Nevanac (Nepafenac 0.1%)

Corneal effects: Topical NSAIDs may cause keratitis, and continued use in susceptible patients may progress to epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation, collectively the topical NSAID corneal melt spectrum. These events may be sight threatening; discontinue immediately on evidence of corneal epithelial breakdown and monitor corneal health closely.

Higher-risk corneas: Complicated ocular surgery, repeat ocular surgery within a short period, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface disease such as dry eye, and rheumatoid arthritis raise the risk of sight-threatening corneal events in postmarketing reports.

Extended perioperative use: Postmarketing reports with topical NSAIDs suggest that use more than 1 day before surgery, or beyond 14 days after surgery, may increase the risk and severity of corneal adverse events.

Delayed healing: Topical NSAIDs may slow or delay healing, and concomitant topical corticosteroids, which also delay healing, may increase the potential for healing problems.

Increased bleeding time: Potential for interference with thrombocyte aggregation; ocularly applied NSAIDs have been reported to increase bleeding of ocular tissues, including hyphema, in conjunction with ocular surgery. Use caution with known bleeding tendencies or concomitant drugs that prolong bleeding time.

Contact lens wear: Not to be administered while contact lenses are worn.

Contamination risk: Dropper tip contact with the eye or adnexa can contaminate the suspension and cause serious ocular infection and vision loss; a separate bottle per eye is preferred for surgical use.