LATANOPROST: Xalatan, Various
Class: Prostag andin, Antig aucoma Agent
Dosage Forms. Ophthalmic Solution: 0.005%
Common FDA Label Indication, Dosing, and Titration.
1. Ocu ar hypertension, open-ang e g aucoma: 1 drop in a ected eye(s) dai y in the evening
O -Label Uses. None
MOA. Latanoprost is a prostag andin F2-a pha ana og. It is be ieved to reduce IOP by increasing the
out ow o aqueous humor. Studies suggest that the main mechanism o action is increased uveosc era
out ow, but the exact mechanism is unknown.
Drug Characteristics: Latanoprost
Dose Adjustment
Hepatic
Not required
Absorption
Dose Adjustment
Renal
Dialyzable
Not required
Distribution
Not dia yzab e
Metabolism
Pregnancy Category
C
Elimination
Lactation
Weigh risks and Pharmacogenetics
bene ts
Hypersensitivity Black Box Warnings
Contraindications
Absorbed through the cornea
where the isopropy ester prodrug
is hydro yzed to the acid orm
to become bio ogica y active.
Systemic absorption o owing
ocu ar insti ation is very ow
Vd = 0.16 L/kg
Metabo ized within the cornea;
any entering systemic circu ation
is metabo ized in the iver, extent
unknown
Rena e imination is 88-98% with
a ha - i e o 17 min
None known
None
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P fize r 0.005% s olution picture d
L
Medication Sa ety Issues: Latanoprost
Suf xes
No
Tall Man Letters
No
Do Not Crush
No
High Alert
No
Con used Names
Lantus, Travatan, Xa acom
Beers Criteria
No
Drug Interactions: Latanoprost
Typical Agents
Pi ocarpine
Mechanism
Coadministration decreases access o atanoprost to the receptor and increases resistance to
f ow through the uveosc era pathway
Clinical Management
Bedtime dose o pi ocarpine shou d be given at
east 10 min (pre erab y 1 h) a ter atanoprost
Less Common (1-10%)
Dry eye, eye id edema
Rare but Serious (<1%)
Macu ar retina edema, dip opia, keratitis
Adverse Reactions: Latanoprost
Common (>10%)
B urred vision, itching, sensation o oreign
body in eye, hyperpigmentation o eye id, iris
pigmentation
E icacy Monitoring Parameters. Reduction in IOP.
Toxicity Monitoring Parameters. Seek medica attention i symptoms o ocu ar irritation are severe.
Key Patient Counseling Points. Wash hands and remove contact enses be ore using the medicine. For administration, ie down or ti t your head back.
With your index inger, pu down the ower id o your eye to orm a pocket. Ho d the dropper c ose to your eye with the other hand. Drop the correct
number o drops into the pocket made between your ower id and eyeba . Gent y c ose your eyes. P ace your index inger over the inner corner o your
eye or 1 min. Do not rinse or wipe the dropper or a ow it to touch anything, inc uding your eye. Put the cap on the bott e right away.
Clinical Pearls. I used concurrent y with pi ocarpine, separate dose by 1 h i possib e. Separate administration rom other ophtha mic products by at
east 5 min. Advise patients that there is a risk o permanent increased iris pigmentation associated with insti ation o this product. Do not administer
more than once dai y to avoid oss o therapeutic e ect. Store intact bott es under re rigeration. Opened bott es may be stored at room temperature
or 6 wk.
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