latanoprost (Rx)

Brand and Other Names:Xalatan, Xelpros
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.005% (2.5mL) (Xalatan)

ophthalmic emulsion

  • 0.005% (2.5mL) (Xelpros)

Elevated Intraocular Pressure

Open-angle glaucoma or ocular hypertension

  • 1 gtt in affected eye(s) qDay in evening; not to exceed once daily

Dosing Considerations

Combined use of ≥2 prostaglandins, or prostaglandin analogs not recommended; administration of prostaglandin drug products more than once daily may decrease intraocular pressure (IOP) lowering effect or cause paradoxical elevations in IOP

Concomitant use with other ophthalmic prostaglandin analogs and topical ophthalmic drug products to lower intraocular pressure may be used; if >1 topical ophthalmic drug being used, administer at least 5 minutes apart

Safety and efficacy not established

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Interactions

Interaction Checker

and latanoprost

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (4)

              • bimatoprost

                latanoprost, bimatoprost. unspecified interaction mechanism. Avoid or Use Alternate Drug. Combined use of 2 or more ophthalmic prostaglandins may decrease the IOP lowering effect or cause paradoxical elevations in IOP.

              • latanoprostene bunod ophthalmic

                latanoprost, latanoprostene bunod ophthalmic. unspecified interaction mechanism. Avoid or Use Alternate Drug. Combined use of 2 or more ophthalmic prostaglandins may decrease the IOP lowering effect or cause paradoxical elevations in IOP.

              • tafluprost

                latanoprost, tafluprost. unspecified interaction mechanism. Avoid or Use Alternate Drug. Combined use of 2 or more ophthalmic prostaglandins may decrease the IOP lowering effect or cause paradoxical elevations in IOP.

              • travoprost ophthalmic

                latanoprost, travoprost ophthalmic. unspecified interaction mechanism. Avoid or Use Alternate Drug. Combined use of 2 or more ophthalmic prostaglandins may decrease the IOP lowering effect or cause paradoxical elevations in IOP.

              Monitor Closely (31)

              • aspirin

                latanoprost, aspirin. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • aspirin rectal

                latanoprost, aspirin rectal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • bromfenac ophthalmic

                latanoprost, bromfenac ophthalmic. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • celecoxib

                latanoprost, celecoxib. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • choline magnesium trisalicylate

                latanoprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • diclofenac

                latanoprost, diclofenac. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • diclofenac ophthalmic

                latanoprost, diclofenac ophthalmic. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • diflunisal

                latanoprost, diflunisal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • etodolac

                latanoprost, etodolac. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • fenoprofen

                latanoprost, fenoprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • flurbiprofen

                latanoprost, flurbiprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • flurbiprofen ophthalmic

                latanoprost, flurbiprofen ophthalmic. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ibuprofen

                latanoprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ibuprofen IV

                latanoprost, ibuprofen IV. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ibuprofen/famotidine

                latanoprost, ibuprofen/famotidine. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • indomethacin

                latanoprost, indomethacin. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ketoprofen

                latanoprost, ketoprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ketorolac

                latanoprost, ketorolac. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ketorolac intranasal

                latanoprost, ketorolac intranasal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • ketorolac ophthalmic

                latanoprost, ketorolac ophthalmic. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • meclofenamate

                latanoprost, meclofenamate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • mefenamic acid

                latanoprost, mefenamic acid. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • meloxicam

                latanoprost, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • nabumetone

                latanoprost, nabumetone. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • naproxen

                latanoprost, naproxen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • nepafenac ophthalmic

                latanoprost, nepafenac ophthalmic. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • oxaprozin

                latanoprost, oxaprozin. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • piroxicam

                latanoprost, piroxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • salsalate

                latanoprost, salsalate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • sulindac

                latanoprost, sulindac. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • tolmetin

                latanoprost, tolmetin. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              Minor (0)

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                Adverse Effects

                >10%

                Increase in brown pigmentation of the iris (15.5%)

                Blurred vision (5-15%)

                Burning and stinging (5-15%)

                Foreign body sensation (5-15%)

                Itching (5-15%)

                Punctate epithelial keratopathy (5-15%)

                Conjunctival hyperemia (5-15%)

                1-10%

                Upper respiratory tract infection/cold/flu (4%)

                Dry eye (1-4%)

                Excessive tearing (1-4%)

                Eye pain (1-4%)

                Lid crusting (1-4%)

                Lid edema (1-4%)

                Lid erythema (1-4%)

                Lid discomfort/pain (1-4%)

                Photophobia (1-4%)

                Chest pain/angina pectoris (1-2%)

                Muscle/joint/back pain (1-2%)

                Rash/allergic skin reactions (1-2%)

                <1%

                Conjunctivitis

                Diplopia

                Discharge from the eye

                Frequency Not Defined

                Dizziness

                Headache

                Retinal artery embolus

                Vitreous hemorrhage from diabetic retinopathy

                Postmarketing Reports

                Eye disorders: Eyelash and vellus hair changes of eyelid (increased length, thickness, pigmentation, and number of eyelashes); keratitis, corneal edema and erosions, intraocular inflammation (iritis/uveitis), macular edema, including cystoid macular edema, trichiasis; periorbital and lid changes resulting in deepening of the eyelid sulcus; iris cyst; eyelid skin darkening; localized skin reaction on the eyelids; conjunctivitis; pseudopemphigoid of the ocular conjunctiva

                Pruritus

                Angina; palpitations; angina unstable

                Chest pain

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                Warnings

                Contraindications

                Hypersensitivity to latanoprost, benzalkonium chloride, or other components of product

