Nepafenac

Identification

Summary

Nepafenacis an ophthalmic NSAID used for the symptomatic treatment of pain and inflammation associated with cataract surgery.

Brand Names
Ilevro, Nevanac
Generic Name
Nepafenac
DrugBank Accession Number
DB06802
Background

Nepafenac is a non-steroidal anti-inflammatory prodrug (NSAID) usually sold as a prescription eye drop. It is used to treat pain and inflammation associated with cataract surgery.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Weight
Average: 254.2839
Monoisotopic: 254.105527702
Chemical Formula
C15H14N2O2
Synonyms
  • 2-amino-3-benzoylbenzeneacetamide
  • Nepafenac
  • Népafénac
  • Nepafenaco
  • Nepafenacum
External IDs
  • AHR 9434
  • AHR-9434
  • AL 6515
  • AL-6515

Pharmacology

Indication

For the treatment of pain and inflammation associated with cataract surgery.

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Associated Conditions
Contraindications & Blackbox Warnings
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Pharmacodynamics

Low but quantifiable plasma concentrations of nepafenac and amfenac were observed in the majority of subjects 2 and 3 hours postdose, respectively, following bilateral topical ocular TID dosing of nepafenac ophthalmic suspension, 0.1%. The mean steady-state Cmax for nepafenac and for amfenac were 0.310 ± 0.104 ng/ml and 0.422 ± 0.121 ng/ml, respectively, following ocular administration.

Mechanism of action

Nepafenac is a prodrug. After penetrating the cornea, nepafenac undergoes rapid bioactivation to amfenac, which is a potent NSAID that uniformly inhibits the COX1 and COX2 activity.

Target Actions Organism
UProstaglandin G/H synthase 1
inhibitor
Humans
UProstaglandin G/H synthase 2
inhibitor
Humans
Absorption

Nepafenac rapidly cross the cornea (6 times faster than diclofenac in vitro).

Volume of distribution

Not Available

Protein binding

Amfenac has high affinity toward serum albumin proteins. In vitro, the percent bound to human albumin and human serum was 95.4% and 99.1% respectively.

Metabolism

Nepafenac (prodrug) is deaminated to amfenac (active compound) in the ciliary body epithelium, retina, and choroid by intraocular hydrolases. Subsequently, amfenac undergoes extensive metabolism to more polar metabolites involving hydroxylation of the aromatic ring leading to glucuronide conjugate formation.

Route of elimination

After oral administration of 14C-nepafenac to healthy volunteers, urinary excretion was found to be the major route of radioactivity elimination, accounting for approximately 85% of the dose, while fecal excretion represented approximately 6% of the dose. Nepafenac (prodrug) and amfenac (active compound) were not quantifiable in the urine.

Half-life

Not Available

Clearance

Not Available

Adverse Effects
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Toxicity

Ocularly applied non-steroidal anti-inflammatory drugs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery.

Pathways
Pathway Category
Nepafenac Action Pathway Drug action
Pharmacogenomic Effects/ADRsBrowse all" title="" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
Not Available

Interactions

Drug InteractionsLearn More" title="" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction
Aceclofenac The risk or severity of adverse effects can be increased when Aceclofenac is combined with Nepafenac.
Acemetacin The risk or severity of adverse effects can be increased when Nepafenac is combined with Acemetacin.
Acetylsalicylic acid The therapeutic efficacy of Acetylsalicylic acid can be decreased when used in combination with Nepafenac.
Alclofenac The risk or severity of adverse effects can be increased when Nepafenac is combined with Alclofenac.
Aminophenazone The risk or severity of adverse effects can be increased when Aminophenazone is combined with Nepafenac.
Aminosalicylic acid The therapeutic efficacy of Aminosalicylic acid can be decreased when used in combination with Nepafenac.
Amitriptyline The risk or severity of gastrointestinal bleeding can be increased when Amitriptyline is combined with Nepafenac.
Amitriptylinoxide The risk or severity of gastrointestinal bleeding can be increased when Amitriptylinoxide is combined with Nepafenac.
Amoxapine The risk or severity of gastrointestinal bleeding can be increased when Amoxapine is combined with Nepafenac.
Antipyrine The risk or severity of adverse effects can be increased when Antipyrine is combined with Nepafenac.
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Food Interactions
No interactions found.

