Nepafenac Shortage Update: What Patients Need to Know in 2026

If you're scheduled for cataract surgery and your doctor prescribed Nepafenac — sold as Nevanac (0.1%) or Ilevro (0.3%) — you may be wondering whether this medication is currently in short supply. Here's the most up-to-date information on Nepafenac availability in 2026 and what to do if your pharmacy doesn't have it.

Official Shortage Status: As of 2026

As of early 2026, Nepafenac (Nevanac and Ilevro) is NOT listed on the FDA's official drug shortage database. This means the manufacturer, Harrow Eye, is fulfilling demand through regular distribution channels — including McKesson, AmerisourceBergen, and Cardinal's Cordlogistics.

However, "not in shortage" does not mean "available everywhere." Specialty ophthalmic medications have uneven distribution across pharmacy types and geographic areas. A large chain pharmacy in one zip code may be out of stock while an independent pharmacy nearby has it readily available.

What Changed in 2023: The Harrow Eye Transition

A notable change in Nepafenac's supply chain occurred in 2023. Harrow Eye completed the transfer of the New Drug Applications (NDAs) for both Nevanac and Ilevro from Novartis/Alcon. This transition changed the marketing and distribution structure for these products.

Harrow now distributes Nepafenac through its Cardinal Cordlogistics partner, with wholesaler distribution via McKesson and AmerisourceBergen. This is a well-established wholesale network, meaning the product should remain broadly accessible to U.S. pharmacies that order it.

Why Individual Pharmacies May Be Out of Stock

Even without a formal FDA shortage, patients encounter out-of-stock situations for several reasons:

• No generic alternative: As of January 2026, no FDA-approved generic Nepafenac exists. This limits supply flexibility.
• Demand spikes around surgical schedules: Many patients fill Nepafenac prescriptions in the same 1–2 week window around cataract surgeries at local surgical centers.
• High unit cost: Nevanac retails for $370–$413; Ilevro for approximately $481 without a discount. Some pharmacies may not keep it stocked unless there is confirmed patient demand or insured coverage.
• Regional inventory differences: Urban areas with high surgical volume may have better consistent availability than rural areas.

Historical Context: Have Nevanac or Ilevro Been in Shortage Before?

Nevanac and Ilevro have not been subject to major nationwide FDA shortages historically, unlike some other specialty medications. The products have been commercially available since 2005 (Nevanac) and 2013 (Ilevro). The 2023 NDA transfer to Harrow Eye represents the most significant change in their distribution history, but both products remained on the market throughout that transition.

What to Do If Your Pharmacy Is Out of Stock

If your pharmacy doesn't have Nepafenac in stock, here are the steps to take:

1. Use medfinder to identify which pharmacies near you currently have Nepafenac in stock without calling each one yourself.
2. Ask your pharmacy to place a special order — most pharmacies can receive Nepafenac within 1–2 business days if they don't have it in stock.
3. Contact your ophthalmologist to discuss whether the other Nepafenac formulation (Nevanac vs. Ilevro) is available and acceptable, or whether a different NSAID eye drop can be substituted.
4. Try independent and specialty pharmacies — they often stock Nepafenac more consistently than large retail chains.

Will Generic Nepafenac Become Available?

As of January 2026, there is no FDA-approved generic version of Nevanac or Ilevro available in the United States. Patents protecting various formulations of nepafenac remain active. When generics eventually do enter the market, they will significantly reduce costs and improve availability, but there is no confirmed timeline for this as of 2026.

The Bottom Line

Nepafenac is not in an official FDA shortage in 2026, but localized availability issues can make it hard to fill. The best approach is to plan ahead — request your prescription at your pre-op appointment and use tools like medfinder to quickly identify which pharmacies have it available near you.

Read more: How to find Nepafenac in stock near you — tools and tips