01/02/2025
What are the topical NSAID drop options for cataracts? Diclofenac, Nepfenac, Ketorolac, and Bromfenac. What are the differences? Mostly cost. Bromfenac and Nevanac (Nevanac) have some studies in humans supporting a reduced frequency of application but there are no canine studies that support lower frequency dosing in dogs. A meta-analysis (reviewing 7234 patients) in humans found Diclofenac to improve anterior chamber inflammation and no difference in adverse events of any NSAIDS compared to placebo (Duan et al 2017). The cost can vary 10-20 fold. I typically will use the generic diclofenac as a first choice due to the cost efficacy for my clients and the human based evidence of the greatest control of inflammation. When it was on backorder last year I used Voltaren (brand name diclofenac), Nepfenac, and Ketorolac in that order solely based on what is most cost effective for our clients. These were all available through either AVP or WDDC.