Ilevro is a nonsteroidal anti-inflammatory drug (NSAID) specifically formulated to treat eye inflammation following cataract surgery. The generic name for Ilevro is nepafenac ophthalmic suspension. It belongs to the class of NSAIDs, which are commonly used to alleviate pain and inflammation. Ilevro is an FDA-approved medication that has gained popularity due to its effectiveness and safety in treating postoperative inflammation.

After cataract surgery, patients may experience inflammation in the eye, leading to discomfort and potential complications. Inflammation is a natural response of the body to surgery, but excessive inflammation can impede the healing process and hinder vision improvement. That’s where Ilevro comes into play. By using Ilevro as prescribed, patients can minimize inflammation and promote a smooth recovery, ultimately leading to better visual outcomes.

Ilevro works by inhibiting the production of prostaglandins, which are hormone-like substances involved in inflammation and pain. The active ingredient, nepafenac, is a prodrug that is converted into its active form, amfenac, by ocular tissue enzymes. Amfenac then exerts its anti-inflammatory effects by targeting cyclooxygenase (COX) enzymes, responsible for prostaglandin synthesis. By reducing the levels of prostaglandins, Ilevro helps suppress inflammation and minimize postoperative pain.

Ilevro is primarily intended for patients who have undergone cataract surgery and are experiencing eye inflammation as a result. It is essential to follow the prescribing doctor’s instructions carefully to ensure optimal results and minimize potential side effects. While Ilevro is highly effective for postoperative inflammation, it may not be suitable for everyone. Patients with certain medical conditions or allergies to the ingredients in Ilevro should avoid its use. Always consult with your healthcare provider to determine if Ilevro is the right choice for your specific needs.

Warnings and Precautions

While it can be highly effective in treating the intended conditions, it is essential to be aware of its potential risks and take necessary precautions for safe usage.

  1. Allergic Reactions: If you have a known allergy to any of the components in Ilevro, do not use the medication. Allergic reactions can lead to severe complications and require immediate medical attention.
  2. Eye Infections: Prior to starting Ilevro, ensure that you don’t have any active eye infections. Using Ilevro in such conditions can worsen the infection and delay healing.
  3. Underlying Eye Conditions: If you have pre-existing eye conditions, such as glaucoma or retinal issues, consult your ophthalmologist before using Ilevro. Some conditions may require adjustments in the treatment plan.
  4. Contact Lenses: Avoid wearing contact lenses while using Ilevro. Contact lenses can hinder the proper absorption of the medication and affect its effectiveness.
  5. Pregnancy and Breastfeeding: Pregnant or breastfeeding individuals should exercise caution and consult their healthcare provider before using Ilevro. The potential risks and benefits must be evaluated before starting the medication.
  6. Children and Adolescents: The safety and efficacy of Ilevro have not been established in children and adolescents below 18 years of age. Use in this age group should be done under close medical supervision.
  7. Systemic Absorption: Ilevro can be systemically absorbed, leading to interactions with other medications. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
  8. Intraocular Pressure: Ilevro may cause a temporary increase in intraocular pressure. Regular monitoring is necessary, especially for individuals with a history of glaucoma.
  9. Delayed Healing: Ilevro may delay wound healing, which is why it’s essential to follow your surgeon’s instructions on post-operative care.
  10. Corneal Effects: Long-term use of corticosteroids like Ilevro may lead to corneal thinning or perforation. Use the medication only for the prescribed duration.
  11. Cataract Formation: Prolonged use of corticosteroids can increase the risk of cataract development. Regular eye examinations can help detect cataracts early.
  12. Immunosuppression: Ilevro can suppress the immune response in the eye, increasing the risk of infections. Avoid exposure to contagious diseases and maintain good hygiene.
  13. Elevated Blood Sugar: Diabetic individuals using Ilevro should monitor their blood sugar levels regularly, as corticosteroids can lead to hyperglycemia.
  14. Tapering Off: Do not stop using Ilevro abruptly. Follow the prescribed tapering schedule to prevent withdrawal symptoms.
  15. Cataract Surgery Complications: In some cases, Ilevro may not prevent complications from cataract surgery. Discuss potential risks with your surgeon.
  16. Driving and Machinery: Ilevro may cause blurred vision temporarily. Avoid driving or operating heavy machinery until your vision stabilizes.
  17. Eye Trauma: If you experience eye trauma while using Ilevro, seek immediate medical attention.
  18. Storage: Store Ilevro at the recommended temperature and away from direct sunlight. Do not use expired medications.
  19. Missed Dose: If you miss a dose, take it as soon as you remember. If it’s almost time for the next dose, skip the missed dose and resume your regular schedule.
  20. Overdose: If you suspect an overdose, contact your healthcare provider or seek emergency medical assistance immediately.
  21. Non-Transferable: Do not share Ilevro with others, even if they have similar symptoms. It is prescribed specifically for your condition.
  22. Patient Counseling: Discuss your medical history, allergies, and medications with your healthcare provider before using Ilevro.
  23. Side Effects: Be aware of common side effects like eye redness, itching, and blurred vision. If they persist or worsen, inform your doctor.
  24. Alcohol and Tobacco: Avoid excessive alcohol consumption and tobacco use, as they can interfere with the effectiveness of Ilevro.
  25. Follow-up Visits: Attend all follow-up appointments with your ophthalmologist to ensure the medication’s efficacy and safety.

