ilevro opthalmic suspension - Nepafenac (0.3% w/v) medicine

Ilevro Ophthalmic Suspension (Nepafenac 0.3%): Complete Medicine Guide

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🏭 Novartis India Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 26, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for approved indications.
Reviewed by
SaathiMed Expert Panel | Sep 26, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Severe eye pain that does not improve
  • Sudden vision loss or severe blurring
  • Signs of eye infection (redness, swelling, discharge)
  • Allergic reaction (rash, itching, swelling of face or throat)
  • Unusual bleeding or bruising
  • Corneal opacity or white spots on the eye

If experiencing severe symptoms, call emergency services immediately.

What is ilevro opthalmic suspension used for?

This medicine is an ophthalmic NSAID used to treat pain and inflammation after cataract surgery. It works by blocking prostaglandins, which are chemicals that cause pain and swelling. It is applied as one drop in the affected eye once daily, starting before surgery and continuing for 2 weeks after.

  • Generic Name: Nepafenac (0.3% w/v)
  • Manufacturer: Novartis India Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 ilevro opthalmic suspension के बारे में (Hindi Summary)

उपयोग: यह दवा नेपाफेनैक 0.3% ऑप्थल्मिक सस्पेंशन है, जिसका उपयोग मोतियाबिंद सर्जरी के बाद आंखों में दर्द और सूजन को कम करने के लिए किया जाता है। यह एक नॉनस्टेरॉइडल एंटी-इंफ्लेमेटरी ड्रग (NSAID) है जो आंखों में प्रोस्टाग्लैंडिन नामक रसायनों को कम करके दर्द और सूजन को कम करती है। यह दवा केवल आंखों में डालने के लिए है और इसे डॉक्टर के निर्देशानुसार ही उपयोग करना चाहिए।

साइड इफेक्ट्स: आम दुष्प्रभावों में धुंधली दृष्टि, आंखों में असुविधा, जलन, और पानी आना शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं लेकिन कॉर्निया में घाव, एलर्जी, या रक्तस्राव की समस्या हो सकती है। यदि आंखों में तेज दर्द, लालिमा, या दृष्टि में कमी हो तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा का उपयोग डॉक्टर के बताए अनुसार ही करें। उपयोग से पहले हाथ धोएं। ड्रॉपर की नोक को आंख या किसी सतह से न छुएं। कॉन्टैक्ट लेंस पहनने से पहले डॉक्टर से सलाह लें। दवा डालने के बाद कुछ मिनट तक धुंधली दृष्टि हो सकती है, इसलिए वाहन न चलाएं। दवा को बच्चों की पहुंच से दूर रखें।

💡 Did You Know? The first generic medicine was introduced in India in 1970 after the Patents Act was amended.

💊 ilevro opthalmic suspension Uses & Benefits

[{"condition":"Postoperative pain and inflammation after cataract surgery","description":"This medicine is used to reduce pain and swelling following cataract extraction and intraocular lens implantation.","evidence":"Well-established"},{"condition":"Postoperative macular edema prevention","description":"It helps reduce the risk of macular edema, a common complication after cataract surgery.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Pain and inflammation after other ocular surgeries","description":"Sometimes used off-label for postoperative inflammation following refractive or corneal surgeries.","evidence":"Limited"},{"condition":"Cystoid macular edema associated with uveitis","description":"May be used off-label to reduce macular edema in inflammatory eye conditions.","evidence":"Limited"}]