Products

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Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start 营销结束 Region Image
Ilevro Suspension / drops 3 mg/1mL Ophthalmic Novartis Pharmaceuticals Corporation 2012-12-20 Not applicable US flag
Ilevro Suspension 0.3 % w/v Ophthalmic Novartis 2014-06-01 Not applicable Canada flag
Ilevro Suspension 3 mg/1mL Ophthalmic ALCON LABORATORIES, INC. 2012-12-20 2021-11-30 US flag
Nevanac Suspension / drops 1 mg/1mL Ophthalmic ALCON LABORATORIES, INC. 2005-09-06 2023-04-30 US flag
Nevanac Suspension / drops 3 mg/ml Ophthalmic Novartis Europharm Limited 2020-12-23 Not applicable EU flag
Nevanac Suspension 0.1 % w/v Ophthalmic Novartis 2008-08-21 Not applicable Canada flag
Nevanac Suspension 1 mg/1mL Ophthalmic Physicians Total Care, Inc. 2011-08-31 Not applicable US flag
Nevanac Suspension / drops 1 mg/ml Ophthalmic Novartis Europharm Limited 2020-12-23 Not applicable EU flag
Nevanac Suspension / drops 3 mg/ml Ophthalmic Novartis Europharm Limited 2020-12-23 Not applicable EU flag
Nevanac Suspension / drops 1 mg/1mL Ophthalmic Novartis Pharmaceuticals Corporation 2005-09-06 Not applicable US flag

Categories

ATC Codes
S01BC10 — Nepafenac
Drug Categories
Chemical TaxonomyProvided byClassyfire
Description
This compound belongs to the class of organic compounds known as benzophenones. These are organic compounds containing a ketone attached to two phenyl groups.
Kingdom
Organic compounds
Super Class
Benzenoids
Class
Benzene and substituted derivatives
Sub Class
Benzophenones
Direct Parent
Benzophenones
Alternative Parents
二苯基甲烷s/Aryl-phenylketones/Phenylacetamides/Benzoyl derivatives/Aniline and substituted anilines/Vinylogous amides/Primary carboxylic acid amides/Amino acids and derivatives/Primary amines/Organopnictogen compounds
show 2 more
Substituents
Amine/Amino acid or derivatives/Aniline or substituted anilines/Aromatic homomonocyclic compound/Aryl ketone/Aryl-phenylketone/Benzophenone/Benzoyl/Carbonyl group/Carboxamide group
show 14 more
Molecular Framework
Aromatic homomonocyclic compounds
External Descriptors
monocarboxylic acid amide (CHEBI:75922)
Affected organisms
Not Available

Chemical Identifiers

UNII
0J9L7J6V8C
CAS number
78281-72-8
InChI Key
QEFAQIPZVLVERP-UHFFFAOYSA-N
InChI
InChI=1S/C15H14N2O2/c16-13(18)9-11-7-4-8-12(14(11)17)15(19)10-5-2-1-3-6-10/h1-8H,9,17H2,(H2,16,18)
IUPAC Name
2-(2-amino-3-benzoylphenyl)acetamide
SMILES
NC(=O)CC1=CC=CC(C(=O)C2=CC=CC=C2)=C1N

References

General References
  1. Gamache DA, Graff G, Brady MT, Spellman JM, Yanni JM: Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: I. Assessment of anti-inflammatory efficacy. Inflammation. 2000 Aug;24(4):357-70. [Article]
  2. Ke TL, Graff G, Spellman JM, Yanni JM: Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: II. In vitro bioactivation and permeation of external ocular barriers. Inflammation. 2000 Aug;24(4):371-84. [Article]
  3. Lane SS, Modi SS, Lehmann RP, Holland EJ: Nepafenac ophthalmic suspension 0.1% for the prevention and treatment of ocular inflammation associated with cataract surgery. J Cataract Refract Surg. 2007 Jan;33(1):53-8. [Article]
  4. Walters T, Raizman M, Ernest P, Gayton J, Lehmann R: In vivo pharmacokinetics and in vitro pharmacodynamics of nepafenac, amfenac, ketorolac, and bromfenac. J Cataract Refract Surg. 2007 Sep;33(9):1539-45. [Article]
  5. 沃特伯里LD Bucci FA Jr: Re:制药acokinetics and pharmacodynamics of nepafenac, amfenac, ketorolac, and bromfenac. J Cataract Refract Surg. 2008 Aug;34(8):1226; author reply 1226-7. doi: 10.1016/j.jcrs.2008.05.019. [Article]
  6. FDA Approved Drug Products: NEVANAC (nepafenac) suspension [Link]
Human Metabolome Database
HMDB0015678
KEGG Drug
D05143
PubChem Compound
151075
PubChem Substance
99443294
ChemSpider
133160
BindingDB
50228731
RxNav
298665
ChEBI
75922
ChEMBL
CHEMBL1021
ZINC
ZINC000005162311
PharmGKB
PA165958407
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Nepafenac
FDA label
Download (119 KB)
MSDS
Download (58.1 KB)

