Latanoprost

Latanoprost is an ophthalmic preparation. It is a miotic antiglaucoma analogue of PG.

[1], [2], [3], [4], [5],

Indications of the latanoprost

It is used to reduce the elevated level of IOP in people who have been diagnosed with open-angle glaucoma.

The drug is also prescribed if the patient has a tolerance for other drugs used to eliminate ophthalmic hypertension.

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Release form

The release occurs in the form of eye drops in bottles-droppers with a volume of 2.5 ml. Inside the pack - 1 bottle with drops.

[7], [8], [9]

Pharmacodynamics

Latanoprost is a prodrug (the so-called inactive form of LS, which passes inside the body under the influence of hydrolysis into the active - it becomes an acid of latanoprost). This active element is an analogue of PG F2-alpha (a selective antagonist of the prostanoid FP receptor), which reduces the level of IOP, increasing the degree of outflow of fluid inside the eyes. Therefore, the main effect of the drug is to enhance the ongoing uveoscleral outflow.

There was no significant effect of drugs on increased production of intraocular fluid. At the same time, the active component of the drug also does not affect the GOB. It is determined that the acid of latanoprost in medicinal doses does not have an effect on the function of the CCC, as well as on the respiratory system.

Due to prolonged use, the medicine can change the shade of the eye iris. Such an effect develops because of the increase in the number of melanomas (these pigment granules). Usually, brown pigmentation appears in the area around the pupil, and then passes to the peripheral parts of the iris. It is possible and solid coloring of the entire iris or its small areas. The hue of the eyes changes slowly and gradually, therefore at the initial stage (in the first months or years) it can be imperceptible. In people with brown eyes this effect is more pronounced. After the end of therapy, this process does not progress, but in some cases may also not regress.

As a result of prolonged use of drops, the darkening of the eye lids sometimes begins. There are cases of increased degree of pigmentation of eyelashes, as well as their thickening and changes in the direction of growth. Such symptoms are usually irreversible.

There is insufficient information on the effect of drugs on the endothelium of the eye cornea with prolonged use of drops.

[10], [11], [12], [13],

Pharmacokinetics

Latanoprost, as well as its analogs, are 2-isopropoxypropane (a complex inactive substance), which after being absorbed into the eye is absorbed into the cornea. The medicine easily passes through the retina. Absorbed, the drug element undergoes hydrolysis with the participation of esterases. It is during this process that the active drug component, latanoprost acid, is formed.

After a lapse of 2 hours after topical application in the intraocular fluid, a peak level of the drug is observed. The active component is located inside the liquid in a period of 4 hours. Inside the blood plasma, Latanoprost is detected within 1 hour after the administration of drops.

The drug is subjected to hepatic metabolism, in which β-oxidative processes occur. The half-life of the blood plasma is 17 minutes. Disintegration products are excreted in the urine, as well as the kidneys.

[14], [15], [16], [17],

Dosing and administration

Drops are buried in the area of the conjunctival sac of the diseased eye once per day (it is recommended to do this in the evening). The dose is 1 drop. If the dosage was missed, the next dose does not need to be doubled.

[24], [25]

Use of the latanoprost during pregnancy

Use drops only with the permission of the doctor and under his supervision. Latanoprost is prescribed in pregnancy only in situations where it is expected that its positive effect will be more likely than fetal development of negative effects.

Due to the fact that the products of drug decay are able to pass into the mother's milk, during the period of therapy it is required to stop breastfeeding.

Contraindications

The main contraindications: a child's age is less than 18 years, as well as an increased sensitivity to the elements that make up the drug.

Caution is required when used in people who have been diagnosed with aphakia or pseudoafakia, but in addition to glaucoma of different types (congenital, inflammatory or neovascular).

[18], [19], [20]

Side effects of the latanoprost

The use of the drug sometimes causes the development of such side effects:

• lesions of the visual organs: sensation of irritation ("sand" in the eyes, burning or pricking), development of blepharitis, erosion in the cornea, conjunctivitis, uveitis with keratitis and iritis. In addition, visual turbidity, swelling of the macular type, as well as in the lower or upper eyelid. At the same time, hyperpigmentation of the iris, thickening or growth of eyelash growth (due to prolonged use of drops) is observed. Single retinal detachment or thrombotic changes inside its arteries develops;
• dermatological disorders: local manifestations on the skin of the eyelids, rashes and pigmentation intensification;
• lesions of organs of the ODA: the appearance of arthralgia or myalgia;
• disturbances of respiratory function: there is an exacerbation of bronchial asthma and dyspnea. In addition, there are more cases of infectious diseases of the upper respiratory system - the development of influenza or colds;
• disorders in the NA: nausea and headaches with dizziness.

In some cases, there are periodic pain in the sternum.

[21], [22], [23]

Overdose

Intoxication develops when using a dosage greater than 5-10 μg / kg. Inside the 1st vial with droplets contains 125 μg of the active ingredient. Poisoning is characterized by such signs: dizziness with nausea, pain in the joints or muscles, flushes of blood to the skin of the face, hyperhidrosis and a feeling of general weakness.

Treatment consists of procedures aimed at eliminating the symptoms of an overdose. The medicine does not have a special antidote.

[26], [27], [28], [29]

Interactions with other drugs

In the case of the joint application of 2 ophthalmic agents in the form of drops, a minimum of 5 minutes between use should be observed.

It is forbidden to combine 2 products of prostaglandins, as well as their derivatives.

There is a mutual strengthening of therapeutic properties when the drug is combined with cholino or adrenomimetics.

When using eye drugs from the category of NSAIDs, the medicinal efficacy of Latanoprost may be weakened.

The drug is absolutely not allowed to combine with eye drops, in which thiomersal is present, since precipitation is observed.

[30], [31], [32], [33]

Storage conditions

Latanoprost should be stored in a dark place, at a temperature of 2-8 ° C, without freezing. The opened vial should be kept at a temperature that does not exceed 25 ° C.

[34], [35]

Special instructions

Reviews

Latanoprost is a very effective tool to help reduce IOP rates - most reviews confirm the effectiveness of the drug. Among the advantages of drugs are also a low cost of the drug. Of the deficiencies noted the frequent development of side effects.

Shelf life

Latanoprost is allowed to be used in the period of 2 years from the moment of making drops. In this case, the opened bottle has a shelf life of not more than 1 month.

[36], [37]