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DOSAGE
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Post-Op Inflammation: 1 gtt qD prior to Surgery, Additional 1 gtt 30-120 mins prior to surgery the Day of, then 1gtt qDay for 2 weeks
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Cystoid Macular Edema (CME): (1) Topical NSAID like Illevro 0.3% qDay or Acular 0.5% QID or Bromfenac 0.09% qDay (2) Predforte 1% QID (3) Discontinue topical epinephrine, dipivefrin, or prostaglandin and/or nicotinic acid
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GENERIC
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nepafenac suspension 0.3%
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INDICATIONS
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ILEVRO 0.3% is indicated for the treatment of pain and inflammation associated with cataract surgery. Off-label for CME
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MECHANISM OF ACTION
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Prodrug of amfenac | COX inhibitor NSAID
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MICROBIOLOGY
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After topical ocular dosing, nepafenac penetrates the cornea and is converted by ocular tissue hydrolases to amfenac, an NSAID. Nepafenac and amfenac are thought to inhibit the action of prostaglandin H synthase (cyclooxygenase), an enzyme required for prostaglandin production.
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CONTRAINDICATIONS & WARNINGS
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Increased Bleeding Time, Delayed Healing, Corneal Effects (Use of topical NSAIDs may result in keratitis. In some susceptible patients, continued use of topical NSAIDs may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation. These events may be sight threatening. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs including ILEVRO* 0.3% and should be closely monitored for corneal health).
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PEDIATRIC USE
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The safety and effectiveness of ILEVRO 0.3% in pediatric patients below the age of 10 years have not been established.
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PREGNANCY
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Teratogenic Effects.Category C: Nepafenac has been shown to cross the placental barrier in rats. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, ILEVRO 0.3% should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
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NOTE
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5 to 10% adverse reactions include capsular opacity, foreign body sensation, increased IOP.
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Prostaglandin biosynthesis inhibitors harm the fetal cardiovascular system.
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