Nevanac - patient leaflet, side effects, dosage

1. What NEVANAC is and what it is used for

NEVANAC contains the active substance nepafenac, and belongs to a group of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs).

NEVANAC is to be used by adults:

• – to prevent and relieve eye pain and inflammation following cataract surgery on the eye

• – to reduce the risk of macular oedema (swelling in the back of the eye) following cataract

surgery on the eye in diabetic patients.

2. What you need to know before you use NEVANAC

Do not use NEVANAC

• – if you are allergic to nepafenac or any of the other ingredients of this medicine (listed in

section 6),

• – if you are allergic to other nonsteroidal anti-inflammatory drugs (NSAID)

• – if you have experienced asthma, skin allergy, or intense inflammation in your nose when using

other NSAIDs. Examples of NSAIDs are: acetylsalicylic acid, ibuprofen, ketoprofen, piroxicam, diclofenac.

Warnings and precautions

Talk to your doctor, pharmacist or nurse before using NEVANAC:

• – if you bruise easily or have bleeding problems or have had them in the past.

• – if you have any other eye disorder (e.g. an eye infection) or if you are using other medicines in

the eye (especially topical steroids).

• – if you have diabetes.

• – if you have rheumatoid arthritis.

• – if you have had repeated eye surgery within a short period of time.

Avoid sunlight during treatment with NEVANAC

Wearing contact lenses is not recommended after cataract surgery. Your doctor will advise you when you can use contact lenses again (see also “NEVANAC contains benzalkonium chloride”)

Children and adolescents

Do not give this medicine to children and adolescents below 18 years old because the safety and efficacy in this population has not been established.

Other medicines and NEVANAC

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

NEVANAC can affect or be affected by other medicines you are using, including other eye drops for the treatment of glaucoma.

Also tell your doctor if you are taking medicines that reduce blood clotting (warfarin) or other NSAIDs. They may increase the risk of bleeding.

Pregnancy and breast-feeding

If you are pregnant, or might get pregnant, talk to your doctor before you use NEVANAC. Women who may become pregnant are advised to use effective contraception during NEVANAC treatment. The use of NEVANAC is not recommended during pregnancy. Do not use NEVANAC unless clearly indicated by your doctor.

If you are breast-feeding, NEVANAC may pass into your milk. However, no effects on breast-fed children are anticipated. NEVANAC can be used during breast-feeding.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Do not drive or use machines until your vision is clear. You may find that your vision is blurred for a time just after using NEVANAC.

NEVANAC contains benzalkonium chloride

This medicine contains 0.25 mg benzalkonium chloride in each 5 ml which is equivalent to 0.05 mg/ml.

The preservative in NEVANAC, bezalkonium chloride, may be absorbed by soft contact lenses and may change the colour of the contact lenses. You should remove contact lenses before using this medicine and put them back 15 minutes afterwards. Benzalkonium chloride may also cause eye irritation, especially if you have dry eyes or disorders of the cornea (the clear layer at the front of the eye). If you feel abnormal eye sensation, stinging or pain in the eye after using this medicine, talk to your doctor.

3. How to use NEVANAC

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Only use NEVANAC for your eyes. Do not swallow or inject.

The recommended dose is

One drop in the affected eye or eyes, three times a day – morning, midday, and evening. Use at the same time each day.

When to take and for how long

Begin 1 day before cataract surgery. Continue on the day of surgery. Then use it for as long as your doctor tells you to. This may be up to 3 weeks (to prevent and relieve eye pain and inflammation) or 60 days (to prevent the development of macular oedema) after your operation.

How to use

Wash your hands before you start.

• Shake well before use.
• Twist off the bottle cap.
• After cap is removed, if tamper evident snap collar is loose, remove before using product.
• Hold the bottle, pointing down, between your thumb and fingers.
• Tilt your head back.
• Pull down your lower eyelid with a clean finger, until there is a ‘pocket’ between the eyelid and

your eye. The drop will go in here (picture 1).

• Bring the bottle tip close to the eye. Do this in front of a mirror if it helps.
• Do not touch your eye or eyelid, surrounding areas or other surfaces with the dropper. It could

infect the drops.

• Gently press on the base of the bottle to release one drop of NEVANAC at a time.
• Do not squeeze the bottle: it is designed so that a gentle press on the bottom is all that it needs

(picture 2).

If you use drops in both eyes, repeat the steps for your other eye. Close the bottle cap firmly immediately after use.

If a drop misses your eye, try again.

If you are using other eye drops, wait at least five minutes between using NEVANAC and the other drops.

If you use more NEVANAC than you should

Rinse your eye out with warm water. Do not put in any more drops until it is time for your next regular dose.

If you forget to use NEVANAC

Use a single dose as soon as you remember. If it is almost time for the next dose, leave out the missed dose and continue with the next dose of your regular routine. Do not use a double dose to make up for a forgotten dose. Do not use more than one drop in the affected eye(s) 3 times daily.

If you stop using NEVANAC

Do not stop using NEVANAC without speaking to your doctor first. You can usually carry on using the drops, unless you experience serious side effects. If you are worried talk to your doctor or pharmacist.

