Lanotan

Lanotan is an analogue of PG. It is a miotic antiglaucoma agent.

Indications Lanotana

Shown in such cases:

• to reduce increased intraocular pressure in people suffering from open-angle glaucoma, as well as those with elevated intraocular pressure;
• to reduce increased intraocular pressure in children with high levels of intraocular pressure, as well as childhood glaucoma.

[ 1 ]

Release form

Available in the form of eye drops in a 2.5 ml bottle.

[ 2 ]

Pharmacodynamics

The active component is latanoprost (analogue of PG F2α) – a selective agonist of the prostanoid receptor type FP, which reduces intraocular pressure by increasing the outflow of aqueous humor. The decrease in intraocular pressure begins approximately 3-4 hours after using the drug, and after 8-12 hours the maximum drug effect is observed. The hypotensive effect lasts at least 24 hours.

Basic testing has shown that latanoprost is very effective in monotherapy. Clinical trials have also been conducted on the subject of combinations of the drug with other drugs. They have demonstrated the effectiveness of the drug in combination with β-blockers (such as timolol). Short-term (1-2 weeks) testing has shown that latanoprost has an additive effect in the case of combination with adrenergic agonists (such as epinephrine dipivalyl) and ICAs (such as acetazolamide). In addition, a partially additive effect is observed when combined with cholinomimetics (such as pilocarpine).

Clinical tests show that Lanotan has little effect on the production of intraocular fluid. There is no information on the effect of the drug on the hemato-ophthalmic barrier.

With short-term treatment, latanoprost does not cause leakage of fluorescein within the posterior segment of the eye.

There is no noticeable therapeutic effect on the cardiovascular system and respiratory organs when using Lanotan in medicinal doses.

Pharmacokinetics

Latanoprost (molecular weight 432.58) is the active element (prodrug) 2-isopropoxypropane. It is inactive by itself, but becomes bioactive after hydrolysis to form latanoprost acid.

Prodrugs are able to pass through the cornea. Like other drugs that penetrate the intraocular fluid, they are hydrolyzed after penetrating the cornea.

Human testing has shown that peak intraocular fluid levels are observed 2 hours after topical application. When applied locally to monkeys, distribution of the drug occurs primarily in the anterior segment of the eye, eyelids, and conjunctiva. Only a small portion of the drug reaches the posterior segment.

The main process of drug metabolism occurs inside the liver. The half-life in humans is 17 minutes.

Dosing and administration

The size of the therapeutic dose is 1 drop in the eye affected by the disease once a day. The best effect is achieved when using the medicine in the evening.

It is not recommended to use drops more than once a day, as there is information that with frequent instillation the effectiveness of the drug decreases. If a dose is missed, it is necessary to continue the course, performing the next instillation at the usual time for the procedure.

As with any eye drops, to reduce the risk of systemic absorption, immediately after instillation of the drops into the eye, pressure should be applied to the lacrimal sac in the medial canthus (lacrimal canalicular occlusion) for approximately 1 minute.

If a person wears contact lenses, they must be removed before the instillation procedure. They can be put back in place after 15 minutes.

If several topical ophthalmic medications are used at once, each one should be applied in turn, with intervals of at least 5 minutes.

[ 4 ], [ 5 ]

Use Lanotana during pregnancy

There is no information about the safety of using the drug in pregnant women. The pharmacological properties of the drug can be potentially dangerous for the fetus or newborn. Because of this, Lanotan is prohibited for use during pregnancy.

Contraindications

Contraindications include intolerance to the drug's components. There is also limited information on the safety and effectiveness of using the drug in infants under 1 year of age. There is no available information on use in premature infants (born before 36 weeks).

Side effects Lanotana

The negative effects are mainly related to the visual organs. According to the results of 5-year drug testing: 33% of people had changes in the pigmentation of the iris. Other ophthalmological side effects are usually transient and appear briefly after using the drops. Among them:

• pathologies of parasitic or infectious nature: herpetic keratitis;
• nervous system organs: dizziness with headaches;
• visual organs: strong pigmentation of the iris, redness of the eye mucosa (mild or moderate), irritation (burning sensation, with tingling in the eyes, as well as itching, "sand" and the presence of a foreign element). The properties of vellus hair with eyelashes may also change (they may thicken, lengthen, change in quantity and pigmentation), temporary punctate keratopathy (usually asymptomatic). In addition, pain in the eyes, photophobia, swelling of the eyelids, dry eye syndrome, and keratitis. Along with this, conjunctivitis or uveitis, inflammation of the iris, and blurred vision may develop. Macular edema, symptomatic erosions with swelling in the cornea, periorbital edema also appear, eyelashes grow in the wrong direction, which can irritate the eyes. Due to the appearance of an additional row of growing eyelashes near the excretory ducts of the meibomian glands (development of distichiasis), some changes in the structure of the eyelids and periorbital changes develop. Because of this, the eyelid fold deepens. An iris cyst also develops;
• cardiac function: development of tachycardia or unstable stage of angina;
• organs of the sternum with mediastinum, as well as the respiratory system: development of dyspnea or bronchial asthma, as well as exacerbation of the latter;
• subcutaneous tissue with skin: rashes, local reactions in the eyelid area, darkening of the eyelids in the palpebral area;
• connective tissues and musculoskeletal organs: development of arthralgia or myalgia;
• general manifestations, as well as local reactions: pain in the sternum.

In extremely rare cases, people with severe corneal damage have developed corneal calcification when using the drops, due to the fact that the medicine contains phosphate.

[ 3 ]

Overdose

Apart from eye irritation and redness of the mucous membrane of the eye, no other negative reactions to drug overdose are observed.

When such disorders develop, it is necessary to perform procedures aimed at eliminating pathological symptoms.

Interactions with other drugs

There is no comprehensive information regarding interactions with other drugs.

There is information about a paradoxical increase in intraocular pressure indicators when used in combination with two PG analogues. Therefore, it is recommended not to combine the drug with 2+ PG, as well as with their analogues or derivatives.

[ 6 ], [ 7 ]

Storage conditions

The medicine must be kept in a place inaccessible to small children, under normal conditions. Temperature level – within 2-8°C.

Shelf life

Lanotan is suitable for use for 2 years. An opened bottle can be stored for no more than 42 days.

[ 8 ]