Xalatan Side Effects

Generic Name: latanoprost ophthalmic

Note: This page contains side effects data for the generic drug latanoprost ophthalmic. It is possible that some of the dosage forms included below may not apply to the brand name Xalatan.

It is possible that some side effects of Xalatan may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to latanoprost ophthalmic: ophthalmic solution

As well as its needed effects, latanoprost ophthalmic (the active ingredient contained in Xalatan) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking latanoprost ophthalmic, check with your doctor immediately:

Less common
  • Eyelid crusting, redness, swelling, discomfort, or pain
Rare
  • Cough
  • difficulty breathing
  • noisy breathing
  • redness of eye or inside of eyelid
  • shortness of breath
  • swelling of the eye
  • tightness in chest
  • wheezing

If any of the following side effects occur while taking latanoprost ophthalmic, check with your doctor or nurse as soon as possible:

More common
  • Blurred vision, eye irritation, or tearing
  • darkening of eyelid skin color
  • increase in brown color in colored part of eye
  • longer, thicker, and darker eyelashes
Less common
  • Angina pectoris or other chest pain
  • cold or flu symptoms
  • eye pain
  • pain in muscles, joints, or back
  • skin rash
Rare
  • Discharge from the eye
  • double vision or other change in vision
  • fever
  • sensitivity of eye to light
  • sore throat

Some latanoprost ophthalmic side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Burning of eye
  • feeling of something in eye
  • itching of eye
  • stinging of eye
Less common
  • Dryness of eye

For Healthcare Professionals

Applies to latanoprost ophthalmic: ophthalmic solution

Ocular

Ocular side effects have been reported the most frequently. These have included blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, increased pigmentation of the iris, and punctate epithelial keratopathy in 5% to 15% of patients. Dry eye, excessive tearing, eye pain, lid crusting, lid discomfort/pain, lid edema, lid erythema and photophobia have been observed in 1% to 4% of patients. Conjunctivitis, diplopia and discharge from the eye have been reported in less than 1% of patients. Retinal artery embolus, retinal detachment, and vitreous hemorrhage from diabetic retinopathy have been reported rarely. Choroidal detachment, hypotony, macular edema (including cystoid macular edema), pigmented iris cysts, corneal edema, corneal erosions, keratitis, and herpes keratitis have also been reported. Paradoxical increases in intraocular pressure (IOP) and recurrence of uveal inflammation have been reported in patients with uveitic glaucoma. Periorbital and lid changes resulting in deepening of the eyelid sulcus have also been reported.[Ref]

Latanoprost can increase the amount of brown pigment in the eye by stimulating melanin production in melanocytes. The change in eye color occurs gradually over months to years and may be permanent. The entire or parts of the iris may be affected. Changes may be more prominent in patients with green- brown, blue/gray- brown or yellow- brown irides.

Conjunctival hyperemia is generally most pronounced during the start of therapy and may subside following prolonged use. In clinical trials, the hyperemia tended to be mild or moderate and rarely resulted in withdrawal from therapy.

A 6- month multicenter, randomized, investigator- masked study (n=136) of patients receiving daily latanoprost therapy reported conjunctival hyperemia in up to 42.5% of patients and a single case of anterior uveitis requiring treatment with topical corticosteroids. The mean grade of hyperemia was 0.28 on a scale of 1 to 3.

An open-label, multinational, multicenter, uncontrolled study of latanoprost administered daily for up to 5 years reported an increase in iris pigmentation in one-third of patients. This effect was generally reported within the first 36 months of therapy in patients with nonhomogenous eye color. There appeared to be no effect on the efficacy or overall safety of latanoprost.[Ref]

Respiratory

Respiratory side effects have included upper respiratory infections in 4% of patients. Asthma, exacerbation of asthma, and dyspnea have also been reported.[Ref]

Musculoskeletal

Musculoskeletal side effects have included arthralgias and myalgias (usually back pain) in 1% to 2% of patients.[Ref]

Cardiovascular

Cardiovascular side effects have rarely included chest pain and angina pectoris (1% to 2%).[Ref]

Hypersensitivity

Hypersensitivity reactions have included rash or skin problems in 1% to 2% of patients.[Ref]

Dermatologic

The manufacturer reports eyelash changes are usually reversible following discontinuation of therapy.

Four cases of poliosis have been reported in as early as 6 weeks of treatment. The affected lashes were interspersed with normally pigmented lashes. Hypertrichosis was also reported in 2 of the 4 patients.

A 6- month, multicenter, randomized, investigator- masked study (n=136) reported a single case of eyelash growth with daily latanoprost therapy.