If you have any further questions on the use of this medicine ask your doctor, pharmacist or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects although not everybody gets them.

There may be a higher risk of corneal side effects (eye surface problems) if you have:

• – complicated eye surgery

• – repeated eye surgery within a short period of time

• – certain disorders of the surface of the eye, such as inflammation or dry eye

• – certain general disease, such as diabetes or rheumatoid arthritis

Contact your doctor immediately if your eyes become more red or more painful whilst using the drops. This may be a result of inflammation on the eye surface with or without loss or damage of cells or an inflammation of the coloured part of the eye (iritis). These side effects have been observed in up to 1 in 100 people.

The following side effects have also been observed with NEVANAC 1 mg/ml eye drops, suspension or NEVANAC 3 mg/ml eye drops, suspension, or both.

Uncommon (may affect up to 1 in 100 people)

• - Effects in the eye: eye surface inflammation with or without loss or damage of cells, foreign

body sensation in the eyes, eyelid crusting or drooping.

Rare (may affect up to 1 in 1,000 people)

• - Effects in the eye : iris inflammation, eye pain, eye discomfort, dry eye, eyelid swelling, eye

irritation, itchy eye, eye discharge, allergic conjunctivitis (eye allergy), increased tear production, deposits on the eye surface, fluid or swelling at the back of the eye, eye redness.

• - General side effects: dizziness, headache, allergic symptoms (eyelid allergic swelling), nausea,

skin inflammation, redness and itching.

Not known (frequency cannot be estimated from the available data)

• Effects in the eye: damage on the surface of the eye such as thinning or perforation, impaired

healing of the eye, eye surface scar, clouding, reduced vision, eye swelling, blurred vision.

• General side effects: vomiting, increased blood pressure.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store NEVANAC

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the bottle and the carton after EXP.

The expiry date refers to the last day of that month.

Do not store above 30°C.

Throw away the bottle 4 weeks after first opening, to prevent infections. Write the date of opening on the bottle and carton label in the space provided.

Do not throw away any medicines via waste water or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What NEVANAC contains

• – The active substance is nepafenac. One ml of suspension contains 1 mg of nepafenac.

• – The other ingredients are benzalkonium chloride (see section 2), carbomer, disodium edetate,

mannitol, purified water, sodium-chloride and tyloxapol.

Tiny amounts of sodium hydroxide and/or hydrochloric acid are added to keep acidity levels (pH levels) normal.

What NEVANAC looks like and the contents of the pack

1. What NEVANAC is and what it is used for

NEVANAC contains the active substance nepafenac, and belongs to a group of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs).

NEVANAC is to be used by adults:

• – To prevent and relieve eye pain and inflammation following cataract surgery on the eye.

• – To reduce the risk of macular oedema (swelling in the back of the eye) following cataract

surgery on the eye in diabetic patients.

2. What you need to know before you use NEVANAC

Do not use NEVANAC

• – if you are allergic to nepafenac or any of the other ingredients of this medicine (listed in

• section 6)

• – if you are allergic to other nonsteroidal anti-inflammatory drugs (NSAID)

• – if you have experienced asthma, skin allergy, or intense inflammation in your nose when using

other NSAIDs. Examples of NSAIDs are: acetylsalicylic acid, ibuprofen, ketoprofen, piroxicam, diclofenac.

Warnings and precautions

Talk to your doctor, pharmacist or nurse before using NEVANAC:

• – if you bruise easily or have bleeding problems or have had them in the past

• – if you have any other eye disorder (e.g. an eye infection) or if you are using other medicines in

the eye (especially topical steroids)

• – if you have diabetes

• – if you have rheumatoid arthritis

• – if you have had repeated eye surgery within a short period of time.

Avoid sunlight during treatment with NEVANAC.

Wearing contact lenses is not recommended after cataract surgery. Your doctor will advise you when you can use contact lenses again (see also “NEVANAC contains benzalkonium chloride”).

Children and adolescents

Do not give this medicine to children and adolescents below 18 years old because the safety and efficacy in this population has not been established.

Other medicines and NEVANAC

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

NEVANAC can affect or be affected by other medicines you are using, including other eye drops for the treatment of glaucoma.

Also tell your doctor if you are taking medicines that reduce blood clotting (warfarin) or other NSAIDs. They may increase the risk of bleeding.

Pregnancy and breast-feeding

If you are pregnant, or might get pregnant, talk to your doctor before you use NEVANAC. Women who may become pregnant are advised to use effective contraception during NEVANAC treatment. The use of NEVANAC is not recommended during pregnancy. Do not use NEVANAC unless clearly indicated by your doctor.

If you are breast-feeding, NEVANAC may pass into your milk. However, no effects on breast-fed children are anticipated. NEVANAC can be used during breast-feeding.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Do not drive or use machines until your vision is clear. You may find that your vision is blurred temporarily just after using NEVANAC.

NEVANAC contains benzalkonium chloride

This medicine contains 0.15 mg benzalkonium chloride in each 3 ml which is equivalent to 0.05 mg/ml.

