Understanding Prolensa Drug Interactions

Prolensa (Bromfenac 0.07%) is applied directly to the eye, which means it has fewer systemic drug interactions than oral medications. But "fewer" doesn't mean "none." There are important interactions to know about — especially with other eye drops and blood-thinning medications.

Before starting Prolensa, make sure your ophthalmologist knows about every medication you use, including other eye drops, oral prescriptions, over-the-counter drugs, and supplements.

How Drug Interactions Work with Eye Drops

When you put a drop in your eye, a small amount is absorbed into the bloodstream through the tear ducts and nasal mucosa. Most of the drug stays local — in your eye tissues — but there's enough systemic absorption to matter in certain situations.

More importantly, interactions between multiple eye medications are a real concern after cataract surgery, when patients often use several drops on overlapping schedules.

Medications That Interact with Prolensa

Major Interactions

• Topical corticosteroids (e.g., Prednisolone acetate, Dexamethasone, Loteprednol) — Many cataract surgery patients use both a steroid and Prolensa. While this combination is common and often intentional, concurrent use can mask signs of infection and may increase the risk of corneal adverse events. Your doctor should monitor you closely.
• Other topical NSAIDs (e.g., Ketorolac/Acular, Diclofenac/Voltaren Ophthalmic, Nepafenac/Nevanac) — Using two ophthalmic NSAIDs at the same time significantly increases the risk of corneal problems, including thinning and perforation. You should not use Prolensa with another NSAID eye drop.
• Anticoagulants and blood thinners (e.g., Warfarin/Coumadin, Heparin, Enoxaparin/Lovenox, Apixaban/Eliquis, Rivaroxaban/Xarelto) — Bromfenac, like all NSAIDs, can increase bleeding risk. Combined with systemic anticoagulants, this may lead to increased bleeding of ocular tissues, including hyphema (blood in the front of the eye). Your surgeon needs to know about all blood thinners before cataract surgery.

Moderate Interactions

• Prostaglandin analogs for glaucoma (e.g., Latanoprost/Xalatan, Travoprost/Travatan Z, Bimatoprost/Lumigan) — NSAIDs like Prolensa may reduce the efficacy of prostaglandin-based glaucoma drops. If you use glaucoma medication, your doctor may adjust your regimen around surgery.
• Other ophthalmic medications — Any eye drop used alongside Prolensa should be spaced at least 5 minutes apart to avoid dilution and ensure proper absorption. This includes artificial tears, antibiotic drops, and steroid drops.

Supplements and OTC Medications to Watch

Because Prolensa is a topical NSAID, the supplement interactions are less pronounced than with oral NSAIDs. However, be aware of:

• Oral NSAIDs (Ibuprofen/Advil, Naproxen/Aleve, Aspirin) — Taking oral NSAIDs alongside topical Prolensa may compound bleeding risk, especially around surgery. Your surgeon may advise stopping these before the procedure.
• Fish oil / Omega-3 supplements — High-dose fish oil can prolong bleeding time. Mention it to your surgeon.
• Vitamin E — High doses may increase bleeding risk.
• Ginkgo biloba, Garlic supplements, Ginger — These can affect platelet function and bleeding time.

Your ophthalmologist or surgeon will typically provide a list of supplements to stop before cataract surgery. Follow their instructions closely.

Food and Drink Interactions

Because Prolensa is a topical eye drop with minimal systemic absorption, there are no significant food or drink interactions. You don't need to worry about taking it with or without food, and there are no dietary restrictions while using it.

What to Tell Your Doctor

Before starting Prolensa, give your ophthalmologist a complete picture:

• All eye drops you currently use — especially glaucoma medications, artificial tears, or any other prescription eye drops
• Blood thinners — both prescription (Warfarin, Eliquis, Xarelto, Plavix) and over-the-counter (Aspirin)
• Oral NSAIDs — regular use of ibuprofen, naproxen, or aspirin
• Supplements — fish oil, vitamin E, and herbal supplements that affect bleeding
• Allergies — especially to aspirin or other NSAIDs. Prolensa is contraindicated in patients with NSAID cross-sensitivity. If you've had asthma, hives, or swelling from aspirin, you likely cannot use Prolensa.
• Medical conditions — diabetes, rheumatoid arthritis, dry eye disease, or bleeding disorders all increase your risk of complications

Don't assume your eye doctor knows about medications prescribed by other doctors. Bring a complete medication list to every appointment.

Final Thoughts

Prolensa has fewer interaction concerns than oral medications, but the ones it does have — especially with other eye drops, blood thinners, and oral NSAIDs — are clinically important. The 5-minute spacing rule for multiple eye drops is essential, and your surgeon needs a complete picture of your medication and supplement use before cataract surgery.

When in doubt, bring your full medication list and ask. It's always better to over-share than to miss something important.

For more about Prolensa, see our guides on what Prolensa is and side effects to watch for. Need to find it in stock? Search Medfinder.