Description
Latanoprost-Optic Pharmacodynamics
Latanoprost, an analogue of prostaglandin F2α, is a selective agonist of FP (prostaglandin F) receptors, which decreases intraocular pressure (IOP) by increasing outflow of aqueous humor, mainly via uveoscleral route as well as via trabecular meshwork. IOP starts decreasing approximately 3-4 hours after the drug is injected, the maximal effect is observed after 8-12 hours, the action lasts for at least 24 hours.
It is established that latanoprost has no significant effect on aqueous humor production and on haemato-ophthalmic barrier.
When used in therapeutic doses, latanoprost has no significant pharmacological effect on the cardiovascular and respiratory systems.
Indications
Decrease of increased intraocular pressure in adults and children (over 1 year of age) with open-angle glaucoma or increased ophthalmotonus.
Contraindications
Hypersensitivity to latanoprost or other drug components. Age under 1 year (efficacy and safety have not been established).
Caution
Aphakia, pseudoaphakia with rupture of the posterior lens capsule; patients with risk factors of macular edema (cases of macular edema, including cystoid edema, have been described for latanoprost treatment); inflammatory, neovascular glaucoma (due to insufficient experience of the drug use); bronchial asthma; history of herpetic keratitis.
The drug should be avoided in patients with an active form of herpetic keratitis and recurrent herpetic keratitis, especially associated with taking prostaglandin F2α analogues. The drug should be used with caution in patients with risk factors for iritis/veitis. There are limited data on the use of the drug in patients scheduled for surgical intervention for cataract. In this regard, the drug should be used with caution in this group of patients.
Administration during pregnancy and breast feeding period.
Pregnancy
The safety of using latanoprost during pregnancy in humans has not been established. Latanoprost may have toxic effects on pregnancy, fetus and newborn. Use during pregnancy is contraindicated.
Breastfeeding period
Latanoprost and its metabolites may penetrate into breast milk. Use during breastfeeding is contraindicated. Breastfeeding should be discontinued if it is necessary to take the drug.
Fertility
No effect of latanoprost on male and female fertility was found in animal studies.
Dosage and administration method
- Topically.
- Dosing regimen in adults (including elderly)
- One drop in the affected eye (a) once a day. Optimal effect is achieved when the drug is used in the evening.
- Do not instill the drug more frequently than once a day, because it has been shown that more frequent instillation reduces the hypotensive effect.
- If one dose is missed, treatment is continued according to the usual scheme. As with any eye drops, in order to reduce the possible systemic effect of the drug, immediately after instillation of each drop it is recommended to press on the lower lacrimal point located at the inner corner of the eye on the lower eyelid for 1 minute. This procedure should be carried out immediately after instillation.
- Contact lenses must be removed before instillation and inserted no sooner than 15 minutes after instillation (see also section “Special Precautions”). If other eye drops have to be administered at the same time, their application should be separated by a 5-minute interval.
- Dosing regimen in children
- Latanoprost is used in children in the same dose as in adults. There are no data on the drug administration in preterm infants (gestational age < 36 weeks). Data in children < 1 year old are very limited.
