Prostaglandin analog F2α, a selective prostanoid agonist of FP receptors. It reduces intraocular pressure by increasing the outflow of aqueous humor. Increases choroidal-scleral outflow and reduces the flow resistance. It does not have a significant effect on the production of aqueous humor, it does not affect the water-liquid barrier. The reduction in intraocular pressure occurs about 3-4 hours after administration of the drug, the maximum effect occurs after 8-12 h, the effect persists for at least 24 h. After administration to the conjunctival sac latanoprost, which is an inactive isopropyl ester (prodrug) is absorbed through the cornea, undergoing complete hydrolysis to the biologically active latanoprost acid. The maximum concentration in aqueous humor occurs approximately 2 hours after administration. It is distributed mainly in the anterior chamber, in the conjunctiva and the eyelids, only minimal amounts reach the chamber of the posterior eye. It is practically not metabolized in the eye. Metabolism occurs mainly in the liver. T0,5 drug in plasma is 17 min. Inactive metabolites are mainly excreted in the urine.
Contraindications:
Hypersensitivity to latanoprost or to any of the excipients.
Precautions:
Use in children is not recommended (safety and efficacy have not been established). Caution should be used in patients with closed-angle, open angle glaucoma in patients with pseudophakia, pigmented glaucoma, inflammatory glaucoma, neovascular glaucoma, acute attacks of closed angle glaucoma, in inflammatory conditions of the eye, in the perioperative period after cataract removal, in patients with aphasia, with pseudophakia and ruptured posterior capsule or implantable anterior chamber lens, in patients at risk of cystic macular edema (patients with diabetic retinopathy and retinal vascular retinal capillaries) and in patients prone to iritis or inflammation of the membrane vascular eye. Use with caution in patients with a history of herpetic herpetic keratitis; avoided in the case of active herpetic keratitis and in patients with a history of recurrent herpetic keratitis, particularly associated with the use of prostaglandin analogs. Caution in patients with asthma. During treatment, the pigmentation of the iris may change; treatment can be continued, however, patients should be examined regularly and if required by the clinical condition, latanoprost should be discontinued; the patient should be informed about the possibility of a permanent change in the color of the iris of the treated eye (treatment of one eye can lead to permanent heterochromia). The preparation contains benzalkonium chloride, which may cause eye irritation, and also cause punctate keratopathy and / or toxic ulcerative keratopathy - patients with dry eye syndrome or corneal injury disorders should be closely monitored if the drug is used frequently or for a long time. Because contact lenses can absorb benzalkonium chloride, they should be removed before instillation; they can be put on again after 15 minutes.
Pregnancy and lactation:
Do not use during pregnancy and breast-feeding.
Side effects:
Very common: increased pigmentation of the iris (most commonly in patients with mixed iris colouration, eg blue-brown, gray-brown, yellow-brown and green-brown, in patients with homogeneous blue eyes, these changes were not observed, and in patients with homogeneous gray, In green or brown eyes, these changes were rare, with the onset of changes usually occurring during the first 8 months of treatment, rarely in the 2nd or 3rd year of treatment, but not in 4.the year of treatment, the rate of progression of iris pigmentation decreases over time and is stable for 5 years; iris color change is not associated with any side effects or pathological changes, it may be persistent), mild or moderate conjunctival hyperemia, eye irritation (pruritus, burning sensation, sand in the eye, pricking and the presence of a foreign body in the eye), eyelash changes and follicular hair (increased length, thickness, pigmentation and number, the vast majority of cases affect the Japanese population). Common: transient punctate epithelial erosions (in most cases asymptomatic), eyelid inflammation, eye pain. Uncommon: eyelid edema, dry eye, keratitis, blurred vision, conjunctivitis, skin rash. Rarely: iritis and / or uveitis (most cases affect patients with comorbid predisposing factors), macular edema, symptomatic swelling and corneal erosions, periorbital edema, changes in the direction of eyelash growth, sometimes causing eye irritation, the occurrence of a double row of eyelashes on the openings thyroid glands (Distichiasis), photophobia, bronchial asthma, exacerbation of bronchial asthma, shortness of breath, local eyelid skin reactions, darkening of eyelid skin. Very rare: changes in the periorbital area and eyelid changes, leading to deeper eyelid sulcus, exacerbation of existing angina pectoris, chest pain. Not known: herpetic keratitis, iris cyst, pain and dizziness, palpitations, muscle pain, arthralgia. There was a change in the color of the skin around the orbital region, with most cases in Japanese patients.
Dosage:
Adults (including the elderly): 1 drop into the conjunctival sac of the affected eye (eyes) once a day, preferably in the evening. If you miss one dose, continue with the Next scheduled dose. Do not administer the preparation more than once a day. Immediately after instillation of each drop, it is recommended to compress the conjunctival sac in the medial part of the eyelid angle (punctual pressure) for a minimum, to limit the absorption of the drug into the bloodstream. When using several topical ophthalmic medications, a gap of at least 5 minutes should be allowed between instillations of subsequent medications.
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