Nevanac (Nepafenac)

Nevanac (nepafenac) is an ophthalmic NSAID used to manage ocular inflammation and pain.

• Post‑cataract surgery inflammation: reduces postoperative ocular inflammation and supports faster visual recovery.
• Post‑cataract surgery pain: alleviates discomfort and burning sensations after the surgical procedure.
• General ocular pain and inflammation: provides anti‑inflammatory relief in other eye conditions where inflammation is present, such as uveitis‑related discomfort.

• Nevanac is a prodrug that penetrates the cornea and is hydrolyzed by intra‑ocular hydrolases to amfenac, the active metabolite. Amfenac selectively inhibits cyclooxygenase (COX‑1 and COX‑2) enzymes, decreasing prostaglandin synthesis and thereby limiting the inflammatory cascade within ocular tissues.

Common ocular reactions may occur during treatment.

Common Side Effects

• Transient eye irritation or burning sensation.
• Redness of the conjunctiva.
• Blurred vision that resolves after a short period.
• Mild headache.
• Dry eye feeling.
• Increased tearing.

Serious or Rare Side Effects

• Corneal ulceration or epithelial defect.
• Severe allergic reaction (e.g., angio‑edema, anaphylaxis).
• Persistent intra‑ocular pressure elevation.
• Vision loss not attributable to the underlying condition.
• Endophthalmitis.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.

Before prescribing Nevanac, clinicians should consider patient‑specific factors and safety measures.

• Hypersensitivity: avoid use in patients with known allergy to nepafenac or other NSAIDs.
• Corneal disease: use with caution in patients with pre‑existing corneal epithelial defects.
• Contact lens wear: advise removal of lenses during treatment and monitor for irritation.
• Systemic NSAID therapy: assess risk of additive systemic effects, especially in patients with cardiovascular disease.
• Pregnancy and lactation: safety not established; weigh potential benefits against unknown risks.
• Store below 25°C: keep in the original container, protect from light and moisture.

Nevanac may interact with other medications that affect ocular or systemic physiology.

Major Interactions (Avoid)

• Systemic NSAIDs: increased risk of systemic adverse effects such as gastrointestinal bleeding.
• Concurrent ocular anti‑inflammatory agents: heightened risk of corneal toxicity.
• Ocular corticosteroids: may mask signs of infection, delaying diagnosis.

Moderate Interactions (Monitor Closely)

• Anticoagulants or antiplatelet drugs: monitor for signs of ocular bleeding.
• Cycloplegic agents: may influence intra‑ocular pressure; observe pressure changes.
• Contact lens wearers: increased potential for irritation; advise close monitoring.