Comprehensive medication guide to Ilevro including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$52.50–$80 copay for the most common version on commercial insurance; Ilevro is covered by approximately 84% of commercial plans. Medicare Part D covers it on Tier 3; prior authorization may be required on some plans.
Estimated Cash Pricing
$380–$482 retail for brand-name Ilevro (3 mL bottle); as low as $149 with a GoodRx coupon, or $59 with the Harrow Connects Savings Program for commercially insured patients. No generic version is currently available.
Medfinder Findability Score
75/100
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Ilevro is the brand name for nepafenac 0.3% ophthalmic suspension — a prescription eye drop used to treat pain and inflammation following cataract surgery. It is manufactured by Harrow (Harrow IP, LLC) and has been on the U.S. market since January 2013. Ilevro comes in sterile 1.7 mL and 3 mL bottles.
Ilevro belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs) and is specifically formulated for topical ophthalmic use. Its FDA-approved indication is for the treatment of pain and inflammation associated with cataract surgery. A key feature of Ilevro is its once-daily dosing schedule — one drop per day starting the day before surgery, continuing on surgery day (with one additional pre-surgical drop), and for two weeks post-operatively.
As of 2026, no FDA-approved generic version of Ilevro exists. It is available by prescription only and is prescribed almost exclusively by ophthalmologists in the context of cataract surgery.
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Ilevro's active ingredient, nepafenac, works as a prodrug — meaning it is inactive as applied and requires conversion inside the eye to become active. After the suspension is applied to the eye's surface, nepafenac rapidly penetrates the cornea. Inside the eye, hydrolase enzymes convert nepafenac into amfenac, its pharmacologically active metabolite.
Amfenac inhibits prostaglandin H synthase (cyclooxygenase-1 and cyclooxygenase-2 enzymes), blocking the production of prostaglandins — the chemical mediators that cause redness, swelling, and pain following the surgical trauma of cataract surgery. By converting inside the eye rather than on the surface, amfenac reaches the deeper intraocular tissues (iris, ciliary body, retina) at therapeutically relevant concentrations.
The prodrug design also means nepafenac has minimal activity at the corneal surface itself, potentially reducing the epithelial toxicity concerns associated with older-generation active-form NSAIDs. Peak intraocular amfenac concentrations occur approximately 45 minutes after application, with levels maintained throughout the 24-hour dosing interval — enabling the once-daily regimen.
0.3% — ophthalmic suspension
3 mg nepafenac per mL; available in 1.7 mL and 3 mL sterile bottles; once-daily dosing
0.3% (1.7 mL) — ophthalmic suspension
Smaller bottle size; typically sufficient for one surgical eye's treatment course
0.3% (3 mL) — ophthalmic suspension
Standard bottle size; most commonly prescribed for 14-day post-cataract course
Ilevro is not on the FDA's official drug shortage list as of 2026, and manufacturer Harrow states the medication is widely available with strong insurance formulary coverage. However, individual patients frequently report difficulty finding Ilevro in stock at their neighborhood pharmacy — particularly at general-purpose chain locations not near ophthalmology clinics.
The primary reasons for localized stock-outs are structural: Ilevro is a brand-name-only specialty ophthalmic product with no generic alternative, so all supply comes from a single manufacturer. Many pharmacies stock it on-demand rather than proactively. Pharmacies located near ophthalmology offices and ambulatory surgical centers tend to stock it more reliably, as they serve higher prescription volumes.
If your pharmacy doesn't have Ilevro in stock, medfinder can call pharmacies near you to check which ones have it available, saving you hours on the phone. This is especially helpful before cataract surgery, when timing is critical.
Ilevro is not a controlled substance and can be prescribed by any licensed healthcare provider in the United States with prescribing authority. Because it is specifically indicated for post-cataract surgery care, prescriptions originate almost exclusively from eye care specialists:
Ophthalmologists (MD/DO) — primary prescribers; perform cataract surgery and manage post-op care
Optometrists (OD) — in most states can prescribe ophthalmic NSAIDs; commonly prescribe Ilevro in co-management arrangements post-cataract surgery
Nurse Practitioners (NP) and Physician Assistants (PA) — working in ophthalmology practices regularly prescribe post-surgical eye drops including Ilevro
Telehealth prescribing: While the initial cataract evaluation and surgical care require in-person visits, established post-op patients may receive Ilevro refills or prescription extensions via telehealth from ophthalmologists or optometrists licensed in their state.
