nepafenac ophthalmic (Rx)

Brand and Other Names:Nevanac, Ilevro
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic suspension

  • 0.1% (Nevanac)
  • 0.3% (Ilevro)
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Ocular Pain & Inflammation

Indicated for pain and inflammation associated with cataract surgery

0.1%: 1 gtt three times daily to affected eye(s) beginning 1 day before cataract surgery, on the day of surgery and through 2 weeks postoperatively

0.3%: 1 gtt once daily beginning 1 day before cataract surgery, on day of surgery, and continue through the first 2 weeks postoperatively; an additional drop should be adminsitered 30-120 minutes before surgery

Administration

Do not wear contact lenses while treating

Shake well before treating

Dosage Forms & Strengths

ophthalmic suspension

  • 0.1% (Nevanac)
  • 0.3% (Ilevro)
more...

Ocular Pain & Inflammation

<10 years

  • Safety and efficacy not established

>10 years

  • Indicated for pain and inflammation associated with cataract surgery
  • 0.1%: 1 gtt three times daily to affected eye(s) beginning 1 day before cataract surgery, on the day of surgery and through 2 weeks postoperatively
  • 0.3%: 1 gtt once daily beginning 1 day before cataract surgery, on day of surgery, and continue through the first 2 weeks postoperatively; an additional drop should be adminsitered 30-120 minutes before surgery

Administration

Do not wear contact lenses while treating

Shake well before treating

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Adverse Effects

1-10%

Capsular opacity (5-10%)

Decreased visual acuity (5-10%)

Foreign body sensation (5-10%)

Increased IOP (5-10%)

Sticky sensation (5-10%)

Conjunctival edema (1-5%)

Corneal edema (1-5%)

Dry eye (1-5%)

Headache (1-4%)

HTN (1-4%)

Lid margin crusting (1-5%)

N/V (1-4%)

Ocular discomfort (1-5%)

Ocular hyperemia (1-5%)

Ocular pain (1-5%)

Ocular pruritus (1-5%)

Photophobia (1-5%)

Tearing (1-5%)

Vitreous detachment (1-5%)

Postmarketing Reports

Increased bleeding time

Delayed effects

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Warnings

Contraindications

Hypersensitivity to NSAIDs or any ingredients

Cautions

Sensitivity to aspirin or phenylacetic acid deivatives

May cause increased bleeding in ocular tissues

May cause keratitis & corneal damage (risk increased if applied earlier than 1 day presurgery or longer than 2 wk postsurgery)

Use caution in patients with bleeding predisposition, ocular disease states, diabetes ( corneal adverse effects may result in loss of vision), rheumatoid arthritis

Do not wear contact lenses while on the medication

Risk of corneal adverse effects increases with use 1 day before surgery or >14 days following surgery

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Unknown if excreted in breast milk; use caution

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

Non-steroidal anti-inflammatory prodrug, converted to amfenac which putatively inhibits prostaglandin biosynthesis

Absorption

Absoption: Low systemic absorption

Peak Plasma: nepafenac 0.31 ng/mL; amfenac: 0.42 ng/mL

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Images

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.