Primary treatment for: Postoperative ocular pain and inflammation

Also treats: Postoperative macular edema

📋 Drug Information

Generic Name(s)Nepafenac (0.3% w/v)
Brand Nameilevro opthalmic suspension
ManufacturerNovartis India Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassOPHTHAL
Action ClassNSAID's- Non-Selective COX 1&2 Inhibitors (Topical)
Route of AdministrationOphthalmic
StorageStore at 2°C to 25°C (36°F to 77°F). Do not freeze. Keep the bottle tightly closed when not in use. Store upright.
Shelf Life24 months from the date of manufacture. Discard 4 weeks after opening.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Shake the bottle well before each use to ensure the suspension is mixed properly.
2
Apply the drop into the lower eyelid pouch, not directly onto the cornea, to minimize discomfort.
3
Press the inner corner of your eye for 1-2 minutes after instillation to reduce systemic absorption.
4
Do not use this medicine if the suspension is discolored or contains particles.
5
Discard the bottle 4 weeks after opening to prevent contamination.
6
Inform your surgeon if you are using any other eye drops, especially steroids or antibiotics.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Eye pain after cataract surgery
This medicine is commonly prescribed for this.
Likely Use
✅
Eye redness and swelling after surgery
This medicine helps reduce postoperative inflammation.
Likely Use
❌
Eye infection
This medicine is not an antibiotic and does not treat infections.
Not Primary
❌
Dry eye
This medicine is not indicated for dry eye.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionSystemic absorption of nepafenac after topical ocular administration is minimal. The drug is absorbed into the eye tissues, primarily the cornea and aqueous humor.
DistributionNepafenac and its active metabolite amfenac distribute into ocular tissues, including the cornea, aqueous humor, and retina. Systemic distribution is limited.
Protein BindingAmfenac is highly bound to plasma proteins (approximately 99%).
MetabolismNepafenac is metabolized primarily by ocular tissue hydrolases to amfenac. Amfenac undergoes further metabolism, mainly by glucuronidation.
Half-LifeThe elimination half-life of amfenac from the eye is not well established. Systemically, amfenac has a half-life of approximately 1-2 hours.
ExcretionSystemically absorbed amfenac and its metabolites are excreted primarily in the urine.
BioavailabilitySystemic bioavailability after topical ocular administration is very low, estimated to be less than 5%.
Onset of ActionPain relief typically begins within 30 minutes to 1 hour after instillation.
Peak Plasma TimePeak plasma concentrations of amfenac are reached approximately 1 hour after topical administration.
Duration of ActionThe anti-inflammatory effect lasts for approximately 24 hours, allowing once-daily dosing.

How It Works

Nepafenac is a prodrug that rapidly penetrates the cornea and is converted by ocular tissue hydrolases to amfenac, a potent nonsteroidal anti-inflammatory drug. Amfenac inhibits the cyclooxygenase enzymes COX-1 and COX-2, thereby reducing the synthesis of prostaglandins and other inflammatory mediators. This leads to decreased pain and inflammation in the eye. The 0.3% suspension provides a longer duration of action compared to the 0.1% formulation, allowing for once-daily dosing.

Mechanism Steps

1
Corneal penetration: Nepafenac, being a prodrug, is highly lipophilic and penetrates the cornea rapidly after topical application.
2
Conversion to amfenac: Inside the eye, tissue hydrolases convert nepafenac to amfenac, its active metabolite.
3
COX inhibition: Amfenac inhibits cyclooxygenase enzymes (COX-1 and COX-2), blocking the conversion of arachidonic acid to prostaglandins.
4
Reduced inflammation and pain: The decrease in prostaglandins leads to reduced ocular pain, inflammation, and vascular permeability.

💡 How to Take ilevro opthalmic suspension

Strength: Ophthalmic suspension, 0.3% w/v

1Wash your hands thoroughly with soap and water.
2Shake the bottle well before use.
3Tilt your head back and pull down your lower eyelid to form a pouch.
4Hold the dropper above the eye and squeeze one drop into the pouch.
5Close your eye gently and press the inner corner of your eye with your finger for 1-2 minutes to prevent the drop from draining into your throat.
6Replace the cap tightly after use.
7Wash your hands again to remove any medicine residue.

Dosage Information

Adult DosageThe recommended dose is one drop in the affected eye(s) once daily, starting 1 day before cataract surgery, continuing on the day of surgery, and for 2 weeks postoperatively, or as prescribed by your ophthalmologist. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageNo specific dose adjustment is required for elderly patients. Use as prescribed by your doctor.
Renal ImpairmentNo dose adjustment is required for renal impairment as systemic absorption is minimal.
Hepatic ImpairmentNo dose adjustment is required for hepatic impairment as systemic absorption is minimal.
Maximum Daily DoseOne drop in the affected eye(s) once daily.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

⏰ What to Do If You Miss a Dose

📌 Less than 12 hours have passed since the missed dose
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than 12 hours have passed since the missed dose
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of ilevro opthalmic suspension

✅ Common Side Effects

Blurred vision (Common (5-10%))
Usually resolves within minutes. Avoid driving until vision clears.
Eye discomfort (Common (5-10%))
May occur immediately after instillation. If persistent, consult your doctor.
Foreign body sensation (Common (5-10%))
Usually transient. If it continues, inform your ophthalmologist.
Increased tearing (Common (5-10%))
This is temporary. No action needed unless severe.

