BMA Concise Guide to Medicine & Drugs

Latanoprost

Brand name Xalatan

Used in the following combined preparation Xalacom

QUICK REFERENCE

Drug group Drug for glaucoma

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Latanoprost is a synthetic derivative of the prostaglandin dinoprost, which constricts the smooth muscle lining the blood vessels and airways. Latanoprost is used as eye drops to reduce pressure inside the eye in open angle (chronic) glaucoma and ocular hypertension by increasing the outflow of fluid from the eye. The drug is used when patients have not responded to or cannot tolerate the drug of first choice, usually a beta-blocker (such as timolol). Sometimes, combined eye drops of latanoprost and timolol may be prescribed when timolol alone is not adequately controlling the pressure.

Latanoprost eye drops can gradually increase the amount of brown pigment in the eye, darkening the iris. This will be particularly noticeable if only one eye needs treatment. Irises of mixed coloration are especially susceptible; pure blue eyes do not seem to be affected. Latanoprost has also been reported to cause darkening, thickening, and lengthening of eyelashes.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Eye drops.

Frequency and timing of doses 1 x daily, in the evening.

Adult dosage range 1 drop per eye, daily.

Onset of effect 3–4 hours.

Duration of action 24 hours.

Diet advice None.

Storage Keep the eye drops in the outer cardboard package to protect from light. Store at room temperature, out of the reach of children. Discard any unused solution 4 weeks after opening.

Missed dose Use the next dose as normal.

Stopping the drug Do not stop taking the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra application is unlikely to cause problems. Excessive use may irritate the eye and produce adverse effects in other parts of the body. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Darkening of the iris is a very common side effect of latanoprost and changes to the eyelashes occur almost as often but neither of these affects vision. Eye irritation and blurred vision are also common. Discuss with your doctor if either of these is severe or if you have eye pain, bloodshot or swollen eyes, inflamed eyelids, or facial swelling. Stop using the drug and seek medical advice if you develop chest pains, wheezing, or breathing difficulty.

INTERACTIONS

Other eye drops should not be used within 5 minutes of using latanoprost.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You wear contact lenses.

· You are allergic to latanoprost or any of the ingredients in the formulation.

· You have heart problems.

· You have asthma.

· You are taking other medicines.

Pregnancy Safety not established. Prostaglandins may affect the fetus. Discuss with your doctor.

Breast-feeding The drug may pass into the breast milk and may affect the baby. Discuss with your doctor.

Infants and children Not recommended. Safety not established.

Over 60 No special problems.

Driving and hazardous work The eye drops may cause temporary blurring of vision. Avoid driving and hazardous work until vision has returned to normal.

Alcohol No known problems.

PROLONGED USE

No known problems apart from changes to iris pigment and eyelashes. These changes do not affect vision, and may not diminish once treatment has been stopped.

Monitoring Although there should be no problems with long-term use, your doctor will continue to monitor eye pigmentation as well as control of the glaucoma.