Sulfasalazine
Contraindicated
Textbook
Exacerbation of inflammatory bowel disease (IBD).
Avoid combining sulfasalazine with traditional NSAIDs.
Source: G&G 14e · p1112
Drug reference
Nepafenac
NSAID · Ophthalmic anti-inflammatory
Also known as Nevanac
NSAIDOphthalmic anti-inflammatory
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Not recommended for pregnant women.
FDA category + note
Top interactionssee all 12 →
- SulfasalazineContraindicatedTextbookG&G 14e · p1112
- AminoglycosideSevereTextbookKDT 7e · p746
- AminoglycosidesSevereTextbookKDT 7e
- AnticoagulantsSevereTextbookKDT 7e
Mechanism
Nepafenac is a non-steroidal anti-inflammatory drug (NSAID) and a phenylacetic acid derivative. It is presumed to exert its anti-inflammatory effects by inhibiting cyclooxygenase (COX) enzymes. This inhibition reduces the synthesis of prostaglandins, which are key mediators of inflammation and pain.
Indications
Prophylaxis and treatment of postoperative pain and inflammation associated with cataract surgeryReduction in the risk of postoperative macular oedema associated with cataract surgery in diabetic patientspostoperative pain and inflammation (after cataract surgery)
Dosing
- Adult
- Consult product literature for dosage TO THE EYE
Contraindications
- Corneal epithelial breakdown (discontinue immediately if evidence of)
- Pregnancy
- Lactation
- Children
Side effects
Common
Eye discomfortEye disordersEye inflammation
Serious
- Corneal epithelial breakdown
- Allergic dermatitis
- Corneal deposits
- Dizziness
- Dry eye
- Headache
- Nausea
- Cutis laxa
- Vision disorders
- Vomiting
- sterile corneal melts
- perforations (especially in older patients with ocular surface disease)
Pregnancy & lactation
Pregnancy
Not recommended for pregnant women.
Lactation
Not recommended for nursing mothers.
Drug interactions
Aminoglycoside
Severe
Textbook
Increased risk of nephrotoxicity.
Avoid concurrent use.
Source: KDT 7e · p746
Aminoglycosides
Severe
Textbook
Increased aminoglycoside levels and potential toxicity.
Monitor aminoglycoside levels and renal function; adjust dosage as needed.
Source: KDT 7e
Anticoagulants
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider alternative analgesics or gastroprotective agents.
Source: KDT 7e
Ciprofloxacin
Severe
Textbook
Enhanced CNS toxicity, seizures reported.
Source: KDT 7e
Citalopram
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Corticosteroids
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents.
Source: KDT 7e
Dapoxetine
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Enalaprilat
Severe
Textbook
Reduced effectiveness of ACE inhibitors. Marked hyperkalemia, potentially leading to cardiac arrhythmia.
Use with caution, especially in the elderly and in patients with hypertension, diabetes mellitus, or ischemic heart disease.
Source: G&G 14e · p836
Escitalopram + Clonazepam
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Escitalopram
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Fluoxetine
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Related guidelines
Diabetic retinopathy
RSSDI · Ophthalmology · 2023
Diabetic retinopathy
AIOS · Ophthalmology · 2023
Inflammatory bowel disease
OTHER · Gastroenterology · 2015
Preventive care in inflammatory bowel disease
ACG · Gastroenterology · 2025
Preoperative cardiac evaluation for non-cardiac surgery
AHA · Cardiology · 2025
Other NSAID drugs
Ask House about Nepafenac
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, BNF·Verified: 2026-05-10 · House clinical team