Nepafenac

Nepafenac is a prescription medication used to relieve eye pain, swelling, and redness caused by cataract surgery. Nepafenac belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) which help to stop the release of substances that cause allergy symptoms and inflammation.

This medication comes in the form of eye drops. One drop of nepafenac should be applied to the affected eye(s) 3 times daily beginning 1 day prior to cataract surgery, continued on the day of surgery and through the first 2 weeks after surgery. Remove contact lenses before instilling nepafenac drops.

Common side effects include headache, runny nose and pain or pressure in the face.

Nepafenac is a prescription medication used to treat eye pain, redness, and swelling in patients who are recovering from cataract surgery (procedure to treat clouding of the lens in the eye).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Nepafenac may be found in some form under the following brand names:

• Ilevro

• Nevanac

Serious side effects have been reported with nepafenac. See the “Drug Precautions” section.

• headache
• runny nose
• pain or pressure in the face
• nausea
• vomiting
• dry, itchy, or sticky eyes

This is not a complete list of nepafenac side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• anticoagulants ('blood thinners') such as warfarin (Coumadin)
• aspirin and other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
• corticosteroid eye drops such as dexamethasone (Maxidex), fluorometholone (FML), hydrocortisone (in Cortisporin), loteprednol (Alrex, Lotemax), medrysone (HMS), prednisolone (Pred Mild), and rimexolone (Vexol)

This is not a complete list of nepafenac drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported including:

• cross-sensitivity reactions. Caution should be used in patients who are allergic to aspirin other NSAIDs such as diclofenac (Voltaren), ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or tolmetin (Tolectin) as these patient may also be allergic to nepafenac.
• increased bleeding time of eye tissues. NSAIDs, like nepafenac, may increase bleeding time and should be used with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time.
• delayed healing. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) including nepafenac, may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. When topical NSAIDs and topical steroids are used at the same time there may be increased risk for healing problems.
• inflammation of the cornea (keratitis). Use of topical NSAIDs like nepafenac may cause problems related to corneal inflammation, corneal thinning, corneal erosion, corneal ulceration or corneal perforation. These events may cause loss of vision. If you develop any of the following symptoms of keratitis stop taking nepafenac and contact your doctor:
• red or bloody eyes
• eye pain
• feeling that something is in the eye
• sensitivity to light
• blurred or decreased vision
• seeing specks or spots
• teary eyes
• eye discharge or crusting

Do not take nepafenac if you are:

• allergic to any ingredient in nepafenac
• allergic to other NSAIDs

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of nepafenac, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking nepafenac, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to any ingredient in nepafenac
• are allergic to an NSAID such as diclofenac, ibuprofen, or naproxen
• have had a bad reaction to aspirin
• have a tendency to bleed or if you are taking certain medications known to increase risk of bleeding
• have an eye infection
• are taking other eye drops
• are pregnant or breastfeeding

Tell your doctor about all of the medicines you are taking including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Nepafenac falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans, though. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Nepafenac has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from Nepafenac, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take nepafenac exactly as prescribed.

• This medication comes as an eye drop.
• Nepafenac is usually instilled 3 times daily beginning 1 day before cataract surgery, on the day of the surgery, and for 14 days after the surgery.
• Use nepafenac eye drops at around the same times every day.
• If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of nepafenac at the same time.
• If your doctor has recommended you use another eye preparation as well as these drops, then leave at least five minutes between putting in nepafenac drops and the other preparation.

How to use these eye drops

1. First wash your hands using soap and water.
2. Remove the cap.
3. Shake the bottle well before use.
4. Tilt your head back a little and pull the lower lid of your eye downwards to form a pocket.
5. Hold the bottle upside down near your eye. Try not to touch your eye as you do this. Avoid touching the dropper tip against your eye or anything else.
6. Gently press the base of the bottle to release one drop into your eye.
7. Close your eye for a minute or two, and press gently on the side of your nose where the corner of your eye meets your nose. This helps to stop the drop from draining away and keeps it in your eye.
8. Repeat the process in your other eye if you have been told to use the drops in both eyes.
9. Replace the cap.

Take exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

One drop of nepafenac should be applied to the affected eye(s) 3 times daily beginning 1 day prior to cataract surgery, continued on the day of surgery and through the first 2 weeks after surgery.

If you take too much nepafenac, or if someone swallows it, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store at room temperature between 2°C and 25˚C (36 - 77˚F).
• Keep this and all medications out of the reach of children.