Reduction of elevated intraocular pressure in patients with open angle glaucoma and ocular hypertension. Reduction of elevated intraocular pressure in children and adolescents with elevated intraocular pressure and childhood and adolescent glaucoma.
Prostaglandin analog F2α and a selective prostanoid receptor FP agonist. It reduces intraocular pressure by increasing the outflow of aqueous humor. The reduction in intraocular pressure occurs after about 3-4 hours after administration, reaching a maximum after 8-12 h, the effect persists for at least 24 h. After administration to the conjunctival sac latanoprost is absorbed through the cornea, undergoing full hydrolysis to the biologically active latanoprost acid . The maximum concentration of latanoprostic acid 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. Latanoprostic acid is practically not metabolised 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:
Data on the efficacy and safety of the drug in children up to 1 year of age are very limited. There are no data on premature babies (born before the 36th week of pregnancy). In children up to 3 years of age, in whom primary congenital glaucoma develops predominantly, surgical treatment is used first (eg trabeculotomy / goniotomy). Long-term safety of the medicine in children has not been established. Caution should be exercised when using the preparation in patients with closed-angle, open-angle glaucoma in patients with pseudophakia, pigmented glaucoma, inflammatory glaucoma, neovascular glaucoma, congenital glaucoma, acute attacks of closed-angle glaucoma, in inflammatory conditions of the eye, in the perioperative period cataract removal, in patients with aphasia, with pseudophakia and discontinuous posterior capsule or implantable intraventricular 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 uveitis. 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 (mostly in patients with mixed iris color, for example: 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,green or brown eyes, these changes were rare; iris color change is very slow, it is not associated with any undesirable symptoms or pathological changes, it may be permanent), mild or moderate conjunctival congestion, eye irritation (burning sensation, sand in the eye, pricking and the presence of a foreign body in the eye), changes in eyelashes 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 syndrome, keratitis, blurred vision, conjunctivitis, skin rash. Rarely: iritis and / or uveitis (the majority of 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, additional row of hairs at the mouth of the glands Meiboma (Distichiasis - eyelash function), bronchial asthma, exacerbation of bronchial asthma, shortness of breath, local eyelid skin reactions, darkening of eyelid skin. Very rare: exacerbation of angina symptoms in patients with angina pectoris, chest pain. Not known: herpetic keratitis, iris cyst, pain and dizziness, palpitations, muscle pain, arthralgia. In children and adolescents, the profile of adverse reactions is similar to that in the adult population; In children and adolescents, rhinopharyngitis and fever have been reported more often than in adults.
Dosage:
Adults (including the elderly): 1 drop to 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. The drug can be used in children and adolescents according to the same dosing regimen as in adults. Immediately after instillation, it is recommended to compress the tear sac in the medial angle of the eye for one minute (punctual closure) to limit the absorption of latanoprost 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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