Clinical Trials

Clinical TrialsLearn More" title="" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count
4 Completed Not Available Cataract Surgery 1
4 Completed Not Available Cataracts 1
4 Completed Not Available Intraocular Pressure (IOP) 1
4 Completed Not Available Vitrectomy therapy 1
4 Completed Prevention Cataracts 1
4 Completed Prevention Epiretinal Membranes 1
4 Completed Prevention Macular Edema 1
4 Completed Prevention Macular Edema, Cystoid 1
4 Completed Treatment Cataracts 2
4 Completed Treatment Cataracts/Macular Edema, Cystoid 1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
Form Route Strength
Suspension / drops Ophthalmic 0.1 %
Suspension Ophthalmic 0.3 % w/v
Suspension Ophthalmic 3 mg/1mL
Suspension / drops Ophthalmic 3 mg/1mL
Suspension Ophthalmic
Suspension Conjunctival; Ophthalmic 3 mg
Suspension Ophthalmic 3 mg
Suspension Conjunctival; Ophthalmic 1 mg
Solution / drops Ophthalmic
Solution / drops Ophthalmic 1 MG/ML
Solution / drops Ophthalmic 3 MG/ML
Suspension Ophthalmic 0.1 % w/v
Suspension Ophthalmic 1 mg/1mL
Suspension / drops Ophthalmic 1 mg/1mL
Suspension / drops Ophthalmic 1 mg/ml
Suspension / drops Ophthalmic 3 mg/ml
Suspension Ophthalmic 0.1 %
Suspension Ophthalmic 1.0 mg/ml
Suspension Ophthalmic 1 mg
Prices
Not Available
Patents
Patent Number Pediatric Extension Approved Expires (estimated) Region
US7834059 No 2010-11-16 2027-01-31 US flag
US8071648 No 2011-12-06 2025-12-02 US flag
US8324281 No 2012-12-04 2025-12-02 US flag
US7947295 No 2011-05-24 2024-06-08 US flag
US6403609 No 2002-06-11 2018-07-17 US flag
US8921337 No 2014-12-30 2032-03-31 US flag
US9662398 No 2017-05-30 2030-12-01 US flag

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
Property Value Source
Water Solubility 0.0197 mg/mL ALOGPS
logP 1.53 ALOGPS
logP 2.08 Chemaxon
logS -4.1 ALOGPS
pKa (Strongest Acidic) 15.82 Chemaxon
pKa (Strongest Basic) 1.83 Chemaxon
Physiological Charge 0 Chemaxon
Hydrogen Acceptor Count 3 Chemaxon
Hydrogen Donor Count 2 Chemaxon
Polar Surface Area 86.18 Å2 Chemaxon
Rotatable Bond Count 4 Chemaxon
Refractivity 74.46 m3·mol-1 Chemaxon
Polarizability 26.67 Å3 Chemaxon
Number of Rings 2 Chemaxon
Bioavailability 1 Chemaxon
Rule of Five Yes Chemaxon
Ghose Filter Yes Chemaxon
Veber's Rule No Chemaxon
MDDR-like Rule No Chemaxon
Predicted ADMET Features
Property Value Probability
Human Intestinal Absorption + 0.9624
Blood Brain Barrier + 0.9918
Caco-2 permeable + 0.5581
P-glycoprotein substrate Non-substrate 0.7608
P-glycoprotein inhibitor I Non-inhibitor 0.5471
P-glycoprotein inhibitor II Non-inhibitor 0.9209
Renal organic cation transporter Non-inhibitor 0.8641
CYP450 2C9 substrate Non-substrate 0.8471
CYP450 2D6 substrate Non-substrate 0.827
CYP450 3A4 substrate Non-substrate 0.6542
CYP450 1A2 substrate Inhibitor 0.6993
CYP450 2C9 inhibitor Inhibitor 0.547
CYP450 2D6 inhibitor Non-inhibitor 0.882
CYP450 2C19 inhibitor Inhibitor 0.5714
CYP450 3A4 inhibitor Non-inhibitor 0.7118
CYP450 inhibitory promiscuity High CYP Inhibitory Promiscuity 0.7441
Ames test Non AMES toxic 0.6193
Carcinogenicity Non-carcinogens 0.6932
Biodegradation Not ready biodegradable 0.719
Rat acute toxicity 2.0064 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.9797
hERG inhibition (predictor II) Non-inhibitor 0.7681
ADMET data is predicted usingadmetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
Spectrum Spectrum Type Splash Key
Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
MS/MS Spectrum - , positive LC-MS/MS splash10-03dr-1490000000-433d63cd52e5b86417da

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Prostaglandin-endoperoxide synthase activity
Specific Function
Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Involved in the constitutive production of prostanoids in particular in the stomach and platelets. In gas...
Gene Name
PTGS1
Uniprot ID
P23219
Uniprot Name
Prostaglandin G/H synthase 1
分子量
68685.82 Da
References
  1. Gamache DA, Graff G, Brady MT, Spellman JM, Yanni JM: Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: I. Assessment of anti-inflammatory efficacy. Inflammation. 2000 Aug;24(4):357-70. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Prostaglandin-endoperoxide synthase activity
Specific Function
Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Constitutively expressed in some tissues in physiological conditions, such as the endothelium, kidney and...
Gene Name
PTGS2
Uniprot ID
P35354
Uniprot Name
Prostaglandin G/H synthase 2
分子量
68995.625 Da
References
  1. Gamache DA, Graff G, Brady MT, Spellman JM, Yanni JM: Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: I. Assessment of anti-inflammatory efficacy. Inflammation. 2000 Aug;24(4):357-70. [Article]

Drug created at September 14, 2010 16:21 / Updated at April 28, 2023 03:25