Bromfenac (DB00963): A Comprehensive Pharmacological and Clinical Monograph

1.0 Executive Summary

Bromfenac is a potent, small-molecule nonsteroidal anti-inflammatory drug (NSAID) belonging to the phenylacetic acid class, identified by DrugBank ID DB00963.[1] It is administered topically as an ophthalmic solution, with its primary clinical indication being the treatment of postoperative inflammation and the reduction of ocular pain in patients who have undergone cataract surgery.[3] The drug exerts its therapeutic effect through the potent inhibition of cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2, thereby blocking the synthesis of prostaglandins that mediate inflammation and pain.[6] Pharmacologically, Bromfenac is distinguished by a notable preference for inhibiting the COX-2 isoenzyme, which is primarily induced during inflammatory processes.[1]

A key feature of Bromfenac is its unique chemical structure, which includes a bromine atom. This halogenation significantly enhances the molecule's lipophilicity, leading to superior penetration into ocular tissues and a higher intrinsic potency compared to other ophthalmic NSAIDs.[8] This pharmacokinetic advantage allows for high, sustained therapeutic concentrations within the aqueous humor for at least 12 hours, facilitating convenient once or twice-daily dosing regimens that can improve patient adherence.[1] The ophthalmic formulation has a well-established safety profile, with the most common adverse effects being localized and transient, such as stinging upon instillation and eye redness.[4] However, a significant, albeit rare, risk involves corneal complications, necessitating careful patient monitoring.[14]