Concentration and dosing of ketorolac versus bromfenac.

摘要

Bucci et al. report that after trough dosing, aqueous ketorolac 0.4% concentrations were significantly higher than bromfenac 0.09% concentrations. In addition, patients treated with ketorolac 0.4% had significantly lower aqueous prostaglandin E_2 (PGE_2) levels than those treated with bromfenac 0.09%. The concentration of ketorolac 0.4% was approximately 4 times higher than that of bromfenac 0.09%. Since both products have an excellent membrane partition coefficient, one would see a greater concentration of ketorolac 0.4% in the aqueous humor; however, that is only relevant to clinical efficacy if ketorolac binds the cyclooxygenase-2 (COX-2) enzyme almost as well as bromfenac. The combination of anterior chamber concentration and COX-2 binding is what determines therapeutic effect.