Side Effects

While it is generally well-tolerated, like any medication, it may cause side effects in some individuals.

Common Side Effects

  1. Eye Irritation: Mild eye irritation, such as a burning or stinging sensation, may occur after using Ilevro. This reaction is usually temporary and should subside on its own.
  2. Blurred Vision: Some patients may experience temporary blurred vision immediately after instilling the eye drops. It typically resolves within a short period.
  3. Eye Redness: Ilevro can cause mild eye redness, which is a common side effect of many eye drops. This redness is generally not a cause for concern and should improve over time.
  4. Watery Eyes: Excessive tearing or watery eyes can occur as the eyes respond to the medication. This is usually transient and poses no long-term risks.
  5. Sensitivity to Light: Some individuals may become more sensitive to light while using Ilevro. Wearing sunglasses can help alleviate this discomfort.

Rare Side Effects

  1. Allergic Reactions: Although rare, some people may experience allergic reactions to Ilevro. Signs of an allergic response include severe eye itching, swelling, rash, or difficulty breathing. If you observe any of these symptoms, seek immediate medical attention.
  2. Corneal Problems: In rare cases, Ilevro may cause corneal problems, such as corneal edema (swelling) or corneal erosion. These issues may manifest as eye pain, changes in vision, or increased sensitivity. Prompt medical evaluation is necessary if you encounter any of these symptoms.
  3. Eye Infections: While uncommon, some patients may develop eye infections while using Ilevro. Symptoms may include eye redness, discharge, pain, and vision changes. If you suspect an infection, consult your eye care professional promptly.

Severe Side Effects

  1. Increased Eye Pressure: In some individuals, Ilevro may elevate intraocular pressure, a condition known as ocular hypertension. This complication requires immediate medical attention to prevent further damage to the eyes.
  2. Cataract Formation: Prolonged or frequent use of Ilevro may contribute to cataract development in some patients. If you notice any changes in your vision, especially cloudiness, consult your eye doctor.
  3. Delayed Wound Healing: Ilevro may slow down the healing process of the eye after surgery in rare cases. If you experience prolonged redness, pain, or discharge, inform your healthcare provider.
  4. Endophthalmitis: While extremely rare, endophthalmitis is a severe eye infection that can occur after cataract surgery and Ilevro use. Symptoms include severe pain, vision loss, and eye redness. Seek immediate medical attention if you suspect this complication.
  5. Retinal Detachment: There have been reports of retinal detachment associated with the use of certain eye drops, including Ilevro. If you experience sudden flashes of light, floaters, or a curtain-like shadow in your vision, seek emergency care.
  6. Vision Changes: Severe vision changes, such as sudden vision loss or significant blurriness, should not be ignored. These symptoms require immediate evaluation by an eye care professional.


While it offers effective relief, it’s essential to understand its interactions with other substances, such as drugs, herbs, and food.

