Home / Medicine / Yellox

Yellox

Marketed in 32 countries, predominantly across the European Economic Area, Yellox is an ophthalmic preparation of bromfenac, classified as a nonsteroidal anti-inflammatory agent. The brand sits within the wider category of ophthalmologicals and is encountered most often by patients in a perioperative setting rather than in everyday primary care.

Bromfenac in this formulation is used in the management of postoperative ocular inflammation and pain following cataract surgery. The structured indication block further down this page details the registered uses of Yellox in each market where it is authorised, along with the formal therapeutic categories assigned by national regulators.

Because Yellox is concentrated in European markets, travellers and expatriates moving between EEA countries will often find the same brand on the shelf — examples include Germany, France, Iceland, Greece, and Estonia. Outside Europe, the same active ingredient circulates under different brand names, and ophthalmic NSAID drops as a category are a routine part of cataract surgery aftercare in most regulated markets worldwide. Packaging, prescription pathways, and postoperative protocols nonetheless vary considerably from one country to another.

Other ophthalmic nonsteroidal anti-inflammatory products exist internationally under different active ingredients, sometimes used in comparable postoperative contexts. They are not freely interchangeable, and a local pharmacist or ophthalmologist is the right person to identify a regional equivalent for a patient continuing care abroad. Anyone using Yellox after eye surgery — or trying to source a comparable product in another country — should treat any change as a clinical matter and confirm the appropriate option with the treating healthcare provider.

How does this drug class actually work?
Read the plain-language explainer in Pharmacology Academy (Non-steroidal anti-inflammatory drugs) →

Overdose

No information provided.

Contraindications

None.

Pharmaceutical form

Eye drops, solution

Undesirable effects

Clinical Trial Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

The most commonly reported adverse reactions reported following use of bromfenac after cataract surgery include: abnormal sensation in eye, conjunctival hyperemia, eye irritation (including burning/stinging), eye pain, eye pruritus, eye redness, headache, and iritis. These reactions were reported in 2 to 7% of patients.

Post-Marketing Experience

The following reactions have been identified during post-marketing use of bromfenac ophthalmic solution 0.09% in clinical practice. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. The reactions, which have been chosen for inclusion due to either their seriousness, frequency of reporting, possible causal connection to topical bromfenac ophthalmic solution 0.09% or a combination of these factors, include corneal erosion, corneal perforation, corneal thinning, and epithelial breakdown.

Therapeutic indications

Ophthalmic solution; Solution-dropsSolution

Yellox (bromfenac ophthalmic solution) 0.09% is indicated for the treatment of postoperative inflammation and reduction of ocular pain in patients who have undergone cataract surgery.

Xibrom (bromfenac ophthalmic solution) 0.09% is indicated for the treatment of postoperative inflammation and reduction of ocular pain in patients who have undergone cataract surgery.

Pharmacokinetic properties

Ophthalmic solution; Solution-dropsSolution

The plasma concentration of bromfenac following ocular administration of 0.09% Yellox (bromfenac ophthalmic solution) in humans is unknown. Based on the maximum proposed dose of one drop to the eye (0.09 mg) twice a day and PK information from other routes of administration, the systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans.

The plasma concentration of bromfenac following ocular administration of 0.09% Xibrom (bromfenac ophthalmic solution) in humans is unknown. Based on the maximum proposed dose of one drop to the eye (0.09 mg) twice a day and PK information from other routes of administration, the systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans.

Qualitative and quantitative composition

Bromfenac

Special warnings and precautions for use

Ophthalmic solution; Solution-dropsSolutionWARNINGS

Included as part of the PRECAUTIONS section.

PRECAUTIONS Sulfite Allergic Reactions

Contains sodium sulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people.

Slow Or Delayed Healing

All topical nonsteroidal anti-inflammatory drugs (NSAIDs) may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems.

Potential For Cross-Sensitivity

There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs. Therefore, caution should be used when treating individuals who have previously exhibited sensitivities to these drugs.

Increased Bleeding Time

With some NSAIDs, there exists the potential for increased bleeding time due to interference with platelet aggregation. There have been reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery.

It is recommended that Yellox ophthalmic solution be used with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time.

Keratitis And Corneal Reactions

Use of topical NSAIDs may result in keratitis. In some susceptible patients, continued use of topical NSAIDs may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration or corneal perforation. These events may be sight threatening. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs and should be closely monitored for corneal health.

Post-marketing experience with topical NSAIDs suggests that patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (e.g., dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk for corneal adverse events which may become sight threatening. Topical NSAIDs should be used with caution in these patients.

Post-marketing experience with topical NSAIDs also suggests that use more than 24 hours prior to surgery or use beyond 14 days post surgery may increase patient risk for the occurrence and severity of corneal adverse events.

Contact Lens Wear

Yellox should not be administered while wearing contact lenses. Remove contact lenses prior to instillation of Yellox. The preservative in Yellox, benzalkonium chloride, may be absorbed by soft contact lenses. Lenses may be reinserted after 10 minutes following administration of Yellox.

