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|Nepafenac

Nepafenac

Trade Names:
Nevanac
- Ophthalmic Suspension 0.1%

Mechanism of Action

Pharmacology

Decreases inflammation by blocking prostaglandin H synthase, an enzyme required for prostaglandin production.

Indications and Usage

Treatment of pain and inflammation associated with cataract surgery.

Contraindications

Standard considerations.

Dosage and Administration

Ophthalmic 1 drop to affected eye tid beginning 1 day prior to cataract surgery and continued on the day of surgery and through the first 2 wk of the postoperative period.

General Advice

• Shake well before use.
• May be used in conjunction with other topical ophthalmic medications (eg, beta-blockers).

Storage/Stability

Store at 36° to 77°F.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypertension (1% to 4%).

CNS

Headache (1% to 4%).

EENT

Capsular opacity, decreased visual acuity, foreign body sensation, increased IOP, sticky sensation (5% to 10%); conjunctival edema, corneal edema, dry eye, lid-margin crusting, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, photophobia, tearing, vitreous detachment (1% to 5%).

GI

Nausea/vomiting (1% to 4%).

Respiratory

Sinusitis (1% to 4%).

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established in children younger than 10 yr of age.

Special Risk Patients

Use with caution in patients with complicated ocular surgery, corneal denervation, corneal surface disease (eg, dry eye syndrome), rheumatoid arthritis, known bleeding tendencies, or repeat ocular surgeries within a short period of time.

Bleeding

There is a potential for increased bleeding time caused by interference with thrombocyte aggregation.

Corneal events

Use of product more than 1 day prior to surgery or beyond 14 days post surgery may increase the risk for occurrence and severity of corneal adverse reactions.

Cross-sensitivity

Because of potential cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs, use caution when treating patients previously exhibiting sensitivity to these agents.

Healing

Healing may be slowed or delayed.

Keratitis

Continued use may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation, which may be sight threatening.

Overdosage

Symptoms

None specified.

Patient Information

• Explain name, dose, action, and potential adverse reactions of drug.
• Obtain patient history, including drug history and any known allergies.
• Advise patients not to administer while wearing contact lenses.
• Advise women to notify health care provider if pregnant, planning to become pregnant, or breast-feeding.
• Caution patient to not take any prescription or OTC medications, herbal preparations, or dietary supplements unless advised by health care provider.
• Advise patient that follow-up visits may be necessary and to keep appointments.