Alternatives to Ilevro If You Can't Fill Your Prescription

Ilevro (nepafenac 0.3%) is a popular choice for managing pain and inflammation after cataract surgery, but it's not the only option. If your pharmacy is out of stock, your insurance won't cover it, or the cost is prohibitive, your ophthalmologist can often substitute another ophthalmic NSAID that works just as well for your situation.

This guide covers every meaningful alternative to Ilevro — comparing dosing schedules, cost, generic availability, and key differences to help you and your surgeon make the right choice.

Important: Talk to Your Ophthalmologist First

Never switch eye drops after cataract surgery without your surgeon's approval. Your ophthalmologist will consider your specific procedure, your risk of complications like cystoid macular edema (CME), and your other medications before recommending an alternative. The options below are common substitutions — but only your doctor can determine what's right for you.

Alternative 1: Bromfenac (Prolensa, BromSite, Generic)

Bromfenac ophthalmic is the closest comparison to Ilevro in terms of modern ophthalmic NSAID design. Like Ilevro, some bromfenac formulations offer once-daily dosing, making patient compliance excellent.

Brand names: Prolensa (0.07%, once daily), BromSite (0.075%, twice daily)

Generic availability: Generic bromfenac 0.07% and 0.09% available — significantly cheaper than brand-name

Cost: Generic bromfenac approximately $80–$200/bottle; brand Prolensa $250–$450

Advantage over Ilevro: Generic available, often lower cost and more widely stocked

Alternative 2: Nevanac (Nepafenac 0.1%)

Nevanac is the lower-concentration version of Ilevro — it's the same active ingredient (nepafenac), just at 0.1% instead of 0.3%. It was the original formulation, approved by the FDA in 2005. The main difference is dosing: Nevanac requires three drops per day, while Ilevro is once daily.

Dosing: 3 drops daily (three times per day) for 14 days post-surgery

Generic availability: No generic available as of 2026

Key consideration: Higher dosing frequency may reduce compliance; some patients prefer once-daily Ilevro

Alternative 3: Ketorolac (Acular, Acular LS, Acuvail — Generic Available)

Generic ketorolac ophthalmic is the most affordable option by far, often costing $15–$50 per bottle. It has a long track record in cataract surgery and is widely stocked at virtually every pharmacy. The trade-off is dosing: older formulations require four drops per day, though Acuvail (preservative-free 0.45%) is used twice daily.

Cost: Generic ketorolac $15–$50/bottle — the most budget-friendly ophthalmic NSAID

Availability: Very widely stocked — one of the most available ophthalmic NSAIDs

Disadvantage: QID (four times daily) dosing with standard formulations; may cause more stinging

Alternative 4: Diclofenac Ophthalmic (Generic)

Generic diclofenac ophthalmic 0.1% is another well-established, affordable option. It requires four daily doses starting 24 hours after surgery and costs approximately $20–$60 per bottle as a generic. It has been used for cataract surgery for decades and is widely available.

Cost: $20–$60 as a generic

Availability: Widely stocked as a generic at most pharmacies

Disadvantage: Four times daily dosing; slightly older formulation compared to Ilevro or bromfenac

Comparing the Options at a Glance

Ilevro (nepafenac 0.3%): Once daily, no generic, $149–$482 retail, brand only

Bromfenac (generic 0.07%/0.09%): Once or twice daily, generic available, $80–$200

Nevanac (nepafenac 0.1%): Three times daily, no generic, similar cost to Ilevro

Ketorolac (generic): Four times daily, generic widely available, $15–$50

Diclofenac (generic): Four times daily, generic widely available, $20–$60

The Bottom Line on Ilevro Alternatives

If you can't find Ilevro, don't panic. Generic bromfenac, ketorolac, and diclofenac are all proven alternatives widely stocked at most pharmacies. Work with your ophthalmologist to choose the best substitute. If you want to try finding Ilevro itself first, read our guide on how to find Ilevro in stock near you before giving up on your original prescription.