Latanoprost

Latanoprost is an ophthalmological drug. It is a miotic antiglaucoma analogue of PG.

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Indications Latanoprost

It is used to reduce elevated IOP in people diagnosed with open-angle glaucoma.

The drug is also prescribed if the patient has tolerance to other drugs used to treat ocular hypertension.

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Release form

The product is released in the form of eye drops in 2.5 ml dropper bottles. Inside the pack there is 1 bottle with drops.

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Pharmacodynamics

Latanoprost is a prodrug (the so-called inactive form of a drug that is converted into an active form in the body under the influence of hydrolysis - it becomes latanoprost acid). This active element is an analogue of PG F2-alpha (a selective antagonist of the FP receptor of prostanoid), which reduces the level of IOP, increasing the degree of fluid outflow inside the eyes. Therefore, the main effect of the drug is to enhance the uveoscleral outflow.

No reliable effect of the drug on the increase in the production of intraocular fluid was found. At the same time, the active component of the drug also does not affect the GOB. It was determined that latanoprost acid in medicinal doses does not have an effect on the function of the cardiovascular system, as well as the respiratory system.

As a result of prolonged use, the medicine may change the shade of the iris. This effect develops due to an increase in the number of melanosomes (these are pigment granules). Usually, brown pigmentation appears in the area around the pupil, and then moves to the peripheral parts of the iris. It is also possible for the entire iris or small areas to become completely colored. The shade of the eyes changes slowly and gradually, so at the initial stage (in the first months or years) this may not be noticeable. In people with brown eyes, this effect is more pronounced. After the end of therapy, this process does not progress, but in some cases it may also not regress.

As a result of long-term use of drops, sometimes the eyelids begin to darken. There are cases of increased pigmentation of the eyelashes, as well as their thickening and change in the direction of growth. Such symptoms are usually irreversible.

There is insufficient information regarding the effect of drugs on the endothelium of the cornea during prolonged use of drops.

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Pharmacokinetics

Latanoprost and its analogues are 2-isoproxylpropane (a complex inactive substance), which after entering the eye is absorbed into the cornea. The drug easily passes through the retina. When absorbed, the medicinal element undergoes hydrolysis with the participation of esterases. It is during this process that the active component of the drug is formed - latanoprost acid.

After 2 hours from topical application, the peak level of the drug is observed in the intraocular fluid. The active component is in the fluid for 4 hours. Latanoprost is detected in the blood plasma for 1 hour after the administration of drops.

The drug undergoes hepatic metabolism, during which β-oxidative processes occur. The half-life from blood plasma is 17 minutes. The breakdown products of the drug are excreted in the urine and kidneys.

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Dosing and administration

Drops are instilled into the conjunctival sac of the diseased eye once a day (it is recommended to do this in the evening). The dose is 1 drop. If a dose is missed, the dose does not need to be doubled the next time you use it.

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Use Latanoprost during pregnancy

The drops can only be used with the permission of a doctor and under his supervision. Latanoprost is prescribed during pregnancy only in situations where its positive effect is expected to be more likely than the development of negative effects in the fetus.

Due to the fact that the breakdown products of the drug can pass into breast milk, breastfeeding must be discontinued during therapy.

Contraindications

Main contraindications: children under 18 years of age, as well as hypersensitivity to the elements that make up the drug.

Caution is required when used in people who have been diagnosed with aphakia or pseudoaphakia, as well as glaucoma of various types (congenital, inflammatory or neovascular).

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Side effects Latanoprost

The use of the drug sometimes causes the development of such side effects:

• damage to the visual organs: a feeling of irritation ("sand" in the eyes, burning or tingling), development of blepharitis, erosion in the cornea, conjunctivitis, uveitis with keratitis and iritis. In addition, visual clouding, macular edema, as well as in the lower or upper eyelid. Along with this, hyperpigmentation of the iris, thickening or disorder of eyelash growth (due to prolonged use of drops) is observed. Retinal detachment or thrombotic changes in its arteries develop sporadically;
• dermatological disorders: local manifestations on the skin of the eyelids, rash and increased pigmentation;
• lesions of the musculoskeletal system: the appearance of arthralgia or myalgia;
• respiratory dysfunction: exacerbation of bronchial asthma and dyspnea is observed. In addition, cases of infectious lesions of the upper respiratory system are becoming more frequent - the development of flu or colds;
• disorders in the nervous system: nausea and headaches with dizziness.

In some cases, periodic pain in the sternum appears.

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Overdose

Intoxication develops when using a dosage greater than 5-10 mcg/kg. One bottle of drops contains 125 mcg of the active component. Poisoning is characterized by the following symptoms: dizziness with nausea, pain in the joints or muscles, flushing of the face, hyperhidrosis and a feeling of general weakness.

Treatment consists of procedures aimed at eliminating the symptoms of overdose. The drug has no specific antidote.

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Interactions with other drugs

In case of combined use of 2 ophthalmic agents in the form of drops, it is necessary to observe at least a 5-minute interval between their use.

It is prohibited to combine 2 prostaglandin agents, as well as their derivatives.

A mutual enhancement of therapeutic properties is observed when the drug is combined with cholino- or adrenergic agents.

When using ophthalmic drugs from the NSAID category, the medicinal effectiveness of Latanoprost may be weakened.

The drug is absolutely not allowed to be combined with eye drops containing thiomersal, as precipitation occurs.

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Storage conditions

Latanoprost should be stored in a dark place, at a temperature of 2-8°C, without freezing. An opened bottle should be kept at a temperature not exceeding 25°C.

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Special instructions

Reviews

Latanoprost is a very effective remedy that helps to reduce IOP indicators - most reviews confirm the effectiveness of the drug. Among the advantages of the drug, the low cost of the drug is also highlighted. Among the disadvantages, they note the frequent development of side effects.

Shelf life

Latanoprost is allowed to be used for a period of 2 years from the date of manufacture of drops. At the same time, an opened bottle has a shelf life of no more than 1 month.

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