Nepafenac ophthalmic (patient information)

# Why is this medication prescribed
Nepafenac ophthalmic 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 medications (NSAIDs). It works by stopping the production of certain natural substances that cause pain and swelling.

# How should this medicine be used
Nepafenac ophthalmic 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:
- Use a mirror or have someone else put the drops in your eye.
- Wash your hands thoroughly with soap and water.
- Shake the container well.
- Remove the protective cap. Make sure that the end of the dropper is not chipped or cracked.
- Avoid touching the dropper tip against your eye or anything else.
- Lie down or tilt your head back and look upward.
- Hold the bottle between your thumb and index finger and place the dropper tip as near as possible to your eyelid without touching it.
- Brace the remaining fingers of that hand against your cheek or nose.
- Use the index finger of your other hand to pull the lower lid of your eye down to form a pocket.
- Drop the prescribed number of drops into the pocket made by the lower lid and the eye.
- Close your eye and press lightly against the lower lid with your finger for 2-3 minutes to keep the medication in the eye. Do not blink.
- Replace and tighten the cap right away. Do not rinse it off.
- Wipe off any excess liquid from your cheek with a clean tissue. Wash your hands again.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
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.
- 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.

# What special dietary instructions should I follow
Unless your doctor tells you otherwise, continue your normal diet.

# What should I do if I forget a dose
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.

# Side effects

## Mild side effects
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
- upset stomach
- vomiting
- dry, itchy, or sticky eyes

## Severe side effects
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.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What storage conditions are needed for this medicine
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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# What other information should I know
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.

# Brand names
- Nevanac