No. Ilevro (nepafenac 0.3% ophthalmic suspension) is not a controlled substance and is not scheduled by the DEA. It is a prescription medication — meaning a valid prescription from a licensed healthcare provider is required to obtain it — but it carries none of the special prescription, dispensing, or monitoring requirements associated with Schedule II-V controlled substances.
Because it is not controlled, Ilevro can be prescribed by any licensed prescriber, may be filled as a 30-day supply or more without quantity restrictions in most cases, and does not require special DEA registration or monitoring programs. Telehealth providers can also prescribe Ilevro for established patients, though in practice the prescription originates as part of in-person cataract surgical care.
The most common ocular side effects occurring in 5-10% of patients using Ilevro after cataract surgery include:
Capsular opacity (cloudiness behind the lens implant)
Decreased visual acuity (temporary blurring)
Foreign body sensation (feeling of something in the eye)
Increased intraocular pressure (temporary)
Sticky sensation, dry eye, ocular discomfort, photophobia, tearing
Systemic (1-4%): headache, nausea, sinusitis, hypertension
Corneal effects: keratitis, corneal thinning, erosion, ulceration, or perforation (sight-threatening; stop Ilevro immediately)
Delayed wound healing (risk increased with concurrent corticosteroid eye drops)
Increased ocular bleeding / hyphema (blood in the eye)
Signs of eye infection: worsening redness, discharge, swollen lids, fever
Allergic reaction: hives, swelling, difficulty breathing
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Bromfenac (Prolensa, BromSite, Generic)
Once or twice daily ophthalmic NSAID; generic bromfenac 0.07%/0.09% available at $80-200; comparable efficacy to Ilevro with lower cost when using generic
Ketorolac (Acular, Acuvail — Generic)
Most affordable ophthalmic NSAID at $15-50 generic; QID dosing (Acuvail BID); widely stocked at virtually all pharmacies
Diclofenac ophthalmic (Generic)
QID dosing; $20-60 as generic; well-established for post-cataract inflammation; widely available
Nevanac (Nepafenac 0.1%)
Same active molecule as Ilevro at lower concentration; TID dosing required (3x daily vs Ilevro's once daily); no generic available; similar cost to Ilevro
Prefer Ilevro? We can find it.
Other topical NSAIDs (ketorolac, bromfenac)
majorConcurrent use increases risk of corneal adverse events including keratitis, thinning, erosion. Do not use two ophthalmic NSAIDs simultaneously.
Topical corticosteroid eye drops (prednisolone, dexamethasone)
moderateCombined use may increase risk of delayed wound healing. Combination is standard practice but requires close post-op monitoring.
Systemic anticoagulants (warfarin, NOACs)
moderateAdditive theoretical risk for bleeding due to antiplatelet effects of nepafenac. Systemic absorption from Ilevro is minimal; inform anticoagulation care team.
Antiplatelet agents (aspirin, clopidogrel)
moderateAdditive antiplatelet effects increase theoretical bleeding risk. Disclose all antiplatelet medications to your ophthalmologist before cataract surgery.
Oral NSAIDs (ibuprofen, naproxen)
minorAdditive anti-inflammatory and antiplatelet effects. Ophthalmologist may advise holding oral NSAIDs perioperatively.
Contact lenses (benzalkonium chloride)
moderateIlevro contains benzalkonium chloride preservative that damages soft contact lenses. Do not wear contact lenses while using Ilevro.
Ilevro (nepafenac 0.3%) is a well-established, once-daily ophthalmic NSAID that plays an important role in post-cataract surgery care. Its prodrug mechanism, convenient dosing, and proven efficacy for PCME prevention make it a preferred choice for many ophthalmologists. The key challenge patients face is cost and pharmacy availability — both of which are manageable with the right savings programs and pharmacy search tools.
No generic version of Ilevro is available in 2026, which keeps retail prices elevated. However, the Harrow Connects Savings Program can reduce the cost to $59 for commercially insured patients, and GoodRx brings it to approximately $149 for cash-pay patients. For those who truly can't access or afford Ilevro, effective alternatives including generic bromfenac and ketorolac are available.
If you're having trouble finding Ilevro at a pharmacy near you, medfinder can call local pharmacies to locate which ones have it in stock — so you can start your post-surgical medication on time and protect your surgical outcome.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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