When You Can't Find Prolensa, You Still Have Options

Your ophthalmologist prescribed Prolensa after cataract surgery, but your pharmacy can't fill it. Maybe it's out of stock, maybe your insurance won't cover it, or maybe the cost is too high. Whatever the reason, you need to manage your post-surgical inflammation — and you need to start soon.

The good news is that Prolensa isn't the only option. There are several effective alternatives your doctor can prescribe. Here's what you need to know about each one.

What Is Prolensa and How Does It Work?

Prolensa contains Bromfenac 0.07%, a nonsteroidal anti-inflammatory drug (NSAID) formulated as an eye drop. It works by blocking COX enzymes that produce prostaglandins — the chemicals responsible for inflammation, swelling, and pain in the eye after surgery.

What makes Prolensa popular with both patients and doctors is its once-daily dosing. You apply one drop per day for 14 days after cataract surgery. That simplicity is a big advantage over older NSAID eye drops that require three or four daily doses.

Understanding how Prolensa works helps you evaluate the alternatives, because they all target the same inflammatory pathway — they just differ in dosing frequency, formulation, and cost.

Alternative #1: Generic Bromfenac 0.07%

The closest alternative to Prolensa is its own generic version. Generic Bromfenac 0.07% ophthalmic solution contains the exact same active ingredient at the exact same concentration.

• Dosing: One drop once daily for 14 days — identical to Prolensa
• Efficacy: Equivalent to brand-name Prolensa (FDA requires generic bioequivalence)
• Cost: Approximately $80–$200 per bottle, compared to $250–$450 for brand Prolensa
• Availability: Often easier to find than brand Prolensa

If your issue is availability or cost, generic Bromfenac should be your first conversation with your doctor. In most cases, it's a straightforward substitution.

Alternative #2: Ilevro (Nepafenac 0.3%)

Ilevro is another popular once-daily NSAID eye drop used after cataract surgery. Its active ingredient is Nepafenac, which is a prodrug — meaning it's converted into its active form (Amfenac) inside the eye.

• Dosing: One drop once daily, starting the day before surgery, continuing on surgery day, and for 14 days after
• Key difference: Treatment begins before surgery, unlike Prolensa which starts the day after
• Cost: Similar price range to brand Prolensa; generic Nepafenac 0.3% may be available
• Availability: Manufactured by Novartis (Alcon); generally available at major pharmacies

Ilevro is a strong alternative if you prefer once-daily dosing. Talk to your ophthalmologist about whether the pre-surgery dosing schedule works with your surgical timeline.

Alternative #3: Nevanac (Nepafenac 0.1%)

Nevanac is the original Nepafenac formulation, available at a lower concentration than Ilevro.

• Dosing: One drop three times daily, starting the day before surgery and continuing for 14 days after
• Key difference: Requires three doses per day, which is less convenient than Prolensa's once-daily regimen
• Cost: May be less expensive than Ilevro; generic versions may be available
• Availability: Widely available at most pharmacies

Nevanac is a solid option, though the three-times-daily dosing can be harder to remember — especially when you're also juggling other post-surgical eye drops.

Alternative #4: Ketorolac Ophthalmic (Acular LS)

Ketorolac is one of the oldest and most widely available NSAID eye drops. It's available as a generic, which makes it the most affordable option on this list.

• Dosing: One drop four times daily, typically starting 24 hours before surgery
• Key advantage: Widely available as a generic; low cost ($15–$50 per bottle)
• Key disadvantage: Four daily doses is significantly less convenient than Prolensa's once-daily schedule
• Side effects: Tends to cause more stinging/burning upon application than Bromfenac or Nepafenac

Many insurance plans require patients to try Ketorolac before they'll approve Prolensa (this is called step therapy). If cost is your main concern, Ketorolac is the most budget-friendly choice.

Alternative #5: Diclofenac Ophthalmic (Voltaren Ophthalmic)

Diclofenac ophthalmic is another well-established generic NSAID eye drop option.

• Dosing: One drop four times daily, starting 24 hours after surgery for 14 days
• Cost: Affordable as a generic ($20–$60 per bottle)
• Availability: Widely available
• Note: Diclofenac ophthalmic is different from over-the-counter Voltaren Gel, which is for joint pain and should never be used in the eye

Diclofenac is a reliable, affordable option with a long track record. Like Ketorolac, the main downside is the four-times-daily dosing schedule.

How to Choose the Right Alternative

Here's a quick comparison to help you and your doctor decide:

• Want once-daily dosing like Prolensa? → Generic Bromfenac or Ilevro
• Need the lowest cost? → Generic Ketorolac or Diclofenac ophthalmic
• Need the most widely available option? → Generic Ketorolac
• Want the exact same medication? → Generic Bromfenac 0.07%

Your ophthalmologist knows your specific eye health history and can guide you to the best fit. Don't switch medications on your own — always consult your doctor before changing your post-surgical treatment plan.

Final Thoughts

Not being able to fill your Prolensa prescription is frustrating, especially when you're recovering from surgery and time is of the essence. But you absolutely have alternatives.

Start by checking if generic Bromfenac is available at your pharmacy or by searching on Medfinder. If that doesn't work, talk to your ophthalmologist about Ilevro, Nevanac, Ketorolac, or Diclofenac ophthalmic. Each has its trade-offs in dosing convenience and cost, but all are proven effective for managing post-cataract surgery inflammation.

The most important thing is to not go without treatment. Post-surgical inflammation needs to be managed promptly. Work with your doctor, explore your options, and get started on whichever medication you can access.