Nepafenac: Brands, Price & Uses in Bangladesh

Nepafenac ophthalmic suspension is a nonsteroidal anti-inflammatory drug (NSAID) used in and around the eye. Its approved and evidence-based uses are:

• Established/FDA-approved use: Treatment of pain and inflammation associated with cataract surgery.
• Formulation-specific approved use: Certain higher-strength formulations of Nepafenac (0.3%) are also approved for reduction of the risk of postoperative macular edema associated with cataract surgery, particularly in patients with diabetes mellitus.

Nepafenac is intended strictly for short-term perioperative use as directed by an ophthalmologist and is not indicated for chronic or unsupervised long-term use.

Cataract Surgery — Pain and Inflammation (0.1% suspension, three-times-daily regimen)

• Instill one drop of Nepafenac in the affected eye(s) three times daily, beginning one day prior to cataract surgery, continued on the day of surgery, and for the first 2 weeks of the postoperative period, as directed by the treating ophthalmologist.

Cataract Surgery — Pain, Inflammation, and Reduction of Macular Edema Risk (0.3% once-daily formulation, where prescribed)

• Instill one drop of Nepafenac in the affected eye(s) once daily, beginning one day prior to cataract surgery, continued on the day of surgery, and continued through the first 2 weeks of the postoperative period (extended courses of up to 60 days may be used in diabetic patients at the ophthalmologist's discretion, per specific product labeling).

An additional drop may be recommended by the treating physician approximately 30 to 120 minutes prior to surgery for some regimens. Always follow the exact schedule given by the prescribing ophthalmologist, as regimens differ between Nepafenac strengths/products.

Renal/Hepatic Impairment

No dedicated dose adjustment has been established for Nepafenac in renal or hepatic impairment, given its minimal systemic absorption via the ophthalmic route; use with the same caution as in patients with normal organ function, under physician guidance.

Most side effects of Nepafenac are local, mild, and transient. Reported adverse effects include:

• Common: Eye pain or discomfort, foreign body sensation, sticky sensation in the eye, blurred or decreased vision, eye redness (conjunctival/ocular hyperemia), tearing, itching, dry eye, capsular opacity.
• Less common: Increased intraocular pressure, corneal edema, iritis (anterior chamber inflammation).
• Rare but serious: Keratitis, corneal epithelial breakdown, corneal thinning, erosion, or (very rarely) corneal perforation, especially with prolonged or inappropriate use; delayed or slowed corneal wound healing.

Patients should seek prompt medical attention if there is worsening eye pain, redness, marked change in vision, or the eye drops appear to make symptoms worse rather than better.