FDA-filed SPL labeling · retrieved through openFDA

Nepafenac Ophthalmic

Nepafenac ophthalmic is a nonsteroidal anti-inflammatory (NSAID) eye drop used to treat pain and inflammation associated with cataract surgery.

Brand names NevanacIlevro
Drug class Nonsteroidal Anti-inflammatory Drug
Rx Form 1 Route Ophthalmic
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 4 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveApr 1, 2026
Clinical labels in scope 4
AvailabilityRx
Earliest approval/marketing year 2005
FDA-listed product records 8
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Nepafenac Ophthalmic at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Nepafenac ophthalmic is an NSAID eye drop that controls pain and inflammation after cataract surgery. Use it exactly as your doctor prescribes — starting the day before surgery and continuing for two weeks after. Watch for any worsening eye symptoms, especially changes in vision or unusual eye bleeding, and contact your doctor promptly if they occur.

📖 Nepafenac Ophthalmic: Patient Information Guide

A plain-language walkthrough of Nepafenac Ophthalmic — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Nepafenac ophthalmic is an NSAID eye drop used to manage eye pain and inflammation after cataract surgery.

  • Ilevro 0.3% is indicated for the treatment of pain and inflammation associated with cataract surgery
  • Nevanac 0.1% is also used for pain and inflammation associated with cataract surgery
⚙️How it works

Nepafenac is a prodrug — meaning it becomes active after you use it. Once the drop is placed in the eye, it penetrates the cornea and is converted by eye tissue into an active form called amfenac. Amfenac (and nepafenac itself) block an enzyme called cyclooxygenase (also known as prostaglandin H synthase), which the body needs to make prostaglandins — the chemicals responsible for pain and swelling. Lowering prostaglandin levels in the eye reduces post-surgical pain and inflammation.

💊How it's taken

Nepafenac ophthalmic is applied directly into the eye as a drop. Ilevro 0.3% is used once daily, beginning one day before cataract surgery, on the day of surgery, and continuing through the first two weeks of recovery. An extra drop is given in the 30 to 120 minutes before the surgery itself.

  • If using other eye drops at the same time, wait at least 5 minutes between each one
  • Do not use while wearing contact lenses
  • Always follow your prescriber's exact instructions — do not use it longer than directed
🤒Side effects — in detail

The most common side effects (reported in about 5–10% of patients) after cataract surgery with nepafenac include:

  • Capsular opacity (cloudiness behind the lens implant)
  • Decreased visual acuity (reduced sharpness of vision)
  • Foreign body sensation (feeling like something is in the eye)
  • Increased intraocular pressure (pressure inside the eye)
  • Sticky sensation in the eye
  • Conjunctival edema (swelling of the white of the eye), corneal edema, dry eye, eye redness, pain, or itching (1–5% of patients)
  • Headache, nausea/vomiting, high blood pressure, or sinus problems (1–4% of patients)

Stop using nepafenac and contact your doctor right away if you notice significant vision changes, unusual eye bleeding, or worsening eye surface irritation — these may indicate a serious corneal problem.

⚠️Warnings & precautions
  • Corneal (front-of-eye) damage: In some patients, topical NSAIDs can cause serious problems including breakdown of the eye surface, corneal thinning, erosion, ulceration, or perforation — all of which can be sight-threatening. Risk is higher if you have diabetes, dry eye, rheumatoid arthritis, or have had multiple or complicated eye surgeries. Using the drops for more than 1 day before surgery or beyond 14 days after can also raise the risk.
  • Increased bleeding: Nepafenac may increase bleeding time and may contribute to bleeding inside the eye (hyphema) during or after surgery. Use with extra caution if you have a bleeding disorder or take blood-thinning medications.
  • Delayed healing: Topical NSAIDs can slow the healing of eye tissue. Using nepafenac together with topical steroid eye drops may further increase this risk.
  • Contact lenses: Do not use Ilevro 0.3% while wearing contact lenses.
🔀What it interacts with

Nepafenac ophthalmic has a few important interactions to be aware of:

  • Other topical eye medications: Can be used together with other eye drops (such as beta-blockers, carbonic anhydrase inhibitors, alpha-agonists, cycloplegics, or mydriatics), but each medication must be given at least 5 minutes apart
  • Topical corticosteroid (steroid) eye drops: Using both at the same time may increase the risk of delayed wound healing
  • Blood-thinning medications: Nepafenac may add to their effect on bleeding time, increasing the risk of ocular bleeding during surgery