                Cautions

                Macular edema, including cystoid macular edema, reported; Caution caution with aphakic and pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema

                Caution in active intraocular inflammation (eg, iritis/uveitis); generally not for use in patients with active intraocular inflammation; may exacerbate inflammation

                Reactivation of herpes simplex keratitis reported; administer with caution in patients with a history of herpetic keratitis; avoid in cases of active herpes simplex keratitis because inflammation may be exacerbated

                Take contact lenses out when applying, reinsert at least 15 min later

                Bacterial keratitis may result from inadvertent contamination of multidose ophthalmic solutions

                Gradual changes in eyelashes and vellus hair (eg, increased length, thickness, pigmentation, number of lashes or hairs, and misdirected growth of eyelashes) may occur; changes are usually reversible upon discontinuation of treatment

                May permanently change brown pigmentation of the iris, eyelid skin, and eyelashes; after discontinuation, pigmentation of the iris is likely to be permanent, while pigmentation of periorbital tissue and eyelash changes may be reversible in some patients; inform patients of possibility of increased pigmentation; continue treatment in patients who develop noticeably increased iris pigmentation and examine them regularly

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                Pregnancy & Lactation

                Pregnancy

                There are no adequate and well-controlled studies in pregnant women

                Only use during pregnancy if potential benefits justifies potential risks to the fetus

                Animal data

                • Reproduction studies performed in rats and rabbits. In rabbits, an incidence of 4 of 16 dams had no viable fetuses at a dose that was ~80 times the maximum human dose, and the highest nonembryocidal dose in rabbits was ~15 times the maximum human dose

                Lactation

                Not known whether this drug or its metabolites are excreted in human milk; because many drugs are excreted in human milk, exercise caution drug is administered to a nursing woman

                Consider developmental and health benefits of breastfeeding along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Prostaglandin F2-alpha analog; increases outflow of aqueous humor

                Absorption

                Ocular and systemic absorption

                Onset of action: 3-4hr

                Peak plasma effect: 8-12hr maximum

                Distribution

                Vd: 0.16 L/kg

                Metabolism

                Metabolized in the liver by fatty acid ß-oxidation to 1,2-dinor & 1,2,3,4-tetranor metabolites

                Excretion

                Urine

                Half-Life: 17 min

                Clearance: 13 mL/min/kg

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                Administration

                Ophthalmic Administration

                Missed dose

                • One dose missed: Continue treatment with next dose as normal
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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Xalatan ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops
                latanoprost ophthalmic (eye)
                -
                0.005 % drops

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                latanoprost ophthalmic (eye)

                LATANOPROST - OPHTHALMIC SOLUTION

                (lay-TAN-oh-prost)

                COMMON BRAND NAME(S): Xalatan

                USES: Latanoprost is used to treat high pressure inside the eye due to glaucoma (open angle type) or other eye diseases (e.g., ocular hypertension). It is similar to a natural chemical in the body (prostaglandin) and works by regulating the flow of fluid within the eye which results in lower pressure. Lowering high pressure inside the eye helps to prevent blindness.

                HOW TO USE: Apply this medication in the affected eye(s) usually once daily in the evening, or as directed by your doctor. Do not use this medication more frequently than prescribed; using more can decrease effectiveness.To apply eye drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.If you are wearing contact lenses, remove them before using this medication. Wait at least 15 minutes before replacing your contact lenses.Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place one drop into the pouch. Look downward, gently close your eyes, and place one finger at the corner of your eye (near the nose). Apply gentle pressure for 1 to 2 minutes before opening your eyes. This will prevent the medication from draining out. Try not to blink or rub your eye. Repeat these steps if your dose is for more than one drop. If directed to use this medication in both eyes, repeat these steps for your other eye. Do not rinse the dropper. Replace the dropper cap after each use.Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day. Keep using latanoprost even if you feel well. Most people with glaucoma or high pressure in the eye do not feel sick.If you are using another kind of eye medication (e.g., drops or ointments), wait at least 5 minutes before applying other products. Use eye drops before eye ointments to allow the eye drops to enter the eye.

                SIDE EFFECTS: Blurred vision, burning/stinging/itching/redness of the eye, feeling as if something is in the eye, changes in eyelash number/color/length/thickness, eyelid changes/skin darkening, dry eye, lid crusting/discomfort, or increased sensitivity to light may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.This medication may slowly (over months to years) cause brown discoloration of the colored portion of the eye (iris). If you are using latanoprost in only one eye, only that iris may change color. This color change may be permanent but the long-term effects are uncertain. Notify your doctor if this occurs and schedule regular eye exams to monitor it.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: eye pain, suspected eye infection (unusual redness or swelling of eyes), rapid vision changes (e.g., loss of vision).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, severe itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using latanoprost, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as preservatives like benzalkonium chloride), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: other eye problems (e.g., macular edema, iritis/uveitis, lens extraction/aphakia, herpes infection of the eye).If you develop an eye infection or injury, or have eye surgery, check with your doctor about the continued use of your current bottle of latanoprost. You may be advised to start using a new bottle.Your vision may be temporarily blurred or unstable after applying this drug. Do not drive, use machinery, or do any activity that requires clear vision until you are sure you can perform such activities safely.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: eyelash treatment (such as topically applied bimatoprost).

                OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.Laboratory and/or medical tests (e.g., eye exams) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, use it as soon as you remember if it is on the same day. If you do not remember until the next day, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.