Drug Interactions

  1. Anticoagulants: Combining Ilevro with anticoagulants like warfarin may increase the risk of bleeding. It’s crucial for your healthcare provider to monitor your blood clotting levels closely if you are on both medications simultaneously.
  2. Corticosteroids: The concomitant use of corticosteroids with Ilevro can heighten the risk of eye issues, such as delayed wound healing. Your doctor may adjust the dosages or closely monitor your condition if both medications are necessary.
  3. Other NSAIDs: Using multiple NSAIDs simultaneously can elevate the risk of adverse effects without increasing the therapeutic benefit. Avoid using other NSAIDs while using Ilevro unless specifically instructed by your doctor.
  4. Aspirin: While Ilevro is an NSAID, it may not have the same protective effect on the heart as aspirin. If you are on an aspirin regimen, consult your healthcare provider before starting Ilevro.
  5. Methotrexate: Using Ilevro along with methotrexate may increase the toxicity of methotrexate. Your doctor may monitor your methotrexate levels and adjust the dosage accordingly.
  6. Selective Serotonin Reuptake Inhibitors (SSRIs): Combining SSRIs with Ilevro may increase the risk of bleeding. If you are taking SSRIs for depression or anxiety, inform your doctor before starting Ilevro.

Herbal Interactions

  1. Ginkgo Biloba: Ginkgo biloba is a popular herbal supplement known for its potential to improve circulation. However, it may increase the risk of bleeding when used alongside Ilevro. Consult your doctor before using ginkgo biloba while on Ilevro.
  2. Garlic and Ginseng: Both garlic and ginseng are believed to have various health benefits. However, they can also thin the blood, potentially enhancing the bleeding risk when taken with Ilevro.
  3. St. John’s Wort: St. John’s Wort is a herbal remedy often used to alleviate depression. When combined with Ilevro, it may reduce the effectiveness of the medication. Inform your doctor if you are taking St. John’s Wort.
  4. Echinacea: Echinacea is commonly used to boost the immune system. However, it may interfere with Ilevro’s anti-inflammatory effects. Consult your doctor before using echinacea with Ilevro.
  5. Feverfew: Feverfew is known for its potential to reduce migraines. However, it can also increase the risk of bleeding. Use with caution when taking Ilevro.

Food Interactions

  1. Avoid Alcohol: Alcohol consumption may increase the risk of stomach irritation when taking Ilevro. It’s best to avoid or limit alcohol intake during the treatment period.
  2. Maintain a Healthy Diet: A nutritious diet rich in fruits, vegetables, whole grains, and lean proteins can support the healing process and optimize the benefits of Ilevro.
  3. Stay Hydrated: Drinking plenty of water is essential to stay hydrated and maintain overall health, which can positively impact your recovery.
  4. Limit Caffeine: Excessive caffeine intake may lead to dehydration, which can affect the efficacy of Ilevro. Limit your caffeine consumption during the treatment period.
  5. Avoid Grapefruit: While Ilevro is not known to interact with grapefruit, it’s best to avoid consuming large amounts of grapefruit or grapefruit juice with any medication to minimize the risk of potential interactions.

Do’s and Dont’s

When using Ilevro, there are some essential dos and don’ts to keep in mind to ensure its effectiveness and safety.


  • Follow Your Doctor’s Instructions: Always adhere to your doctor’s prescribed dosage and administration schedule.
  • Wash Hands Before Use: Before applying Ilevro, wash your hands thoroughly to avoid contaminating the medication.
  • Store Properly: Keep Ilevro at room temperature and away from direct sunlight.
  • Continue Regular Check-ups: Attend follow-up appointments with your eye specialist to monitor progress.


  • Double Dose: Never double the dosage if you miss an application. Stick to the regular schedule or consult your doctor if you’re unsure.
  • Share Medication: Ilevro is prescribed for individual use and should not be shared with others, even if they have similar symptoms.
  • Drive or Operate Machinery: Ilevro may cause temporary blurred vision. Avoid driving or operating machinery until your vision has returned to normal.

How to Use

Proper administration of Ilevro ensures that the medication reaches its intended target and provides the desired results.

  1. Wash your hands thoroughly before handling the eye drops.
  2. Tilt your head slightly backward and pull down the lower eyelid to create a small pocket.
  3. Hold the Ilevro bottle upside down and squeeze one drop into the pocket formed by the lower eyelid.
  4. Close your eye gently and apply slight pressure on the inner corner of your eye for about one minute. This prevents the medication from draining into the tear duct.
  5. If you need to apply drops to both eyes, repeat the process for the other eye.


Proper dosing is crucial for its effectiveness and safety.

Initial Dosing

To initiate Ilevro treatment, the standard recommended dosage is one drop of the ophthalmic solution applied to the affected eye(s) once a day. This administration typically begins on the day before cataract surgery and continues on the day of the surgery and the following weeks, as prescribed by your healthcare provider.