🚨 Serious Side Effects

Corneal erosion or ulcer (Rare (<0.1%))
Seek immediate medical attention if you experience severe eye pain, redness, or vision loss.
Delayed wound healing (Rare (<0.1%))
Contact your eye doctor if the surgical site does not heal as expected.
Increased bleeding tendency (Rare (<0.1%))
Inform your doctor if you notice unusual bleeding or bruising.
Allergic reaction (Rare (<0.1%))
Stop using the medicine and seek immediate medical help if you experience swelling of the face, lips, or throat, or difficulty breathing.

⚠️ Rare Side Effects

Corneal perforation
Seek emergency medical care immediately.
Severe anterior segment inflammation
Contact your ophthalmologist right away.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Warfarin Major
Other topical NSAIDs Major
Topical corticosteroids Moderate
Antiglaucoma medications Moderate
Other eye drops Minor

🚨 Major Interactions

  • Other topical NSAIDs
  • Anticoagulants (e.g., warfarin)

⚡ Moderate Interactions

  • Corticosteroids (topical ocular)
  • Antiglaucoma medications

🍷 Alcohol Interaction

No known interaction between this medicine and alcohol. However, alcohol may increase the risk of gastrointestinal bleeding if the medicine is absorbed systemically. Consult your doctor for personalized advice.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Hypersensitivity to nepafenac or any component of the formulation","Hypersensitivity to other NSAIDs","Active corneal epithelial herpes simplex keratitis","Use in patients wearing contact lenses during the postoperative period"]

⚠️ Warnings & Precautions

["For ophthalmic use only. Do not inject or take orally.","Use with caution in patients with bleeding disorders or on anticoagulants.","May delay wound healing; monitor after surgery.","Do not use if the suspension is discolored or contains particles.","Avoid contact of the dropper tip with any surface to prevent contamination.","Remove contact lenses before use and wait 10 minutes before reinserting.","Consult your doctor if symptoms persist or worsen."]

🤱 Lactation Safety

It is not known whether nepafenac is excreted in human breast milk. Caution should be exercised when used by a breastfeeding woman. Consult your doctor.

💊 Overdose Management

Overdose with this medicine is unlikely due to its ophthalmic route. If accidental ingestion occurs, seek medical attention. In case of excessive eye exposure, flush the eye with water and consult a doctor.

⏰ Missed Dose

If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Additional Safety Advice

General Safety

Use this medicine exactly as prescribed by your eye doctor. Wash your hands before and after applying the drops. Do not touch the dropper tip to your eye or any surface to avoid contamination. If you wear contact lenses, remove them before application and wait at least 10 minutes before reinserting, unless your doctor advises otherwise. Do not use this medicine if the suspension is discolored or contains particles. Avoid driving or operating machinery immediately after instillation if your vision is temporarily blurred. Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Do not use this medicine for any condition other than the one for which it was prescribed. Keep out of reach of children. Discard the bottle 4 weeks after opening, or as directed by your pharmacist.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more susceptible to corneal adverse events and bleeding. Use with caution and monitor closely.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, consult your doctor before using this medicine. It should be used only if clearly needed.

🏥 Post-Surgery Considerations

This medicine is specifically used after cataract surgery. Follow your surgeon's instructions for use and attend all postoperative visits.

🦷 Dental Procedures

Inform your dentist if you are using this medicine, as it may increase bleeding risk during dental procedures.

💚 Lifestyle Tips for Better Results

🏃
Avoid rubbing your eyes after surgery.
🥗
Wear sunglasses to protect your eyes from bright light and wind.
😴
Follow a healthy diet rich in vitamins A, C, and E for eye health.
💧
Get adequate rest and avoid strenuous activities that may increase eye pressure.
🧘
Attend all follow-up appointments with your eye doctor.

🏋️ Exercise Considerations

Avoid strenuous exercise or activities that increase intraocular pressure, such as heavy lifting or bending, immediately after eye surgery. Consult your doctor before resuming exercise.