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Tell your doctor if you have ever had an allergic reaction to any NSAID (such as aspirin, ibuprofen, or naproxen) or to any ingredient in this product — use is contraindicated in those patients
  • Inform your doctor if you have a bleeding disorder or take medications that slow clotting
  • Let your doctor know if you have diabetes, dry eye syndrome, rheumatoid arthritis, or any other eye surface disease — your risk of corneal side effects may be higher
  • Do not use Ilevro 0.3% while wearing contact lenses
  • Pregnancy: Nevanac 0.1% should be used during pregnancy only if clearly necessary; avoid use during late pregnancy due to potential effects on the baby's cardiovascular system (closure of the ductus arteriosus, a critical blood vessel)
  • Breastfeeding: Use Nevanac 0.1% with caution — it is unknown whether this drug passes into human breast milk
  • Children: Safety and effectiveness of Nevanac 0.1% have not been established in children under 10 years of age
  • Older adults: No meaningful differences in safety or effectiveness compared to younger adults have been observed
🔬Pharmacokinetics — how your body processes it

After eye drops are applied, small but measurable amounts of nepafenac and its active form, amfenac, are absorbed into the bloodstream — typically detectable within 2 to 3 hours of dosing. Blood levels remain very low (well under 1 nanogram per milliliter), which means systemic effects are minimal. Studies show that nepafenac does not meaningfully interfere with liver enzymes (the cytochrome P450 system) that process many other drugs, making drug-drug interactions through this pathway unlikely. Interactions through protein binding are also considered unlikely at these low blood concentrations.

📦How to store it

Store at 2°C to 25°C (36°F to 77°F). Protect from light.

📄 Written from Nepafenac Ophthalmic’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

9

Supplements & herbs that interact with Nepafenac Ophthalmic

9 supplements and herbal products have documented interactions with Nepafenac Ophthalmic in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 2
  • Moderate · 6
  • Minor · 1
Every supplement checked against Nepafenac Ophthalmic — ranked by severity The full interaction hub: 2 major · 6 moderate · 1 minor · every one linked to its full report. Check Nepafenac Ophthalmic against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

1

Nutrient depletion considerations

Nepafenac Ophthalmic has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

See the full Nepafenac Ophthalmic nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Nepafenac Ophthalmic — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is this eye drop for?
This drop is used to control pain and swelling in your eye after cataract surgery. It belongs to a class of medicines called NSAIDs — the same family as ibuprofen — but in eye drop form, so it works right where the inflammation is happening.
How do I use it and when do I start?
For Ilevro 0.3%, you start one drop in the affected eye the day before your surgery. On the day of surgery, you put in your regular daily drop and then an extra drop 30 to 120 minutes before the procedure. After surgery, you continue one drop a day for the first two weeks. If you use other eye drops, make sure to wait at least 5 minutes between each one.
Can I wear my contact lenses while using this?
No — do not put your contact lenses in while you are using this medication. This is an important precaution during your recovery period.
What side effects should I watch out for?
Some common things people notice are a sticky or foreign body sensation in the eye, some redness or discomfort, or mild changes in vision. These are usually manageable. The more serious thing to watch for is any significant worsening of your eye — like increasing pain, vision getting worse, or signs of bleeding inside the eye. If any of that happens, stop the drops and call your doctor right away.
I take a blood thinner — is this drop safe for me?
You should definitely let your doctor know. NSAIDs, even as eye drops, can affect how your blood clots, and combining them with blood-thinning medications could increase your risk of bleeding in the eye around the time of surgery. Your doctor can weigh the risks and monitor you carefully.
Can I use this drop if I'm pregnant or breastfeeding?
You should talk to your doctor before using this if you're pregnant or breastfeeding. Avoiding use during late pregnancy is recommended because drugs that block prostaglandins can potentially affect the baby's heart circulation. For breastfeeding, it's not yet known whether this drug passes into human breast milk, so your doctor should help you decide what's safest.
Is Nepafenac Ophthalmic available over the counter?
Nepafenac Ophthalmic is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Nepafenac Ophthalmic first available?
Nepafenac Ophthalmic has been available in the United States since at least 2005, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Nepafenac Ophthalmic?
Nepafenac Ophthalmic is supplied by 3 manufacturers listed in the FDA NDC Directory, including Novartis Pharmaceuticals Corporation, Harrow Eye, LLC, Alcon Laboratories, Inc..

