Nevanac (Nepafenac)

(ne paf fen' ak)

Ophthalmic nepafenac is 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). Nepafenac is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the production of certain natural substances that cause pain and swelling.

Ophthalmic nepafenac comes as a suspension (liquid) to instill in the eyes. It is usually instilled three times a day beginning one 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. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use nepafenac eye drops exactly as directed. Do not use more or less of them or use them more often than prescribed by your doctor. To use the eye drops, follow these steps:

• Wash your hands thoroughly with soap and water.
• Check the dropper tip to make sure that it is not chipped or cracked.
• Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
• While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
• Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
• Brace the remaining fingers of that hand against your face.
• While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
• Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
• Place a finger on the tear duct and apply gentle pressure.
• Wipe any excess liquid from your face with a tissue.
• If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
• Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
• Wash your hands to remove any medication.

Before using nepafenac eye drops,
• tell your doctor and pharmacist if you are allergic to nepafenac; aspirin or other NSAIDs such as diclofenac (Voltaren), ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or tolmetin (Tolectin); any other medications, or any of the ingredients in nepafenac eye drops. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin and other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); and corticosteroid eye drops such as dexamethasone (Maxidex), fluorometholone (FML), hydrocortisone (in Cortisporin), loteprednol (Alrex, Lotemax), medrysone (HMS), prednisolone (Pred Mild), and rimexolone (Vexol). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are using another topical eye medication, instill it at least 5 minutes before or after you instill nepafenac eye drops.
• tell your doctor if you have or have ever had diabetes, rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), dry eye disease or any eye problem other than cataracts, or any condition that causes you to bleed easily.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while using nepafenac eye drops, call your doctor.
• if you wear contact lenses, remove them before you use nepafenac eye drops.

Unless your doctor tells you otherwise, continue your normal diet.

Instill the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill extra eye drops to make up for a missed dose.

Nepafenac eye drops may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

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

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• 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

Nepafenac eye drops may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Keep all appointments with your doctor Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.