Latanoprost
Glaucoma · Rx
Trade namesXalatan, Iyuzeh (PF), Xelpros (BAK-free)
Drug classProstaglandin analog (FP agonist)
Strength0.005%
AvailabilityRx
Mechanism of actionFP prostanoid receptor agonist; increases uveoscleral (and some trabecular) aqueous outflow. ~25-35% IOP reduction, the most effective single topical class.
Indication / reason for useFirst-line therapy for open-angle glaucoma and ocular hypertension.
Usual adult dosing1 drop in the affected eye(s) once daily in the evening. More frequent dosing paradoxically reduces efficacy.
PreservativeBAK 0.02% (Iyuzeh preservative-free; Xelpros BAK-free) , a preservative-free option exists
Contact lensesRemove lenses before instillation; reinsert after 15 minutes (BAK). PF option preferable for lens wearers and ocular surface disease.
Common / important adverse effectsIris hyperpigmentation (permanent, esp. hazel/green irides), eyelash lengthening/darkening, periorbital fat atrophy and deepening of the upper lid sulcus (prostaglandin-associated periorbitopathy), conjunctival hyperemia, punctate keratitis; rare CME and anterior uveitis; reactivation of herpetic keratitis.
Contraindications & cautionsCaution: aphakia / pseudophakia with a torn posterior capsule, active uveitis, history of HSV keratitis, macular edema risk.
Pregnancy / lactationAvoid where possible; prostaglandins theoretically affect uterine tone. Discuss risk/benefit.
Practice notesOriginal Xalatan needs refrigeration until opened, then 6 weeks at room temperature; generics/Xelpros are room-temp stable. Cosmetic asymmetry is a real adherence issue in unilateral treatment.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.