Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension

Bruce I Gaynes1,2, Anne Onyekwuluje11Departments of Ophthalmology and 2Pharmacology, Rush College of Medicine, Chicago, Illinois, USAAbstract: The removal of diclofenac sodium ophthalmic solution as a viable pharmaceutical entity in September 1999 from the US market spurred considerable interest in...

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Autores principales:	Bruce I Gaynes, Anne Onyekwuluje
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/cf3ed326b6f84751894071bf78d47dc3
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spelling	oai:doaj.org-article:cf3ed326b6f84751894071bf78d47dc32021-12-02T03:53:15ZTopical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension1177-54671177-5483https://doaj.org/article/cf3ed326b6f84751894071bf78d47dc32008-06-01T00:00:00Zhttp://www.dovepress.com/topical-ophthalmic-nsaids-a-discussion-with-focus-on-nepafenac-ophthal-a1791https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Bruce I Gaynes1,2, Anne Onyekwuluje11Departments of Ophthalmology and 2Pharmacology, Rush College of Medicine, Chicago, Illinois, USAAbstract: The removal of diclofenac sodium ophthalmic solution as a viable pharmaceutical entity in September 1999 from the US market spurred considerable interest in the general safety and effectiveness of topical ophthalmic NSAIDs for treatment of anterior segment inflammation. In late 1999 the use of topical ocular NSAIDs declined in the US as a result of incidents involving corneal melts and toxicity surrounding use of generic diclofenac. However, since the removal of diclofenac sodium ophthalmic solution from the marketplace, ophthalmic NSAIDs have regained use as viable pharmacotherapeutic entities. Moreover, several new ophthalmic NSAID products have recently been introduced for commercial use in the US including the novel chemical entity nepafenac. The purpose of this report is to revisit the use of topical ophthalmic NSAIDs for the treatment of surgically induced anterior segment inflammation with a particular focus on nepafenac. Nepafenac is unique among ophthalmic NSAIDs in that it is a prodrug deaminated to amfenac, a highly effective non-selective cyclooxygenase inhibitor. In the case of topical ophthalmic NSAIDs, practitioners should carefully weigh the cost-benefit of implementing &ldquo;highly potent&rdquo; new drug products because perturbations in pharmacodynamic response due to the inherent novelty in terms of chemical designs may outweigh the demonstrated replicative pharmacologic action of all topical ophthalmic NSAIDs.Keywords: ophthalmic NSAIDs, nepafenac, ocular inflammatory disease Bruce I GaynesAnne OnyekwulujeDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 2, Pp 355-368 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Bruce I Gaynes Anne Onyekwuluje Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension
description	Bruce I Gaynes1,2, Anne Onyekwuluje11Departments of Ophthalmology and 2Pharmacology, Rush College of Medicine, Chicago, Illinois, USAAbstract: The removal of diclofenac sodium ophthalmic solution as a viable pharmaceutical entity in September 1999 from the US market spurred considerable interest in the general safety and effectiveness of topical ophthalmic NSAIDs for treatment of anterior segment inflammation. In late 1999 the use of topical ocular NSAIDs declined in the US as a result of incidents involving corneal melts and toxicity surrounding use of generic diclofenac. However, since the removal of diclofenac sodium ophthalmic solution from the marketplace, ophthalmic NSAIDs have regained use as viable pharmacotherapeutic entities. Moreover, several new ophthalmic NSAID products have recently been introduced for commercial use in the US including the novel chemical entity nepafenac. The purpose of this report is to revisit the use of topical ophthalmic NSAIDs for the treatment of surgically induced anterior segment inflammation with a particular focus on nepafenac. Nepafenac is unique among ophthalmic NSAIDs in that it is a prodrug deaminated to amfenac, a highly effective non-selective cyclooxygenase inhibitor. In the case of topical ophthalmic NSAIDs, practitioners should carefully weigh the cost-benefit of implementing &ldquo;highly potent&rdquo; new drug products because perturbations in pharmacodynamic response due to the inherent novelty in terms of chemical designs may outweigh the demonstrated replicative pharmacologic action of all topical ophthalmic NSAIDs.Keywords: ophthalmic NSAIDs, nepafenac, ocular inflammatory disease
format	article
author	Bruce I Gaynes Anne Onyekwuluje
author_facet	Bruce I Gaynes Anne Onyekwuluje
author_sort	Bruce I Gaynes
title	Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension
title_short	Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension
title_full	Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension
title_fullStr	Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension
title_full_unstemmed	Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension
title_sort	topical ophthalmic nsaids: a discussion with focus on nepafenac ophthalmic suspension
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/cf3ed326b6f84751894071bf78d47dc3
work_keys_str_mv	AT bruceigaynes topicalophthalmicnsaidsadiscussionwithfocusonnepafenacophthalmicsuspension AT anneonyekwuluje topicalophthalmicnsaidsadiscussionwithfocusonnepafenacophthalmicsuspension
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Topical ophthalmic NSAIDs: a discussion with focus on nepafenac ophthalmic suspension

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