Drug information of Nepafenac Ophthalmic
NEVANAC® (nepafenac ophthalmic suspension) 0.1% is a sterile, topical, nonsteroidal anti-inflammatory (NSAID) prodrug for ophthalmic use
Mechanism of effect
Absorption: Nepafenac rapidly cross the cornea (6 times faster than diclofenac in vitro).
Protein binding: Amfenac has high affinity toward serum albumin proteins. In vitro, the percent bound to human albumin and human serum was 95.4% and 99.1% respectively.
Metabolism: Nepafenac (prodrug) is deaminated to amfenac (active compound) in the ciliary body epithelium, retina, and choroid by intraocular hydrolases. Subsequently, amfenac undergoes extensive metabolism to more polar metabolites involving hydroxylation of the aromatic ring leading to glucuronide conjugate formation.
Sensitivity to aspirin or phenylacetic acid deivatives
May cause increased bleeding in ocular tissues
May cause keratitis & corneal damage (risk increased if applied earlier than 1 day presurgery or longer than 2 wk postsurgery)
Use caution in patients with bleeding predisposition, ocular disease states, diabetes ( corneal adverse effects may result in loss of vision), rheumatoid arthritis
Do not wear contact lenses while on the medication
Risk of corneal adverse effects increases with use 1 day before surgery or >14 days following surgery
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.