II. Indication

  1. First line agent for Open Angle Glaucoma

III. Contraindications

  1. Active Uveitis

IV. Mechanism

  1. Prostaglandin analogs that increase uveoscleral aqueous outflow (lowers IOP 25 to 35%)

V. Medications (Teal Caps)

  1. Latanoprost (Xalatan) 0.005% one drop daily
  2. Bimatoprost (Lumigan) 0.03% one drop daily
  3. Travoprost (Travatan) 0.004% one drop daily
  4. Unoprostone (Rescula) 0.15% one drop daily
  5. Tafluprost (Zioptan) 0.0015% one drop daily
  6. Latanoprostene bunod (Vyzulta)
    1. Breaks down to Latanoprost and nitric oxide, but with no significant benefit over Latanoprost alone
    2. Released in 2018, costing 10x the cost of Latanoprost alone (which is $12 per bottle)
    3. (2018) Presc Lett 25(5): 28

VI. Efficacy: Latanoprost

  1. Highly effective, low side effect agent
  2. Currently most prescribed Glaucoma agent worldwide
  3. References
    1. Hedman (2000) Eur J Ophthalmol 10:95-104 [PubMed]

VII. Adverse Effects

  1. Increased eyelash growth
  2. Eyelid fat atrophy (with secondary Eyelid droop or Ptosis)
  3. Increased pigmentation (Hyperpigmentation) of iris, eyelashes or periocular skin including Eyelids
  4. Hyperemia
  5. Local irritation
    1. Burning, stinging, itching, Eye Pain or foreign body Sensation

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Related Studies

Cost: Medications

latanoprost (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LATANOPROST 0.005% EYE DROPS Generic $1.75 per ml
xalatan (on 8/17/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
XALATAN 0.005% EYE DROPS Generic $1.75 per ml
bimatoprost (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
BIMATOPROST 0.03% EYE DROPS Generic $31.11 per ml
BIMATOPROST 0.03% EYELASH SOLN Generic $26.03 per ml
lumigan (on 1/14/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LUMIGAN 0.01% EYE DROPS $87.53 per ml
travoprost (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TRAVOPROST 0.004% EYE DROP Generic $26.10 per ml
travatan (on 7/27/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TRAVATAN Z 0.004% EYE DROP Generic $22.25 per ml
tafluprost (on 2/22/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
TAFLUPROST 0.0015% EYE DROP Generic $4.29 each
zioptan (on 10/19/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ZIOPTAN 0.0015% EYE DROP Generic $4.78 each
ZIOPTAN 0.0015% EYE DROPS $7.39 each
vyzulta (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
VYZULTA 0.024% OPHTH SOLUTION $87.46 per ml