Version May 2024
Elevated intraocular pressure: Ophthalmic: Instill 1 drop into affected eye(s) once daily in the evening (maximum: 1 drop into affected eye(s) once daily).
There are no dosage adjustments provided in the manufacturer's labeling; dosage adjustments are unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; dosage adjustments are unlikely due to low systemic absorption.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%:
Local: Application site pain (20%)
Ophthalmic: Conjunctival hyperemia (53%), conjunctival hemorrhage (20%), corneal deposits (20%; verticillata)
1% to 10%:
Dermatologic: Erythema of eyelid (5% to 10%)
Local: Application site erythema (5% to 10%)
Ophthalmic: Blurred vision (5% to 10%), corneal staining (5% to 10%), decreased visual acuity (5% to 10%), increased lacrimation (5% to 10%)
There are no contraindications listed in the manufacturer's labeling
Concerns related to adverse effects:
• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.
Special populations:
• Contact lens wearers: Contains benzalkonium chloride, which may be absorbed by soft contact lenses. Remove contact lens prior to instillation; may reinsert 15 minutes following administration.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Rhopressa: 0.02% (2.5 mL) [contains benzalkonium chloride]
No
Solution (Rhopressa Ophthalmic)
0.02% (per mL): $155.73
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Ophthalmic: For ophthalmic use only. May be used with other eye drops to lower intraocular pressure. If using more than 1 ophthalmic product, wait at least 5 minutes in between application of each medication. Remove contact lenses prior to administration and wait at least 15 minutes (after administration) before reinserting. Avoid touching the dropper tip with fingers, eyes, eyelids, or surrounding areas to minimize contamination of the dropper tip.
Elevated intraocular pressure (IOP): Reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension
None known.
There are no known significant interactions.
Adverse events were not observed in animal reproduction studies following clinically relevant systemic exposure. Systemic absorption is minimal following ophthalmic application. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples 1988).
It is not known if netarsudil is present in breast milk; however, systemic absorption is minimal following ophthalmic application. According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.
Intraocular pressure
Although the exact mechanism of action of netarsudil, a rho kinase inhibitor, is unknown, it may reduce IOP by increasing the outflow of aqueous humor through the trabecular meshwork route.
Metabolism: Metabolized by esterases in the eye to active metabolite AR-13503.
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