Netarsudil
Glaucoma · Rx
Trade namesRhopressa
Drug classRho kinase (ROCK) inhibitor
Strength0.02%
AvailabilityRx
Mechanism of actionInhibits Rho-associated kinase and the norepinephrine transporter; relaxes the trabecular meshwork to increase conventional outflow, lowers episcleral venous pressure, and reduces aqueous production. Targets the diseased outflow pathway directly.
Indication / reason for useOpen-angle glaucoma and ocular hypertension.
Usual adult dosing1 drop in the affected eye(s) once daily in the evening.
PreservativeBAK 0.015%
Contact lensesRemove lenses; reinsert after 15 minutes.
Common / important adverse effectsConjunctival hyperemia (very common, ~50%), conjunctival hemorrhages (small, benign, recurrent), cornea verticillata (reversible whorl keratopathy, usually visually insignificant), instillation-site pain, reticular corneal epithelial edema (less common).
Contraindications & cautionsHypersensitivity.
Pregnancy / lactationNo human data.
Practice notesHyperemia and the cosmetic subconjunctival hemorrhages drive most discontinuations, set expectations. Efficacy is preserved at low baseline IOP, which is useful in normal-tension glaucoma.
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.