Nonclinical Toxicology Carcinogenesis, Mutagenesis, Impairment Of Fertility

Long-term carcinogenicity studies in rats and mice given oral doses of bromfenac up to 0.6 mg/kg/day (systemic exposure 30 times the systemic exposure predicted from the recommended human ophthalmic dose [RHOD] assuming the human systemic concentration is at the limit of quantification) and 5 mg/kg/day (340 times the predicted human systemic exposure), respectively revealed no significant increases in tumor incidence. Bromfenac did not show mutagenic potential in various mutagenicity studies, including the reverse mutation, chromosomal aberration, and micronucleus tests.

Bromfenac did not impair fertility when administered orally to male and female rats at doses up to 0.9 mg/kg/day and 0.3 mg/kg/day, respectively (systemic exposure 90 and 30 times the predicted human exposure, respectively).

Use In Specific Populations Pregnancy - Pregnancy Category C Risk Summary

There are no adequate and well-controlled studies with Yellox in pregnant women. No malformations were observed in reproduction studies in rats and rabbits with oral doses of bromfenac at exposures up to 150 times (rats) and 90 times (rabbits) the predicted human systemic exposure; however, both embryolethality and maternal toxicity were observed at the highest dose exposures. The systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans, following ocular administration. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Clinical Considerations

Premature closure of the ductus arteriosus in the fetus has occurred with third trimester use of oral and injectable NSAIDs. Measurable maternal and fetal plasma drug levels are available with oral and injectable routes of NSAID administration. The maternal plasma level of Yellox following ocular administration is unknown.

Animal Data

Reproduction studies performed in rats at oral doses of bromfenac up to 0.9 mg/kg/day (systemic exposure 90 times the systemic exposure predicted from the recommended human ophthalmic dose [RHOD] assuming the human systemic concentration is at the limit of quantification) and rabbits at oral doses up to 7.5 mg/kg/day (150 times the predicted human systemic exposure) produced no drug-related malformations in reproduction studies. However, embryo-fetal lethality and maternal toxicity were produced in rats and rabbits at 0.9 mg/kg/day and 7.5 mg/kg/day, respectively. In rats, bromfenac treatment caused delayed parturition at 0.3 mg/kg/day (30 times the predicted human exposure), and caused dystocia, increased neonatal mortality and reduced postnatal growth at 0.9 mg/kg/day.

Nursing Mothers

It is not known if Yellox is present in human milk. The systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans, following ocular administration. Based on the low level of systemic exposure, it is unlikely that Yellox would be detected in human milk using available assays. Caution should be exercised when Yellox ophthalmic solution is administered to a nursing woman.

Pediatric Use

Safety and efficacy in pediatric patients below the age of 18 have not been established.

Geriatric Use

There is no evidence that the efficacy or safety profiles for Yellox differ in patients 65 years of age and older compared to younger adult patients.

WARNINGS

Included as part of the PRECAUTIONS section.

PRECAUTIONS Sulfite Allergic Reactions

Contains sodium sulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people.

Slow Or Delayed Healing

All topical nonsteroidal anti-inflammatory drugs (NSAIDs) may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems.

Potential For Cross-Sensitivity

There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs. Therefore, caution should be used when treating individuals who have previously exhibited sensitivities to these drugs.

Increased Bleeding Time

With some NSAIDs, there exists the potential for increased bleeding time due to interference with platelet aggregation. There have been reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery.

It is recommended that Xibrom ophthalmic solution be used with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time.

Keratitis And Corneal Reactions

Use of topical NSAIDs may result in keratitis. In some susceptible patients, continued use of topical NSAIDs may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration or corneal perforation. These events may be sight threatening. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs and should be closely monitored for corneal health.

Post-marketing experience with topical NSAIDs suggests that patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (e.g., dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk for corneal adverse events which may become sight threatening. Topical NSAIDs should be used with caution in these patients.

Post-marketing experience with topical NSAIDs also suggests that use more than 24 hours prior to surgery or use beyond 14 days post surgery may increase patient risk for the occurrence and severity of corneal adverse events.

Contact Lens Wear

Xibrom should not be administered while wearing contact lenses. Remove contact lenses prior to instillation of Xibrom. The preservative in Xibrom, benzalkonium chloride, may be absorbed by soft contact lenses. Lenses may be reinserted after 10 minutes following administration of Xibrom.

Nonclinical Toxicology Carcinogenesis, Mutagenesis, Impairment Of Fertility

Long-term carcinogenicity studies in rats and mice given oral doses of bromfenac up to 0.6 mg/kg/day (systemic exposure 30 times the systemic exposure predicted from the recommended human ophthalmic dose [RHOD] assuming the human systemic concentration is at the limit of quantification) and 5 mg/kg/day (340 times the predicted human systemic exposure), respectively revealed no significant increases in tumor incidence. Bromfenac did not show mutagenic potential in various mutagenicity studies, including the reverse mutation, chromosomal aberration, and micronucleus tests.

Bromfenac did not impair fertility when administered orally to male and female rats at doses up to 0.9 mg/kg/day and 0.3 mg/kg/day, respectively (systemic exposure 90 and 30 times the predicted human exposure, respectively).