A 61- year- old man reported his upper eyelashes had been obscuring his vision for approximately 2 months after instilling latanoprost daily to both eyes for approximately a 2- year duration. Further examination revealed bilateral trichomegaly with potentially irreversible lash ptosis.[Ref]

Dermatologic side effects have rarely included reversible hyperpigmentation of the eyelids, eyelashes, periocular area, temporal area, neck, and back. Increase in length, thickness, and number of eyelashes and/or vellus hairs, changes in the direction of the growth of eyelashes, poliosis, contact dermatitis, and toxic epidermal necrolysis have also been reported. One case of lash ptosis has been reported.[Ref]

Nervous system

Nervous system side effects have included postmarketing reports of dizziness and headache.[Ref]

References

1. "Product Information. Xalatan (latanoprost ophthalmic)." Pharmacia and Upjohn, Kalamazoo, MI.

2. Levine JE, Braun T, Penza SL, et al. "Prospective trial of chemotherapy and donor leukocyte infusions for relapse of advanced myeloid malignancies after allogeneic stem-cell transplantation." J Clin Oncol 20 (2002): 405-12

3. Mishima HK, Masuda K, Kitazawa Y, Azuma I, Araie M "A comparison of latanoprost and timolol in primary open-angle glaucoma and ocular hypertension: a 12-week study." Arch Ophthalmol 114 (1996): 929-32

4. Stewart WC, Kolker AE, Stewart JA, Leech J, Jackson AL "Conjunctival hyperemia in healthy subjects after short-term dosing with latanoprost, bimatoprost, and travoprost." Am J Ophthalmol 135 (2003): 314-20

5. Noecker RS, Dirks MS, Choplin NT, Bernstein P, Batoosingh AL, Whitcup SM "A six-month randomized clinical trial comparing the intraocular pressure-lowering efficacy of bimatoprost and latanoprost in patients with ocular hypertension or glaucoma." Am J Ophthalmol 135 (2003): 55-63

6. Alm A, Schoenfelder J, McDermott J "A 5-year, multicenter, open-label, safety study of adjunctive latanoprost therapy for glaucoma." Arch Ophthalmol 122 (2004): 957-65

7. Altuna JC, Greenfield DS, Wand M, Liebmann JM, Taglia DP, Kaufman PL, Cioffi GA, Lee DA, Robin AL, Crichton A, Costa VP "Latanoprost in glaucoma associated with Sturge-Weber syndrome: Benefits and side-effects." J Glaucoma 8 (1999): 199-203

8. Alm A, Villumsen J, Tornquist P, Mandahl A, Airaksinen J, Tuulonen A, Marsk A, Resul B, Stjernschantz J "Intraocular pressure-reducing effect of PhXA41 in patients with increased eye pressure. A one-month study." Ophthalmology 100 (1993): 1312-6;disc. 1316-7

9. Arranz-Marquez E, Teus MA, Saornil MA, Mendez MC, Gil R "Analysis of irises with a latanoprost-induced change in iris color." Am J Ophthalmol 138 (2004): 625-30

10. Sacca S, Pascotto A, Siniscalchi C, Rolando M "Ocular complications of latanoprost in uveitic glaucoma: Three case reports." J Ocul Pharmacol Therapeut 17 (2001): 107-13

11. Camras CB, Alm A, Watson P, Stjernschantz J, Aasved H, Jangard P, Lundandersen H, Flesner P, Soderstrom M, Ehinger B, Holmin C, "Latanoprost, a prostaglandin analog, for glaucoma therapy: efficacy and safety after 1 year of treatment in 198 patients." Ophthalmology 103 (1996): 1916-24

12. Nagasubramanian S, Sheth GP, Hitchings RA, Stjernschantz J "Intraocular pressure-reducing effect of PhXA41 in ocular hypertension. Comparison of dose regimens." Ophthalmology 100 (1993): 1305-11

13. Wand M, Shields BM "Cystoid macular edema in the era of ocular hypotensive lipids." Am J Ophthalmol 133 (2002): 393-7

14. Herndon LW, Robert D Williams, Wand M, Asrani S "Increased periocular pigmentation with ocular hypotensive lipid use in African Americans." Am J Ophthalmol 135 (2003): 713-5

15. Loeffler KU, Sahm M, Spitznas M "Short-time application of latanoprost does not stimulate melanogenesis in bovine ocular melanin-containing cells in vitro." Ophthalmic Res 33 (2001): 102-6

16. Browning DJ, Perkins SL, Lark KK "Iris cyst secondary to latanoprost mimicking iris melanoma." Am J Ophthalmol 135 (2003): 419-21

17. Spaeth GL "Allergic contact dermatitis caused by topical eye drops." Am J Ophthalmol 142 (2006): 706

18. Wand M, Ritch R, Isbey EK, Zimmerman TJ "Latanoprost and periocular skin color changes." Arch Ophthalmol 119 (2001): 614-5

19. Casson RJ, Selva D "Lash ptosis caused by latanoprost." Am J Ophthalmol 139 (2005): 932-3

20. Chen CS, Wells J, Craig JE "Topical prostaglandin F(2alpha) analog induced poliosis." Am J Ophthalmol 137 (2004): 965-6

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