Pharm

Intraocular Prostaglandin

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Intraocular Prostaglandin, Prostaglandin Analog Antiglaucoma Preparation, Latanoprost, Xalatan, Bimatoprost, Lumigan, Travoprost, Travatan, Unoprostone, Rescula, Tafluprost, Zioptan, Vyzulta

  • Indication
  1. First line agent for Open Angle Glaucoma
  • Contraindications
  1. Active Uveitis
  • Mechanism
  1. Prostaglandin analogs that increase uveoscleral aqueous outflow (lowers IOP 25 to 35%)
  • Medications (Teal Caps)
  1. Latanoprost (Xalatan) 0.005% one drop daily
  2. Bimatoprost (Lumigan) 0.03% one drop daily
  3. Travoprost (Travatan) 0.004% one drop daily
  4. Unoprostone (Rescula) 0.15% one drop daily
  5. Tafluprost (Zioptan) 0.0015% one drop daily
  6. Latanoprostene bunod (Vyzulta)
    1. Breaks down to Latanoprost and nitric oxide, but with no significant benefit over Latanoprost alone
    2. Released in 2018, costing 10x the cost of Latanoprost alone (which is $12 per bottle)
    3. (2018) Presc Lett 25(5): 28
  • Efficacy
  • Latanoprost
  1. Highly effective, low side effect agent
  2. Currently most prescribed Glaucoma agent worldwide
  3. References
    1. Hedman (2000) Eur J Ophthalmol 10:95-104 [PubMed]
  • Adverse Effects
  1. Increased eyelash growth
  2. Eyelid fat atrophy (with secondary Eyelid droop or Ptosis)
  3. Increased pigmentation (Hyperpigmentation) of iris, eyelashes or periocular skin including Eyelids
  4. Hyperemia
  5. Local irritation
    1. Burning, stinging, itching, Eye Pain or foreign body Sensation
  • References
  1. Harris (2023) Am Fam Physician 107(3): 238-46 [PubMed]