Maintenance Dosing

Following the initial dosing period, your healthcare provider may adjust the dosing schedule. In most cases, the maintenance dosing involves applying one drop of Ilevro to the affected eye(s) once daily for up to 2 weeks after cataract surgery. However, individual variations may occur, so it is essential to strictly follow your healthcare provider’s instructions.

Missed Dose

If you accidentally miss a dose of Ilevro, don’t panic. Simply apply the missed dose as soon as you remember it, unless it is already time for the next scheduled dose. In that case, skip the missed dose and proceed with the regular dosing schedule. Avoid doubling the dose to compensate for the missed one.


Using more Ilevro than prescribed can lead to an overdose, which could result in adverse effects. If you suspect an overdose or experience severe eye irritation, immediately seek medical attention. Be sure to inform your healthcare provider about the exact amount of medication used, the timing, and any symptoms you may be experiencing.


Whether you are a patient using Ilevro for post-operative eye inflammation or a healthcare professional responsible for dispensing the medication, following the ideal storing guidelines is essential to maintain its quality and maximize its benefits.

  1. Keep Ilevro in a Cool Place: Store the eye drops at a temperature between 2°C to 8°C (36°F to 46°F). Avoid exposing the medication to extreme heat or freezing temperatures.
  2. Protect from Light: Ilevro is sensitive to light. Always store the container in the original carton to shield it from direct sunlight or artificial light.
  3. Refrigerate Ilevro when Unopened: If the eye drops are unopened, keep them in the refrigerator as per the recommended temperature range.
  4. Do Not Freeze: While refrigeration is necessary, do not freeze Ilevro, as freezing may compromise its efficacy.
  5. Allow Warm-up Time: When removing Ilevro from the refrigerator, allow the container to reach room temperature before using it. Cold eye drops may cause discomfort when instilled into the eyes.
  6. Check for Particles or Discoloration: Before each use, inspect the eye drops for any particles or changes in color. If you notice any abnormalities, do not use the medication and consult your healthcare provider.
  7. Avoid Contamination: Always use clean hands while handling the eye drops to prevent contamination.
  8. Keep the Container Tightly Closed: After each use, ensure the container is tightly closed to prevent air and moisture from affecting the medication.
  9. Write the Date of First Opening: Upon opening the Ilevro container, write down the date of first use on the carton. This will help you keep track of the medication’s expiration date.
  10. Store Away from Children and Pets: Keep Ilevro out of reach of children and pets to avoid accidental ingestion.
  11. Do Not Share Ilevro: Do not share your eye drops with anyone else, even if they have similar eye conditions.
  12. Avoid Transferring Ilevro to Other Containers: Transferring the medication to another container may lead to contamination or degradation. Always use the original container provided by the manufacturer.
  13. Dispose of Expired Medication Properly: Check the expiration date on the carton and discard any unused or expired Ilevro following the recommended disposal guidelines.
  14. Keep Ilevro Upright: Store the eye drop container in an upright position to prevent leakage and maintain proper dosing.
  15. Do Not Use If Seal is Broken: If the safety seal on the container is broken or missing, do not use the eye drops and request a replacement from your healthcare provider or pharmacist.
  16. Store Away from Heat Sources: Avoid storing Ilevro near heat sources such as stoves, radiators, or heating vents.
  17. Keep Ilevro in Original Packaging: To ensure proper identification and instructions, store Ilevro in its original packaging with the product label intact.
  18. Avoid Exposure to Humidity: High humidity levels can affect the stability of Ilevro. Store the medication in a dry environment.
  19. Keep Track of Dosage Instructions: If your healthcare provider has prescribed a specific dosage regimen, ensure you follow it diligently.
  20. Follow Storage Recommendations After Use: After applying the eye drops, make sure to store the container following the same guidelines mentioned above.
  21. Inform Your Healthcare Provider of Any Changes: If you experience any changes in the medication’s appearance or efficacy, inform your healthcare provider immediately.
  22. Store Away from Toilets and Sinks: Avoid keeping Ilevro near toilets or sinks, as accidental spills may occur.
  23. Keep Ilevro Away from Allergens: Store the medication away from potential allergens or contaminants that could compromise its quality.
  24. Avoid Extreme Humidity in Bathroom Storage: Bathrooms can have high humidity levels due to showers, which may not be suitable for storing Ilevro.
  25. Educate Yourself About Ilevro Storage: Understanding the ideal storage guidelines for Ilevro is crucial for maintaining its potency and ensuring effective treatment.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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