Skip to Content

Latanoprost

Medically reviewed by Drugs.com. Last updated on Aug 3, 2020.

Pronunciation

(la TA noe prost)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Emulsion, Ophthalmic:

Xelpros: 0.005% (2.5 mL) [contains edetate disodium, propylene glycol]

Solution, Ophthalmic:

Xalatan: 0.005% (2.5 mL) [contains benzalkonium chloride]

Generic: 0.005% (2.5 mL)

Brand Names: U.S.

  • Xalatan
  • Xelpros

Pharmacologic Category

  • Ophthalmic Agent, Antiglaucoma
  • Prostaglandin, Ophthalmic

Pharmacology

Latanoprost is a prostaglandin F2-alpha analog believed to reduce intraocular pressure by increasing the outflow of the aqueous humor

Absorption

Through the cornea where the isopropyl ester prodrug is hydrolyzed by esterases to the biologically active acid. Peak concentration is reached in 2 hours after topical administration in the aqueous humor.

Distribution

Vd: 0.16 ± 0.02 L/kg

Metabolism

Primarily hepatic via fatty acid beta-oxidation

Excretion

Urine (as metabolites)

Onset of Action

3 to 4 hours; Peak effect: Maximum: 8 to 12 hours

Half-Life Elimination

17 minutes

Use: Labeled Indications

Elevated intraocular pressure: Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma and ocular hypertension.

Contraindications

Hypersensitivity to latanoprost, benzalkonium chloride, or any component of the formulation

Dosing: Adult

Elevated intraocular pressure: Ophthalmic: One drop in the affected eye(s) once daily in the evening; do not exceed the once daily dosage (may decrease the IOP-lowering effect)

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Reduction of intraocular pressure: Limited data available: Infants, Children, and Adolescents: Ophthalmic solution (eg, Xalatan): Ophthalmic: 1 drop to affected eye(s) once daily in the evening (Maeda-Chubachi 2013; Quaranta 2017).

Administration

Ophthalmic: May be used with other eye drops to lower IOP. If more than one topical ophthalmic drug is being used, administer the drugs at least 5 minutes apart. Remove contact lenses prior to administration and wait 15 minutes before reinserting.

Storage

Emulsion: Store at 2°C to 25°C (36°F to 77°F). Protect from light. May be maintained at temperatures up to 40°C (104°F) for up to 8 days during shipment.

Solution: Store intact bottles under refrigeration at 2°C to 8°C (36°F to 46°F). Protect from light. Once opened, the container may be stored at room temperature up to 25°C (77°F) for 6 weeks.

Drug Interactions

Bimatoprost: The concomitant use of Latanoprost and Bimatoprost may result in increased intraocular pressure. Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: May diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents may also enhance the therapeutic effects of Prostaglandins (Ophthalmic). Monitor therapy

Nonsteroidal Anti-Inflammatory Agents (Ophthalmic): May diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents (Ophthalmic) may enhance the therapeutic effect of Prostaglandins (Ophthalmic). Monitor therapy

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Central nervous system: Foreign body sensation of eye (2% to 13%)

Ophthalmic: Eye pain (≤55%), stinging of eyes (≤55%), ocular hyperemia (41%), conjunctival hyperemia (8% to 15%), eye discharge (12%), increased eyelash length (11%)

1% to 10%:

Dermatologic: Erythema of eyelid (3%), hyperpigmentation of eyelashes (1%), allergic skin reaction (≤1%, including eyelid), skin rash (≤1%)

Infection: Influenza (≤3%)

Neuromuscular & skeletal: Arthralgia (≤1%), back pain (≤1%), myalgia (≤1%)

Ophthalmic: Punctate keratitis (1% to 10%), blurred vision (8%), increased eyelash thickness (8%), eye pruritus (5% to 8%), burning sensation of eyes (7%), iris hyperpigmentation (7%), decreased visual acuity (4%), eyelid pain (4%), lacrimation (4%), crusting of eyelid (3%), dry eye syndrome (3%), photophobia (2%), eyelid edema (1% to 2%), conjunctival edema (1%)

Respiratory: Nasopharyngitis (≤3%), upper respiratory tract infection (≤3%)

<1%, postmarketing, and/or case reports: Angina pectoris, asthma, bacterial keratitis, chest pain, conjunctivitis (including pseudopemphigoid of the ocular conjunctiva), corneal edema, corneal erosion, dizziness, dyspnea, exacerbation of asthma, eye disease (periorbital and lid changes resulting in deepening of the eyelid sulcus), headache, herpes simplex keratitis, hyperpigmentation of eyelids, increased growth in number of eyelashes, iris cyst, iritis, keratitis, macular edema (including cystoid macular edema), misdirected growth of eyelashes (including trichiasis), palpitations, pruritus, toxic epidermal necrolysis, unstable angina pectoris, uveitis

Warnings/Precautions

Concerns related to adverse effects:

• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions, has caused bacterial keratitis.

• Ocular effects: May change/increase brown pigmentation of the iris, the eyelid skin, and eyelashes; length and/or number of eyelashes may also be increased. Pigmentation of the iris is likely to be permanent although iris color change may not be noticeable for months to years; pigmentation of the periorbital tissue and eyelash changes may be reversible following discontinuation of therapy. Long-term consequences and potential injury to eye are not known.

• Ocular inflammation: Intraocular inflammation and exacerbation of inflammation may occur; use with caution in patients with a history of intraocular inflammation (eg, iritis/uveitis) and generally avoid use in patients with active intraocular inflammation.

Disease-related concerns:

• Herpetic keratitis: Use with caution in patients with a history of herpes simplex keratitis; reactivation may occur. Avoid use in patients with active herpes simplex keratitis.

• Ocular disease: Use with caution in aphakic patients, pseudophakic patients with a torn posterior lens capsule, or patients with risk factors for macular edema. Safety and efficacy have not been determined for use in patients with angle-closure, inflammatory, or neovascular glaucoma.

Special populations:

• Contact lens wearers: Solution contains benzalkonium chloride which may be absorbed by contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting.

Monitoring Parameters

Monitor IOP; regularly examine patients who develop increased iris pigmentation.

Reproductive Considerations

Ophthalmic prostaglandins, such as latanoprost, have a theoretical risk of miscarriage. To decrease this risk, agents other than latanoprost may be preferred for the treatment of glaucoma in patients planning to become pregnant (Strelow 2020).

Pregnancy Considerations

Information related to latanoprost use in pregnancy is limited (DeSantis 2004).

Ophthalmic prostaglandins, such as latanoprost, are generally avoided during pregnancy due to a theoretical risk of miscarriage and premature labor. Agents other than latanoprost may be preferred for the treatment of glaucoma during pregnancy, especially during the first trimester. In general, if ophthalmic agents are needed in pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease exposure to the fetus (Belkin 2020; Prum 2016; Strelow 2020).

Patient Education

What is this drug used for?

• It is used to treat glaucoma.

• It is used to lower high eye pressure.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Blurred vision

• Burning

• Stinging

• Eyelash changes

• Foreign body sensation in eye

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Eye discharge

• Eye discoloration

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Frequently Asked Questions