Nepafenac belongs to the class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). It works by reducing pain, swelling, and inflammation. Nepafenac eye drops are used to reduce eye pain and inflammation before and after cataract surgery.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The recommended dose of nepafenac eye drops is 1 drop in the affected eye once daily, starting the day before cataract surgery, continued on the day of surgery, and for as long as your doctor asks you to keep using them. This may be for as long as 2 weeks after the surgery.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

To use eye drops properly:

1. Wash your hands before using the eye drops.
2. Shake the container well before use to ensure the medication is evenly mixed throughout the bottle.
3. Remove the cap and place it in a clean location. To avoid possible contamination, keep the tip of the container away from contact with any surface.
4. Tilt your head back and look towards the ceiling.
5. With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
6. Apply one drop into the pouch but do not allow the tip of the container to touch the eye or areas around the eye.
7. Gently apply pressure to the inner corner of the eye (at the bridge of the nose) for about 30 seconds. (This is called nasolacrimal occlusion.) This prevents the medication from dripping down through the tear duct and entering the bloodstream, which could cause you to experience some side effects.
8. Repeat with the other eye, if prescribed by your physician.
9. Wash your hands again to remove any medication.

If you are using more than one topical eye medication (eye drops or ointment), wait at least 5 minutes before putting another medication in the eye. Contact lenses should not be worn during treatment with this medication.

Ask your doctor or pharmacist to show you the correct method of applying eye drops. It is very important to avoid touching the dropper tip to any surface, skin, or your eye. This contamination can result in a bacterial infection. Report any signs of an eye infection (e.g., redness, irritation, pain) to your doctor immediately.

It is important that this medication be used exactly as prescribed by your doctor. If you miss a dose, instill it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not instill a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture and keep it out of the reach of children.

Safely discard any medication remaining in the dropper bottle after you have used the medication for the full length of time recommended by your doctor. Discard any remaining medication 28 days after opening the bottle.

Each mL of ophthalmic suspension contains 3 mg (0.3%) of nepafenac. Nonmedicinal ingredients: boric acid, propylene glycol, carbomer 974P, sodium chloride, guar, carmellose sodium, disodium edetate, sodium hydroxide and/or hydrochloric acid (to adjust pH), purified water, and the preservative benzalkonium chloride 0.005%.

Do not use this medication if you:

• are allergic to nepafenac or any ingredients of this medication
• are allergic or sensitive to other NSAIDs (e.g., naproxen, acetylsalicylic acid [ASA], diclofenac)
• have developed asthma, itching, or a runny nose after taking ASA or NSAIDs

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by least 0.1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• blurred vision
• crusty eyelids
• dry eyes
• eyelid swelling or drooping
• eye discharge
• eye pain
• headache
• increased tear production
• itchy eyes
• nausea
• sensation of something in the eye
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• dizziness
• increased blood pressure
• inflammation of the surface of the eye
• increased sensitivity to light
• red, irritated, or bloodshot eyes
• watery eyes

Stop taking the medication and seek immediate medical attention if any of the following occur:

• eyes become redder or more painful while using the drops
• reduced vision
• signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergies: Some people who are allergic to ASA or nonsteroidal anti-inflammatory medications (NSAIDs) also experience allergic reactions to nepafenac. Before you use these eye drops, tell your doctor about any previous side effects you have had to medications, especially NSAIDs and ASA. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Bleeding problems: Nepafenac eye drops may increase the time it takes for your blood to clot. If you have a history of prolonged bleeding time or a bleeding disorder, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience unusual irritation or redness of the eye or area around the eye, bruising, or unexpected bleeding, contact your doctor immediately.

Contact lenses: Contact lenses should not be worn following cataract surgery. Do not wear contact lenses while you are using nepafenac eye drops.

Slowed healing: Topical NSAIDs, including nepafenac, may slow down the healing process. If you do not experience improvement in your condition, or if your eyes become redder, more painful, or more sensitive to the light, contact your doctor as soon as possible.

Vision: This medication can cause blurred or reduced vision. If you experience these symptoms, do not drive or operate machinery until these symptoms go away.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast feeding: It is not known if nepafenac passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between nepafenac eye drops and any of the following:

• corticosteroid eye drops (e.g., dexamethasone, prednisolone, etc.)
• prostaglandin eye drops (e.g., bimatoprost, latanoprost, travoprost)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.