Lanotan

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

Indications of the lanotan

It is shown in such cases:

• to reduce increased intraocular pressure in people suffering from open-angle glaucoma, as well as having an increased level of intraocular pressure;
• to reduce the increased intraocular pressure in children with a high level of intraocular pressure, as well as the children's form of glaucoma.

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Release form

Issued in the form of eye drops in a vial with a volume of 2.5 ml.

[2]

Pharmacodynamics

The active ingredient is latanoprost (analogue of PG F2α), a selective agonist of the prostanoid receptor type FP, which reduces intraocular pressure by increasing the outflow of ophthalmic aqueous humor. The decrease in the level of intraocular pressure begins about 3-4 hours after the use of the drug, and after 8-12 hours the maximum of the drug effect is observed. The hypotensive effect lasts a minimum of 24 hours.

Basic tests have demonstrated that latanoprost is very effective in monotherapy. Clinical tests were also performed to combine drugs with other drugs. They demonstrated the effectiveness of the drug in combination with β-blockers (such as timolol). Short (within 1-2 weeks) testing showed that latanoprost has an additive effect when combined with adrenoreceptor agonists (such as diphenyl epinephrine) and ICA (such as acetazolamide). In addition, a partially additive effect is when combined with cholinomimetics (such as pilocarpine).

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

With a short treatment, latanoprost does not cause leakage of fluorescein inside the posterior ocular segment.

A noticeable therapeutic effect on the cardiovascular system and respiratory organs when using Lanotan in medicinal doses does not arise.

Pharmacokinetics

Latanoprost (with a molecular weight of 432.58) is 2-isopropoxypropane of the active element (prodrug). It itself is inactive, but after the process of hydrolysis, as a result of which the acid of latanoprost is formed, it becomes bioactive.

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

Human testing demonstrated that the peak value in the intraocular fluid was observed 2 hours after local use. With local use in monkeys, the distribution of matter mainly occurs in the region of the anterior ocular segment, eyelids and conjunctiva. Only a small part of the medicine reaches the posterior ocular segment.

The main process of drug metabolism is carried out inside the liver. The human half-life is 17 minutes.

Dosing and administration

The size of therapeutic doses is 1 drop in the diseased eye once a day. The most qualitative impact is in the case of using the medication in the evening.

It is not recommended to use drops for more than 1 time per day, since there is evidence that the drug's effectiveness decreases with frequent instillation. If the dose has been missed, it is required to continue the course by following the instillation at the usual time for the procedure.

As with any eye drops to reduce the risk of systemic suction, immediately after instillation of the eye, it should be about 1 minute to press the tear eye bag in the medial corner (lacrimal duct obstruction).

If a person wears contact lenses, they must be removed before the instillation procedure. Return them to the site is allowed after 15 minutes.

If several local ophthalmic medicines are used at once, it is necessary to apply each of them in turn, with intervals of at least 5 minutes.

[4], [5]

Use of the lanotan during pregnancy

There is no information on the safety of use of the drug in pregnant women. Pharmacological properties of drugs can be potentially dangerous to the fetus or newborn. Because of this during pregnancy, Lanotan is forbidden to use.

Contraindications

Among the contraindications: intolerance of the elements of the medicine. Also, there are only limited information on the safety and efficacy of using drugs for infants up to 1 year. There is also no available information on the use in preterm infants (born before the 36th week).

Side effects of the lanotan

In general, negative manifestations are associated with the visual organs. According to the results of 5-year drug tests: in 33% of people recorded changes in the pigmentation of the iris. Other ophthalmic side effects are usually transient and briefly appear after the use of drops. Among them:

• Pathology parasitic or infectious: herpetic form of keratitis;
• organs of the National Assembly: dizziness with headaches;
• visual organs: a strong pigmentation of the iris, redness of the eye mucosa (in mild or moderate degree), irritation (a burning sensation in which tingling in the eyes, and in addition itching, "sand" and the presence of a foreign element). The properties of pulmonary hair with eyelashes can also vary (thickening, elongation, quantity and pigmentation occur), temporary spot keratopathy (usually asymptomatic). In addition, pain in the eyes, photophobia, eyelid edema, dry eye syndrome, and keratitis. Together with this, it is possible to develop conjunctivitis or uveitis, inflammation of the iris, blurred vision. Also there are macular puffiness, symptomatic erosions with edemas in the cornea, periorbital puffiness, eyelashes grow in the wrong direction, which can irritate the eyes. Due to the emergence of an additional series of growing eyelashes near the outgoing ways of meibomian glands (the development of distichiasis), some changes in the structure of the eyelids and periorbital changes develop. Because of this, the age-old fold deepens. The iris cyst also develops;
• cardiac function: development of tachycardia or unstable stage of angina pectoris;
• organs of the sternum with mediastinum, as well as the respiratory system: the development of dyspnea or bronchial asthma, as well as exacerbation of the latter;
• subcutaneous tissue with skin: rashes, local reactions in the eyelids, darkening of the eyelids in the palpebral region;
• connective tissues and organs ODA: development of arthralgia or myalgia;
• general manifestations, as well as local reactions: pain in the sternum.

In extremely rare cases, people with severe corneal lesions, when using drops, developed its calcification - because the medicine contains phosphate.

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Overdose

In addition to eye irritation, as well as redness of the eye mucosa, no other adverse reactions to drug overdose are observed.

In the development of such disorders, procedures are required to eliminate pathological symptoms.

Interactions with other drugs

There is no comprehensive information on the interaction with other drugs.

There is evidence of a paradoxical increase in intraocular pressure indicators when combined with two analogues of PG. Therefore, it is recommended not to combine the medicine with 2+ PG, as well as their analogs or derivatives.

[6], [7]

Storage conditions

Keep the medication required in a place inaccessible to small children, under normal conditions. The temperature level is within 2-8 ° C.

Shelf life

Lanotan is suitable for use for 2 years. The opened bottle is allowed to be stored no more than 42 days.

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