The preservative in NEVANAC, benzalkonium chloride, may be absorbed by soft contact lenses and may change the colour of the contact lenses. You should remove contact lenses before using this medicine and put them back 15 minutes afterwards. Benzalkonium chloride may also cause eye irritation, especially if you have dry eyes or disorders of the cornea (the clear layer at the front of the eye). If you feel abnormal eye sensation, stinging or pain in the eye after using this medicine, talk to your doctor.

3. How to use NEVANAC

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Only use NEVANAC for your eyes. Do not swallow or inject.

The recommended dose is

One drop in the affected eye or eyes, once a day. Use at the same time each day.

When to take and for how long

Begin 1 day before cataract surgery. Continue on the day of surgery. Then use it for as long as your doctor tells you to. This may be up to 3 weeks (to prevent and relieve eye pain and inflammation) or 60 days (to prevent the development of macular oedema and to improve vision) after your operation.

How to use

Wash your hands before you start.

• Shake well before use.
• Turn the closed bottle upside down and shake down once before each use.
• Twist off the bottle cap.
• After cap is removed, if a tamper evident snap collar is present and is loose, remove before

using product.

• Hold the bottle, pointing down, between your thumb and fingers.
• Tilt your head back.
• Pull down your lower eyelid with a clean finger, until there is a ‘pocket’ between the eyelid and

your eye. The drop will go in here (picture 1).

• Bring the bottle tip close to the eye. Do this in front of a mirror if it helps.
• Do not touch your eye or eyelid, surrounding areas or other surfaces with the dropper. It could

infect the drops.

• Gently squeeze the sides of the bottle until one drop is released into your eye (picture 2).

If you use drops in both eyes, repeat the steps for your other eye. It is not necessary to close and shake the bottle between administrations for both eyes. Close the bottle cap firmly immediately after use.

If a drop misses your eye, try again.

If you are using other eye drops, wait at least five minutes between using NEVANAC and the other drops.

If you use more NEVANAC than you should

Rinse your eye out with warm water. Do not put in any more drops until it is time for your next regular dose.

If you forget to use NEVANAC

Use a single dose as soon as you remember. If it is almost time for the next dose, leave out the missed dose and continue with the next dose of your regular routine. Do not use a double dose to make up for a forgotten dose. Do not use more than one drop in the affected eye(s).

If you stop using NEVANAC

Do not stop using NEVANAC without speaking to your doctor first. You can usually carry on using the drops, unless you experience serious side effects.

If you have any further questions on the use of this medicine ask your doctor, pharmacist or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

There may be a higher risk of corneal side effects (eye surface problems) if you have:

• – complicated eye surgery

• – repeated eye surgery within a short period of time

• – certain disorders of the surface of the eye, such as inflammation or dry eye

• – certain general diseases, such as diabetes or rheumatoid arthritis.

Contact your doctor immediately if your eyes become more red or more painful whilst using the drops. This may be a result of inflammation on the eye surface with or without loss or damage of cells or an inflammation of the coloured part of the eye (iritis). These side effects have been observed in up to 1 in 100 people.

The following side effects have been observed with NEVANAC 3 mg/ml eye drops, suspension or NEVANAC 1 mg/ml eye drops, suspension or both.

Uncommon (may affect up to 1 in 100 people)

• Effects in the eye: eye surface inflammation with or without loss or damage of cells, foreign

body sensation in the eyes, eyelid crusting or drooping.

Rare (may affect up to 1 in 1,000 people)

• Effects in the eye: iris inflammation, eye pain, eye discomfort, dry eye, eyelid swelling, eye

irritation, itchy eye, eye discharge, allergic conjunctivitis (eye allergy), increased tear production, deposits on the eye surface, fluid or swelling at the back of the eye, eye redness.

• General side effects: dizziness, headache, allergic symptoms (eyelid allergic swelling), nausea,

skin inflammation, redness and itching.

Not known (frequency cannot be estimated from the available data)

• Effects in the eye: damage of the surface of the eye such as thinning or perforation, impaired

healing of the eye, eye surface scar, clouding, reduced vision, eye swelling, blurred vision.

• General side effects: vomiting, increased blood pressure.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store NEVANAC

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the bottle and the carton after EXP.

The expiry date refers to the last day of that month.

Do not store above 25°C. Keep the bottle in the outer carton in order to protect from light.

Throw away the bottle 4 weeks after first opening, to prevent infections. Write the date of opening on the carton label in the space provided.

Do not throw away any medicines via waste water or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What NEVANAC contains

• – The active substance is nepafenac. One ml of suspension contains 3 mg of nepafenac.

• – The other ingredients are boric acid, propylene glycol, carbomer, sodium chloride, guar,

What NEVANAC looks like and contents of the pack

NEVANAC eye drops, suspension (eye drops) is a liquid (light yellow to dark orange suspension) supplied in a plastic bottle with a screw cap. Each bottle may be placed in a pouch.

Each pack contains one bottle of 3 ml.

Marketing Authorisation Holder

Novartis Europharm Limited

Vista Building

Elm Park, Merrion Road

Dublin 4

Ireland

Manufacturer

S.A. Alcon – Couvreur N.V

Rijksweg 14

B-2870 Puurs

Belgium

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

This leaflet was last revised in

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency web site:

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