Nepafenac: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the local prescribing information.

Generic Medicine Info

Indications and Dosage

Ophthalmic
Postoperative ocular inflammation

Adult: Instillation starts 1 day before the cataract surgery, the day of surgery, and through the 1st 2 wk post-op period. As 0.1% susp: Instill 1 drop into the affected eye(s) tid. As 0.3% susp: Instill 1 drop into the affected eye(s) once daily; w/ an additional drop 30-120 min before surgery.
Child: ≥10 yr Same as adult dose.

Ophthalmic
Macular oedema risk reduction following cataract surgery in diabetic patients

Adult: Instillation starts 1 day before the cataract surgery, the day of surgery, and up to 60 days post-op period. As 0.1% susp: Instill 1 drop into the affected eye(s) tid; w/ an additional drop 30-120 min before surgery.

Contraindications

Hypersensitivity to nepafenac or other NSAIDs.

Special Precautions

Patient w/ complicated ocular surgeries, corneal denervation, corneal epithelial defects, DM, ocular surface disease (e.g. dry eye syndrome), rheumatoid arthritis, repeat ocular surgeries w/in a short period of time, predisposition to bleeding. Pregnancy and lactation.

Adverse Reactions

Significant: Punctate keratitis.
Nervous: Headache.
CV: HTN.
GI: Nausea, vomiting.
Resp: Sinusitis.
Ophthalmologic: Capsular opacity, decreased visual acuity, foreign body sensation, increased IOP, sticky sensation, conjunctival/corneal oedema, dry eye, lid margin crusting, discomfort, hyperaemia, ocular pain and pruritus, photophobia, tearing, vitreous detachment.

Pregnancy Category (US FDA)

Ophth: C

Patient Counseling Information

Avoid wearing contact lens during treatment. This drug may cause transient blurring of vision, if affected, do not drive or operate machinery.

Drug Interactions

Increased potential for healing problems w/ ophth corticosteroids.

Action

Description: Nepafenac is an NSAID and analgesic prodrug which penetrates the cornea after ocular application. It is converted by ocular hydrolases to amfenac, an active metabolite that decreases the production of prostaglandin by inhibiting prostaglandin H synthase or cyclooxygenase enzyme.
Pharmacokinetics:
Distribution: Plasma protein binding: 95.4%, primarily to albumin.
Metabolism: Undergoes rapid bioactivation by intraocular hydrolases to amfenac, an active metabolite.

Chemical Structure

Storage

Store between 2-25°C. Protect from light.

MIMS Class

Ophthalmic Decongestants, Anesthetics, Anti-Inflammatories

ATC Classification

S01BC10 - nepafenac ; Belongs to the class of non-steroidal antiinflammatory agents. Used in the treatment of inflammation of the eye.

References

Anon. Nepafenac. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 27/04/2017.

Buckingham R (ed). Nepafenac. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 27/04/2017.

Ilevro Suspension (Alcon Laboratories, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 27/04/2017.

Joint Formulary Committee. Nepafenac. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 27/04/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Nepafenac (EENT). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 27/04/2017.

Nevanac Suspension/Drops (Alcon Laboratories, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 27/04/2017.

Nevanac Topical Ophthalmic (Alcon Laboratories, Inc). U.S. FDA. https://www.fda.gov/. Accessed 27/04/2017.

Disclaimer: This information is independently developed by MIMS based on Nepafenac from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com