotic eye drops, and possibly glaucoma eye drops. These can all be taken at the same time, but give doses at least five minutes apart.

• Standard Prolensa dosage for cataract surgery:

  • One drop applied to the affected eye(s) the day before surgery

  • Followed by one drop applied to the affected eye(s) on the morning the surgery is performed

  • Followed by one drop per day in the affected eye(s) for14 days following the cataract surgery

Prolensa dosage for children

Prolensa is FDA approved for use in people undergoing cataract surgery. The FDA has not approved Prolensa as safe or effective for pediatric patients under 18 years of age.

Prolensa dosage restrictions

Prolensa has no dosage restrictions or modifications for people with kidney disease, liver disease, or any other medical condition. However, Prolensa contains sodium sulfite, a preservative, that may cause severe allergic reactions in people with sulfite allergies. 

Prolensa dosage for pets 

Veterinarians often treat cataracts in dogs and cats in the same way they’re treated in humans—with cataract surgery. As with humans, dogs and cats will require two, three, or four weeks of daily eye drops including a topical corticosteroid, antibiotic, a topical NSAID, and possibly a topical glaucoma drug. A veterinarian is unlikely to prescribe a brand-name bromfenac ophthalmic solution such as Prolensa, Bromsite, Bromday, or Xibrom. Pet parents are more likely to be sent home with a less expensive generic NSAID. Topical NSAID dosages will vary depending on the veterinarian.

How to take Prolensa

Prolensa helps relieve eye pain, swelling, and inflammation following cataract surgery. It also helps indirectly prevent retinal edema, so people should apply Prolensa doses faithfully every day for as long as instructed.

• Your doctor will tell you how much medicine to use. Do not use more than directed.

• Keep using this medicine for the full treatment time, even if you feel better after the first few days.

• A Prolensa bottle is used to treat one eye and one eye only. If you have had cataract surgery on both eyes, you will need a separate bottle of medicine for each eye to prevent infection. You must keep these bottles separate so that you don’t mix them up.

• Do not allow the dropper tip to touch your eye, finger, hand, or any other object.

• Contact lenses are rarely allowed after cataract surgery. If a healthcare provider approves their use, remove the contact lenses before applying a dose of Prolensa. Do not replace them for at least 10 minutes after the dose has been given.

• You will probably be using other eye drops along with Prolensa. The doses can be taken at the same time as Prolensa, but the doses must be spaced 5 minutes apart.

• To apply a dose to the eye:

• Wash your hands with soap and water before and after using this medicine.

• Lie down or tilt your head back. 

• With your index finger, pull down the lower lid of your eye to form a pocket.

• Hold the dropper close to your eye with the hand that is not pulling the eyelid down. DO NOT TOUCH THE EYE WITH THE TIP OF THE EYEDROPPER.

• Squeeze one drop into the pocket between your lower lid and eyeball. 

• Gently close your eyes. 

• Place your index finger over the inner corner of your eye for one minute. 

• Do not rinse or wipe the dropper or allow it to touch anything. 

• Put the cap on the bottle right away. 

Store the medicine in its original container at room temperature. Make sure the bottle is upright and tightly closed.

Prolensa dosage FAQs

How long does it take Prolensa to work?

Prolensa treatment begins before cataract surgery, so it is already working to reduce swelling. In clinical trials, Prolensa completely cleared eye pain in about 80% of participants by the first day after surgery. For swelling, Prolensa cleared up eye swelling in about 24% to 30% of participants by the eighth day after surgery and in about 45% of participants by the end of the treatment period (15 days after surgery). 

How long does Prolensa stay in your system?

In animal studies, bromfenac was detectable in all the eye’s tissues for over 24 hours. However, so little bromfenac enters the bloodstream that it’s not even detectable. 

What happens if I miss a dose of Prolensa?

If you miss a dose, take it as soon as you remember. Prolensa doses are usually given once per day, so take a missed dose on the day it was missed. If it’s the next day, skip the missed dose. Take the next day’s dose as scheduled. Do not take extra doses to make up for a missed dose.

If you miss the first dose the day before surgery, you must tell the doctor before the surgery. The operation may need to be rescheduled. Do not take two doses on the day of the surgery to make up for that first missed dose. 

How long can you take Prolensa?

Prolensa treatment lasts only a short period, typically 14 days following cataract surgery. It may be prescribed for longer in people with certain eye conditions. However, when ophthalmic NSAID treatment lasts beyond two weeks after cataract surgery, there are risks of developing serious eye problems such as corneal ulcers or perforations. For longer treatment periods, ophthalmologists will examine the eye regularly to ensure there are no problems. 

How do I stop taking Prolensa?

Prolensa can be stopped at any time without causing withdrawal symptoms. However, it’s vital to take Prolensa doses for the full duration prescribed. If you need to stop Prolensa because of side effects or an allergic reaction, immediately call the ophthalmologist or other healthcare professional so that a suitable replacement can be prescribed.

What is the maximum dosage for Prolensa?

Prolensa’s maximum dosage is one drop in the affected eye once daily.

Can you overdose on Prolensa?

Prolensa is applied topically to the eye. An overdose is unlikely, but should you apply too much Prolensa to the eye, call the ophthalmologist or another healthcare provider for medical advice. If someone swallows the medicine, call a poison control center or take the person to an emergency room.

What interacts with Prolensa?

Bromfenac ophthalmic solution has no known drug interactions. Used as directed, only undetectable amounts of the drug enter the bloodstream. Keep in mind that when administering Prolensa with other eye drops, make sure to separate doses at least 5 minutes apart.

What happens when you mix Prolensa and alcohol?

Prolensa does not interact with alcohol. However, to apply Prolensa eye drops correctly and safely, do not drink alcohol or be impaired in any way before giving yourself a dose.

Is it safe to take Prolensa during pregnancy?

Depending on the situation, eye surgeons may ask pregnant women to wait until after delivery to have cataract surgery. If a pregnant woman does undergo cataract surgery, the FDA advises that doctors avoid Prolensa and similar drugs because of a possible risk to the fetus. Some ophthalmologists may advise a woman not to get pregnant until post-operative treatment for cataract surgery is finished. Inform your healthcare provider if you are pregnant.

Is it safe to take Prolensa while breastfeeding

The FDA counsels doctors to use Prolensa cautiously in women who are breastfeeding. There is no evidence that Prolensa causes problems with lactation or side effects in a nursing infant. 

What should I know about the side effects of Prolensa?

The most common side effects of Prolensa are swelling of the front chamber of the eye (anterior chamber inflammation), ocular pain, foreign body sensation in the eye, blurred vision, and sensitivity to light (photophobia). However, anyone taking Prolensa should be aware that the drug can cause serious but rare adverse events:

• Slowed healing

• Increased bleeding time

Serious eye problems such as corneal ulcer, swelling of the cornea (keratitis), thinning of the eye’s outer surface, and corneal perforation

Sources

• A review of post-operative drops used in cataract surgery, American Academy of Ophthalmology

• Cataract in the adult eye preferred practice pattern, American Academy of Ophthalmology

• Cataract surgery and nonsteroidal anti-inflammatory drugs, Journal of Cataract & Refractory Surgery

• Management of ocular inflammation and pain following cataract surgery: focus on bromfenac ophthalmic solution, Clinical Ophthalmology

• Prolensa bromfenac sodium solution/drops prescribing information, DailyMed (NIH National Library of Medicine)

• Prolensa drug summary, Prescriber’s Digital Reference

• Topical NSAIDs: best practices for safe use, EyeNet Magazine (American Academy of Ophthalmology)