Latanoprost

Latanoprost, sold under the brand name Xalatan among others, is a medication used to treat increased pressure inside the eye (intraocular pressure).

Common side effects include blurry vision, redness of the eye, itchiness, and darkening of the iris.

Latanoprost was approved for medical use in the United States and the European Union in 1996. Latanoprost is available as a generic medication. In 2023, it was the 67th most commonly prescribed medication in the United States, with more than 9million prescriptions. It is available as a fixed-dose combination with netarsudil as netarsudil/latanoprost and with timolol as latanoprost/timolol.

Medical uses

In the United States, latanoprost is indicated for the reduction of elevated intraocular pressure in people with open-angle glaucoma or ocular hypertension.

Open-angle glaucoma

thumb|Latanoprost eye drops, marketed by Pfizer

thumb|Latanoprost in Japanese-language packaging

In people with ocular hypertension (IOP ≥21 mm Hg) including open-angle glaucoma, treatment with latanoprost reduced IOP levels by 22-39% over 1 to 12 months' treatment. Latanoprost is more effective than timolol 0.5% twice daily in 3 of 4 large (n = 163 to 267) randomised, double-blind trials. Latanoprost demonstrated a stable long-term IOP-lowering effect in 1- or 2-year continuations of these trials, with no sign of diminishing effect during prolonged treatment.

Meta-analysis suggests that latanoprost is more effective than timolol in lowering intraocular pressure (IOP). However, it often causes iris pigmentation. While current evidence suggests that this pigmentation is benign, careful lifetime evaluation of patients is still justified.

Closed-angle glaucoma

People who had elevated IOP despite iridotomy and/or iridectomy (including people of Asian descent), latanoprost was significantly more effective than timolol in two double-blind, monotherapy trials (8.2 and 8.8 mm Hg vs 5.2 and 5.7 mm Hg for latanoprost vs timolol at 12 and 2 weeks, respectively).

Adverse effects

Listed from most to least common:

Research suggests that wiping the eye with an absorbent pad after the administration of eye drops can result in shorter eyelashes and a lesser chance of hyperpigmentation in the eyelid, compared to not wiping off excess fluid.

Pregnancy

Interactions

Interactions are similar to other prostaglandin analogs. Paradoxically, the concomitant use of latanoprost and bimatoprost or other prostaglandins may result in increased intraocular pressure.

Pharmacology

Mechanism of action

Like other prostaglandin analogues, latanoprost acid is an analog of prostaglandin F<sub>2α</sub> that acts as a selective agonist at the prostaglandin F receptor. Prostaglandins increase the sclera's permeability to aqueous fluid. By giving latanoprorost, it increases prostaglandin's scleral activity, increasing outflow of aqueous fluid and lowering intraocular pressure.

Society and culture

Legal status

Latanoprost was approved for medical use in the United States and the European Union in 1996. Iyuzeh, Xelpros, and Catiolanze.

Cosmetic use

Lengthening and thickening of the eyelashes (used, like bimatoprost, in the cosmetic industry as eyelash growth enhancers).

Research

Hair loss

Latanoprost is being developed as a topical therapy for the treatment of androgenic alopecia (pattern hair loss), both alone (DQL01) and in combination with minoxidil (ANR-001.1) and with minoxidil and finasteride (TH-07; Triple Hair).