Comparison of ketorolac 0.4% and bromfenac 0.09% at trough dosing: aqueous drug absorption and prostaglandin E2 levels.
OBJECTIVE
To compare aqueous drug concentrations and prostaglandin E(2) (PGE(2)) levels in patients treated with ketorolac 0.4% and bromfenac 0.09% at trough dosing.


METHODS
Private practice, Wilkes-Barre, Pennsylvania, USA.


METHODS
This single-center randomized investigator-masked clinical study comprised 56 patients having cataract surgery. Patients received 1 drop of ketorolac 0.4% or bromfenac 0.09% 6 hours and 12 hours preoperatively consistent with on-label dosing schedules. Aqueous humor was collected at the start of surgery and analyzed for concentrations of ketorolac and bromfenac using a reverse-phase high-performance liquid chromatography-mass spectroscopy system and for PGE(2) levels by competitive enzyme immunoassay.


RESULTS
The mean aqueous PGE(2) level was 204.2 pg/mL +/- 95.5 (SD) in patients treated with ketorolac 0.4% and 263.7 +/- 90.0 pg/mL in patients treated with bromfenac 0.09%, (P = .020). The mean aqueous concentration of ketorolac and bromfenac at trough dosing was 130.5 +/- 37.8 ng/mL and 6.2 +/- 3.1 ng/mL, respectively (P = .004).


CONCLUSIONS
Higher aqueous levels and greater PGE(2) inhibition were observed in cataract surgery patients treated with ketorolac 0.4% than in patients treated with bromfenac 0.09% at trough dosing. These findings suggest that ketorolac 0.4% administered 4 times a day may provide better control of prostaglandin-mediated inflammation than bromfenac 0.09% administered twice a day.
Bucci
Frank A
FA
Bucci Laser Vision Institute, 158 Wilkes-Barre Township Boulevard, Wilkes-Barre, PA 18702, USA. buccivision@aol.com
Waterbury
L David
LD
D000042:Absorption; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001082:Aqueous Humor / Q000378:metabolism*; D001577:Benzophenones / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001969:Bromobenzenes / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid; D015232:Dinoprostone / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D020910:Ketorolac / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics; D018918:Phacoemulsification
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001577:Benzophenones; D001969:Bromobenzenes; D009883:Ophthalmic Solutions; C053083:bromfenac; D015232:Dinoprostone; D020910:Ketorolac