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

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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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 distributed in milk; use caution

            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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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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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.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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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.