🥗 Diet Recommendations

Include foods rich in omega-3 fatty acids, such as fish and flaxseeds.
Eat plenty of fruits and vegetables rich in antioxidants.
Stay well hydrated to maintain eye moisture.
Limit caffeine and alcohol as they may affect hydration and healing.

💼 Impact on Daily Work & Life

You may experience temporary blurred vision after applying the drops. Avoid driving or operating heavy machinery until your vision is clear. Most patients can resume normal activities within a few days after surgery, as advised by their doctor.

🛑 When to Stop This Medicine

Stop using this medicine after the prescribed duration or as directed by your ophthalmologist. Do not stop abruptly without consulting your doctor, especially if you are still experiencing symptoms.

📅 Long-Term Use Effects

Long-term use of this medicine beyond the prescribed period is not recommended. Prolonged use may increase the risk of corneal adverse events, delayed wound healing, and increased bleeding tendency. Regular follow-up with your ophthalmologist is advised.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Cold compresses

Can help reduce eye swelling and discomfort after surgery.

Evidence: Well-established
Artificial tears

May provide symptomatic relief for dry eye after surgery.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No known interaction between this medicine and vaccines. However, consult your doctor before receiving any vaccine while using this medicine.

📦 Storage Guide

✅ DO

Store at 2°C to 25°C (36°F to 77°F)

❌ DON'T

Do not freeze

✅ DO

Keep the bottle tightly closed when not in use

❌ DON'T

Do not leave the cap off

✅ DO

Store upright

❌ DON'T

Do not store in a tilted position

✅ DO

Discard 4 weeks after opening

❌ DON'T

Do not use beyond the expiry date

✈️ Traveling with This Medicine

Carry this medicine in its original packaging with the prescription label. Keep it in your hand luggage to avoid temperature extremes. Bring a copy of your prescription in case of customs checks. If traveling across time zones, continue with your regular dosing schedule as advised by your doctor. Store the bottle upright and avoid freezing.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 65-year-old man undergoing cataract surgery
He was prescribed this medicine one day before surgery and continued for two weeks after. He reported significant reduction in postoperative pain and swelling. He emphasized the importance of shaking the bottle and not missing doses.
💡 Lesson: Consistent use as prescribed leads to better recovery and fewer complications.
👤 A 58-year-old woman with a history of bleeding disorder
She was prescribed this medicine after cataract surgery. Her doctor monitored her closely due to increased bleeding risk. She experienced mild eye discomfort but no serious bleeding. She was advised to avoid other NSAIDs.
💡 Lesson: Patients with bleeding disorders need careful monitoring while using this medicine.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Pain relief typically begins within 30 minutes to 1 hour after instillation, but full anti-inflammatory effects may take a few days.

Q: Can I use this medicine for eye allergies?

A: No, this medicine is specifically for postoperative pain and inflammation, not for allergic eye conditions.

Q: Is this medicine safe during pregnancy?

A: Consult your doctor before use. It should be used only if clearly needed.

Q: Can I wear contact lenses while using this medicine?

A: Remove contact lenses before application and wait at least 10 minutes before reinserting, unless your doctor advises otherwise.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I use this medicine for eye allergies?
  • Will it affect my vision permanently?
  • Can I drive after using this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while using this?

🔄 Substitutes for ilevro opthalmic suspension

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be used for any eye pain.
    Fact: It is specifically for postoperative eye pain and inflammation, not for general eye pain or infections.
  • Myth: More drops mean faster relief.
    Fact: Using more than prescribed does not improve results and may increase side effects.
  • Myth: It is safe to use with contact lenses.
    Fact: Contact lenses should be removed before application and not reinserted for at least 10 minutes, unless advised otherwise.

🔄 Alternative Options

Generic Alternatives

  • Nepafenac 0.3% ophthalmic suspension

Brand Alternatives

  • Nepafenac 0.3% ophthalmic suspension

📊 Comparison with Similar Medicines

[{"medicine":"Nepafenac 0.3%","class":"NSAID prodrug","frequency":"Once daily","common_use":"Post-cataract surgery"},{"medicine":"Bromfenac 0.09%","class":"NSAID","frequency":"Once daily","common_use":"Post-cataract surgery"},{"medicine":"Ketorolac 0.5%","class":"NSAID","frequency":"Four times daily","common_use":"Post-cataract surgery"}]

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