Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. One of several first-line agents to reduce elevated IOP.
Safety and efficacy not established for the treatment of angle-closure, inflammatory, or neovascular glaucoma.
Appears to be more effective than unoprostone, as effective as travoprost, and slightly less effective than bimatoprost in reducing IOP in patients with open-angle glaucoma or ocular hypertension.
May be more effective or at least as effective as twice daily administration of timolol 0.5% in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Appears to be more effective than thrice-daily administration of dorzolamide 2%.
May be used in conjunction with a topical β-adrenergic blocking agent (e.g., betaxolol, carteolol, levobunolol, metipranolol, timolol), topical dipivefrin, topical epinephrine, an oral carbonic anhydrase inhibitor (e.g., acetazolamide), or a topical carbonic anhydrase inhibitor (e.g., dorzolamide).
Tolerance does not occur, and reduction in mean IOP is maintained for up to at least 24 months of therapy after initial stabilization.
Dosage and Administration
Administration
Ophthalmic Administration
Apply topically to the affected eye(s).
Avoid contamination of the solution container.
If more than one topical ophthalmic drug is used, administer the drugs at least 5 minutes apart. (See Interactions.)
Dosage
Adults
Ocular Hypertension and Glaucoma
Ophthalmic
One drop of a 0.005% solution (1.5 mcg) in the affected eye(s) once daily in the evening. More frequent dosing may paradoxically diminish the IOP-lowering effect of the drug. If a dose is missed, omit the dose and apply the next dose the following evening.
Cautions
Contraindications
Known hypersensitivity to latanoprost, benzalkonium chloride, or any ingredient in the formulation.
Warnings/Precautions
Warnings
Ocular Effects
Increases in brown pigmentation of the iris and periorbital tissue (eyelid) or increases in length, thickness, and pigmentation of eyelashes or vellus hair in the treated eye reported; misdirected growth of eyelashes also may occur. Pigmentation is expected to increase throughout the treatment period. Increased pigmentation of the iris may be permanent, while pigmentation of the periorbital tissue and eyelash changes reportedly are reversible in some patients. Long-term effects (i.e., beyond 5 years) of increased pigmentation are unknown.
Increased pigmentation of iris develops slowly; may not be evident until after several months to years of latanoprost therapy. In clinical studies, noticeable increased pigmentation of the iris generally occurred within the first year of therapy. Therapy generally may be continued in the presence of increased iris pigmentation; patients should be examined regularly.
General Precautions
Ocular Precautions
Macular edema, including cystoid macular edema, reported in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema; use with caution in such patients.
Use with caution in patients with a history of intraocular inflammation (e.g., iritis, uveitis); use generally not recommended in patients with active intraocular inflammation.
Specific Populations
Pregnancy
Category C.
Lactation
Not known if distributed into milk; use with caution.
Pediatric Use
Safety and efficacy not established in pediatric patients.
Geriatric Use
No substantial differences in safety and efficacy relative to younger adults.
Common Adverse Effects
Blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, pruritus, increased pigmentation of the iris, punctate epithelial keratopathy.
Interactions
Ocular Hypotensive Agents
Potential for additive IOP-lowering effects when used concomitantly with another ocular hypotensive agent (e.g., topical β-adrenergic blocking agent, oral or topical carbonic anhydrase inhibitor). Additive effect may be used to therapeutic advantage.
Thimerosal
Precipitation occurs when ophthalmic solutions containing thimerosal are admixed with latanoprost ophthalmic solution. If more than one topical ophthalmic drug is used, administer the drugs at least 5 minutes apart.
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