Latanoprost

When ATH:
S01EE01

Characteristic.

Colorless or slightly yellow oil. Easily soluble in acetonitrile, soluble in acetone, ethanol, ethyl acetate, isopropanol, methanol and octanol, practically soluble in water.

Pharmacological action.
Protivoglaukomnoe.

Application.

According to Physicians Desk Reference (2008), latanoprost shown at elevated intraocular pressure in patients with open angle glaucoma and ocular hypertension, incl. with tolerance to other IOP lowering means or their insufficient effectiveness.

Contraindications.

Hypersensitivity.

Restrictions apply.

Pregnancy, breast-feeding, childhood (Safety and efficacy have not been established); inflammatory activity in the eyeball (Irit, uveitis), afakija, psevdoafakiya with damage to the lens capsule, states, accompanied by the risk of macular edema, angle-closure glaucoma with signs of inflammation or neovascularization, wearing contact lenses, liver and kidney damage.

Pregnancy and breast-feeding.

If pregnancy should be used with caution, only if the expected benefit to the mother outweighs the potential risk to the fetus.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

Studies of the effect of latanoprost on reproduction were conducted in rats and rabbits. In four of the sixteen rabbits, receiving a dose of latanoprost, about 80 times the MRDC, in the uterus were not detected fetal viability; dose, DO NOT PROVIDE embriotsidnogo action in rabbits, made 15 MRDC. Such adequate controlled studies in pregnant women has not been.

Data on the penetration of latanoprost or its metabolites in breast milk is not. Because many drugs are excreted in breast milk, should be used with caution in nursing women latanoprost.

Side effects.

Change eyelashes (lengthening, thickness, and pigmentation of lashes), darkening of the eyelid skin, intraocular inflammation (Irit, uveitis), changes in pigmentation of the iris, macular edema.

According multicenter, double-blind, Controlled Trials, 5-15% of patients, treated with latanoprost for 6 Months, The following adverse reactions were noted by the eye: blurred vision, tingling and burning sensations, conjunctival hyperemia (less than 1% patients required discontinuation of therapy due to intolerance of conjunctival hyperemia), foreign body sensation in the eye, itch, increased pigmentation of the iris, point epithelial keratopathy. In 1-4% of patients had xerophthalmia, excessive tearing, eye pain, crusts on the eyelids, pain / discomfort in the centuries, swelling and redness century, photophobia. Less than 1% Patients were marked conjunctivitis, diplopia, discharge from the eyes. Very rarely observed retinal artery embolism, retinal disinsertion, vitreous hemorrhage in diabetic retinopathy.

The most common systemic side effects: in 4% patients had an upper respiratory infection / cold / flu, 1–2% have chest pain/angina, pain in muscles / joints / back, rash / allergic skin reactions.

In postmarketing observations have been noted: asthma or worsening asthma, edema and corneal erosion, dyspnoea, change eyelashes and vellus hair (lengthening, thickness, and pigmentation of), darkening of the eyelid skin, herpetic keratitis, intraocular inflammation (Irit, uveitis), keratit, macular edema, violation of the direction of growth of eyelashes, leading to eye irritation, toxic epidermal necrolysis. As reports of these side effects come from a population of unknown Voluntary, ie. not controlled properly and, perhaps, They have been associated not only with the use of latanoprost, but also other factors,, it is impossible to assess their significance and frequency.

Cooperation.

Pharmaceutical incompatible with Thimerosal (possible precipitation, and between applications is required not less than 5-minute interval). It can be used in conjunction with other agents, lowering IOP (and in this case it is necessary at least 5-minute interval).

Overdose.

Symptoms: eye irritation, conjunctival or episcleral hyperemia.

In / in the introduction of high doses of latanoprost monkeys causes a transient bronchoconstriction, but its use in 11 patients with asthma did not induce bronchoconstriction. IV administration of latanoprost to healthy volunteers at a dose up to 3 mg / kg, providing excess of its average plasma concentrations compared with therapeutic doses 200 time, It did not cause adverse reactions. In/in the introduction of 5.5-10 mcg/kg latanoprost caused abdominal pain, dizziness, fatiguability, hot flashes, nausea, Sweating.

Treatment: symptomatic.

Dosing and Administration.

By instillation 1 drop (1,5 g) in the affected eye, 1 once a day in the evening.

Precautions.

Do not use more often than latanoprost 1 once a day, tk. more frequent administration may reduce the therapeutic effect. It should warn patients of the need for urgent doctor's advice during the development of any adverse reactions on the part of the eye (conjunctivitis, changes in the age and others.). The development of bacterial keratitis associated with the use of multidose vials of ophthalmic agents (tk. Open the contents of the vial does not preserve sterility), and the presence in many cases of comorbidity eyes and epithelial damage eyeball. With the development of intercurrent eye diseases (trauma, infection etc.) or surgery on the eyeball should immediately consult with your doctor about the use of ophthalmic agents in multidose vials (possible contamination of the vial pathogenic flora).

Before initiation of therapy patients should be informed about the possible irreversible change eye color (especially in the treatment of only one eye, When can develop irreversible heterochromia), length changes, thickness, color and number of eyelashes and vellus hair, the direction of growth of eyelashes and eyelid skin darkening. It should be a regular eye examination; if increased pigmentation treatment can be discontinued.

Before instillation of latanoprost should remove contact lenses (contained in the solution of benzalkonium chloride can be adsorbed on the lens); They put them later 15 min after instillation. Use of latanoprost is contraindicated in patients with known hypersensitivity to benzalkonium chloride and other auxiliary components of the drug.