Dosing & Uses
Dosage Forms & Strengths
ophthalmic suspension
- 0.1% (Nevanac)
- 0.3% (Ilevro)
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)
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
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
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
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.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
Images
Patient Handout
Formulary
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