💬 Answers drafted from Nepafenac Ophthalmic’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Nepafenac Ophthalmic comes

Nepafenac Ophthalmic is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Eye drops

In the eye
Brands Ilevro Nevanac
How this form is used
What it may be used for
  • Ilevro 0.3% is used to treat pain and inflammation associated with cataract surgery
  • Nevanac 0.1% is used to treat pain and inflammation associated with cataract surgery
Important instructions
  • Ilevro 0.3%: apply one drop to the affected eye once daily, starting 1 day before cataract surgery, on the day of surgery, and through the first 2 weeks after surgery
  • Ilevro 0.3%: apply one additional drop 30 to 120 minutes before the surgical procedure
  • If using Ilevro 0.3% with other eye drops, wait at least 5 minutes between each medication
  • Do not use Ilevro 0.3% while wearing contact lenses
Available strengths 2 strengths
8 FDA-listed product records

📊 Nepafenac Ophthalmic across the U.S. market

How Nepafenac Ophthalmic appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
3
Manufacturers
2
Brand names
8
FDA-listed product records
2005
First marketed
Novartis Pharmaceuticals Corporation63%
Harrow Eye, LLC25%
Alcon Laboratories, Inc.13%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Nepafenac Ophthalmic is used

A general measure of how commonly Nepafenac Ophthalmic is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Nepafenac Ophthalmic is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

849
Medicaid prescriptions filled (Q1–Q4 2025)
$318,750 gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Nepafenac Ophthalmic prescribed? Of the 1,596 medications we measure, Nepafenac Ophthalmic ranks #1,306 by Medicaid prescriptions — more than 18% of them.

Where Nepafenac Ophthalmic ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Nepafenac Ophthalmic product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 3 mg/mL ophthalmic suspension is the most-dispensed Nepafenac Ophthalmic product — about 84% of these Medicaid prescriptions.

nepafenac 3 MG/ML Ophthalmic Suspension Most dispensed

713 Medicaid prescriptions (Q1–Q4 2025) 84% of Nepafenac Ophthalmic prescriptions shown $270,841 gross reimbursement (before rebates) ≈ $380 per prescription (gross)

Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1362132

nepafenac 1 MG/ML Ophthalmic Suspension

136 Medicaid prescriptions (Q2–Q4 2025) 16% of Nepafenac Ophthalmic prescriptions shown $47,910 gross reimbursement (before rebates) ≈ $352 per prescription (gross)

Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 578044

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Nepafenac Ophthalmic, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 3 of 6 listed Nepafenac Ophthalmic NDCs with Medicaid activity.

🔍 Compare Nepafenac Ophthalmic products

A representative set of FDA-listed product records for Nepafenac Ophthalmic — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category Details
💊Eye drops
1 mg/mL Ophthalmic Alcon Laboratories, Inc. NDA View NDC →
1 mg/mL Ophthalmic Harrow Eye, LLC NDA View NDC →
3 mg/mL Ophthalmic Harrow Eye, LLC NDA View NDC →
1 mg/mL Ophthalmic Novartis Pharmaceuticals Corporation × 2 listings NDA View NDC →
3 mg/mL Ophthalmic Novartis Pharmaceuticals Corporation × 3 listings NDA View NDC →

Showing 8 of 8 products — FDA National Drug Code Directory. See every product, package size and price: browse all 8 Nepafenac Ophthalmic NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Nepafenac Ophthalmic RxCUI 298665 1 dose form · 2 strengths
  1. Dose form (SCDF) Ophthalmic Suspension RxCUI 578043 In current FDA listings
    Clinical drug / strength (SCD) 1 MG/ML RxCUI 578044 3 MG/ML RxCUI 1362132

Look up RxCUI 298665 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Nevanac Ilevro

🏭 Manufacturers & labelers

Novartis Pharmaceuticals Corporation 5 Harrow Eye, LLC 2 Alcon Laboratories, Inc. 1

RxNorm drug class

Nepafenac Ophthalmic belongs to the Nonsteroidal Anti-inflammatory Drug class.

Pharmacologic class Nonsteroidal Anti-inflammatory Drug
Drug family (ATC) Antiinflammatory agents, non-steroids
How it works Cyclooxygenase Inhibitors

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Apr 1, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Nepafenac Ophthalmic.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Nepafenac Ophthalmic after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
4
NDC products indexed
8
Distinct labelers/manufacturers represented
3
Linked representative label
Novartis Pharmaceuticals Corporation
Linked label effective
Apr 1, 2026
Composite sections available
19
Linked SPL Set ID
f089b583-0310-4ca8-8d41-52b06b08d1ed
Linked SPL Document ID
4e6e6db9-e1cf-83cb-e063-6294a90a2420
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 4 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Novartis Pharmaceuticals Corporation is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.