Use In Specific Populations Pregnancy - Pregnancy Category C Risk Summary

There are no adequate and well-controlled studies with Xibrom in pregnant women. No malformations were observed in reproduction studies in rats and rabbits with oral doses of bromfenac at exposures up to 150 times (rats) and 90 times (rabbits) the predicted human systemic exposure; however, both embryolethality and maternal toxicity were observed at the highest dose exposures. The systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans, following ocular administration. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Clinical Considerations

Premature closure of the ductus arteriosus in the fetus has occurred with third trimester use of oral and injectable NSAIDs. Measurable maternal and fetal plasma drug levels are available with oral and injectable routes of NSAID administration. The maternal plasma level of Xibrom following ocular administration is unknown.

Animal Data

Reproduction studies performed in rats at oral doses of bromfenac up to 0.9 mg/kg/day (systemic exposure 90 times the systemic exposure predicted from the recommended human ophthalmic dose [RHOD] assuming the human systemic concentration is at the limit of quantification) and rabbits at oral doses up to 7.5 mg/kg/day (150 times the predicted human systemic exposure) produced no drug-related malformations in reproduction studies. However, embryo-fetal lethality and maternal toxicity were produced in rats and rabbits at 0.9 mg/kg/day and 7.5 mg/kg/day, respectively. In rats, bromfenac treatment caused delayed parturition at 0.3 mg/kg/day (30 times the predicted human exposure), and caused dystocia, increased neonatal mortality and reduced postnatal growth at 0.9 mg/kg/day.

Nursing Mothers

It is not known if Xibrom is present in human milk. The systemic concentration of bromfenac is estimated to be below the limit of quantification (50 ng/mL) at steady-state in humans, following ocular administration. Based on the low level of systemic exposure, it is unlikely that Xibrom would be detected in human milk using available assays. Caution should be exercised when Xibrom ophthalmic solution is administered to a nursing woman.

Pediatric Use

Safety and efficacy in pediatric patients below the age of 18 have not been established.

Geriatric Use

There is no evidence that the efficacy or safety profiles for Xibrom differ in patients 65 years of age and older compared to younger adult patients.

Dosage (Posology) and method of administration

Ophthalmic solution; Solution-dropsSolutionRecommended Dosing

One drop of Yellox ophthalmic solution should be applied to the affected eye two times daily beginning 24 hours after cataract surgery and continuing through the first 2 weeks of the postoperative period.

Use With Other Topical Ophthalmic Medications

Yellox ophthalmic solution may be administered in conjunction with other topical ophthalmic medications such as alpha-agonists, beta-blockers, carbonic anhydrase inhibitors, cycloplegics, and mydriatics. Drops should be administered at least 5 minutes apart.

Recommended Dosing

One drop of Xibrom ophthalmic solution should be applied to the affected eye two times daily beginning 24 hours after cataract surgery and continuing through the first 2 weeks of the postoperative period.

Use With Other Topical Ophthalmic Medications

Xibrom ophthalmic solution may be administered in conjunction with other topical ophthalmic medications such as alpha-agonists, beta-blockers, carbonic anhydrase inhibitors, cycloplegics, and mydriatics. Drops should be administered at least 5 minutes apart.

Frequently asked questions

What is Yellox used for?

Yellox is used in the ophthalmic setting, specifically in the management of postoperative pain and inflammation following cataract surgery. It belongs to the nonsteroidal anti-inflammatory category formulated for use in the eye rather than systemically. The structured indication section further down this page lists each registered use as recognised by the national regulators in the markets where Yellox is authorised.

Which active substance is in Yellox?

Yellox contains bromfenac, a nonsteroidal anti-inflammatory agent formulated for ophthalmic use. Bromfenac is the same molecule whether sold under the Yellox brand or under other commercial names in different markets — the active ingredient circulates internationally under several brand names, particularly across regions where ophthalmic NSAID drops are part of routine cataract surgery aftercare.

In how many countries is Yellox available?

Yellox carries marketing authorisation in 32 countries, with a footprint concentrated heavily across the European Economic Area. Examples include Germany, France, Iceland, Greece, Estonia, and Croatia. The brand is less commonly encountered outside Europe, though bromfenac itself is available in several non-European markets under different brand names. If your country is not listed, a local pharmacist can confirm what ophthalmic NSAID options are available.

Are there alternatives to Yellox?

Bromfenac is sold under several brand names internationally, and the broader category of ophthalmic nonsteroidal anti-inflammatory drops includes other active ingredients used in similar postoperative settings. These alternatives are not freely interchangeable — molecules within the class differ in formulation and clinical positioning. To identify a regional bromfenac-containing product or a comparable ophthalmic NSAID, search the active ingredient on Pill2Trip or ask a pharmacist or ophthalmologist locally.

Should I consult a doctor before taking Yellox?

Yes. Yellox is a prescription ophthalmic medication used in a specific perioperative context, and its use is normally directed by the ophthalmic surgeon overseeing cataract recovery. Prescription requirements, available brand names, and post-surgical protocols differ between countries, which matters for patients travelling shortly after eye surgery or relocating mid-treatment. Any decision about starting, continuing, or substituting Yellox should be made with the treating healthcare provider.