Version May 2024
Elevated intraocular pressure: Ophthalmic: One drop in the affected eye(s) once daily in the evening; do not exceed the once daily dosage (may decrease the IOP-lowering effect)
There is no dosage adjustment provided in manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
There is no dosage adjustment provided in manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
Refer to adult dosing.
(For additional information see "Latanoprost: Pediatric drug information")
Glaucoma , elevated intraocular pressure: Limited data available: Infants, Children, and Adolescents: Ophthalmic solution (eg, Xalatan): Ophthalmic: 1 drop to affected eye(s) once daily in the evening (Ref).
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely due to low systemic absorption.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%: Ophthalmic: Abnormal sensation in eyes (14%), conjunctival hyperemia (8% to 34%), eye discharge (12%), eye irritation (19%), eye pain (≤55%), eye pruritus (5% to 15%), foreign body sensation of eye (2% to 13%), increased eyelash length (11%), ocular hyperemia (41%), stinging of eyes (≤55%)
1% to 10%:
Dermatologic: Allergic skin reaction (≤1%, including eyelid), skin rash (≤1%)
Infection: Influenza (≤3%)
Neuromuscular & skeletal: Arthralgia (≤1%), back pain (≤1%), myalgia (≤1%)
Ophthalmic: Blepharitis (1%), blurred vision (7% to 8%), burning sensation of eyes (7%), conjunctival edema (1%), crusting of eyelid (3%), decreased visual acuity (4%), dry eye syndrome (3%), erythema of eyelid (3%), eyelid edema (1% to 2%), eyelid pain (4%), hyperpigmentation of eyelashes (1%), increased eyelash thickness (8%), iris hyperpigmentation (7%), lacrimation (4% to 5%), photophobia (2% to 3%), punctate keratitis (1% to 10%)
Respiratory: Nasopharyngitis (≤3%), upper respiratory tract infection (≤3%)
Postmarketing:
Cardiovascular: Angina pectoris (including unstable angina pectoris), chest pain, palpitations
Dermatologic: Pruritus, toxic epidermal necrolysis
Gastrointestinal: Nausea, vomiting
Nervous system: Dizziness, headache
Ophthalmic: Conjunctivitis (including pseudopemphigoid of the ocular conjunctiva), corneal edema, corneal erosion, deepening of the eyelid sulcus, herpes simplex keratitis, hyperpigmentation of eyelid, hypertrichosis of eyelid, iris cyst, iritis, keratitis, macular edema (including cystoid macular edema), misdirected growth of eyelashes (including trichiasis), uveitis
Respiratory: Asthma (including exacerbation of asthma), dyspnea
Hypersensitivity to latanoprost, benzalkonium chloride, or any component of the formulation
Concerns related to adverse effects:
• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions, has caused bacterial keratitis.
• Ocular effects: May change/increase brown pigmentation of the iris, the eyelid skin, and eyelashes; length and/or number of eyelashes may also be increased. Pigmentation of the iris is likely to be permanent although iris color change may not be noticeable for months to years; pigmentation of the periorbital tissue and eyelash changes may be reversible following discontinuation of therapy. Long-term consequences and potential injury to eye are not known.
• Ocular inflammation: Intraocular inflammation and exacerbation of inflammation may occur; use with caution in patients with a history of intraocular inflammation (eg, iritis/uveitis) and generally avoid use in patients with active intraocular inflammation.
Disease-related concerns:
• Herpetic keratitis: Use with caution in patients with a history of herpes simplex keratitis; reactivation may occur. Avoid use in patients with active herpes simplex keratitis.
• Ocular disease: Use with caution in aphakic patients, pseudophakic patients with a torn posterior lens capsule, or patients with risk factors for macular edema. Safety and efficacy have not been determined for use in patients with angle-closure, inflammatory, or neovascular glaucoma.
Special populations:
• Contact lens wearers: Solution contains benzalkonium chloride which may be absorbed by contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Emulsion, Ophthalmic:
Xelpros: 0.005% (2.5 mL) [contains edetate (edta) disodium, propylene glycol]
Solution, Ophthalmic:
Iyuzeh: 0.005% (5 ea) [contains edetate (edta) disodium, peg-40 hydrog castor oil(cremophor rh40)]
Xalatan: 0.005% (2.5 mL) [contains benzalkonium chloride]
Generic: 0.005% (2.5 mL)
May be product dependent
Emulsion (Xelpros Ophthalmic)
0.005% (per mL): $28.80
Solution (Iyuzeh Ophthalmic)
0.005% (per each): $11.96
Solution (Latanoprost Ophthalmic)
0.005% (per mL): $3.63 - $38.11
Solution (Xalatan Ophthalmic)
0.005% (per mL): $120.82
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.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Monoprost: 0.005% (0.2 mL) [contains edetate (edta) disodium]
Xalatan: 0.005% (2.5 mL) [contains benzalkonium chloride]
Generic: 0.005% (2.5 mL, 5 mL)
Ophthalmic: Wash hands prior to use. May be used with other eye drops to lower intraocular pressure. If more than 1 topical ophthalmic drug is being used, administer the drugs at least 5 minutes apart. Remove contact lenses prior to administration and wait 15 minutes before reinserting.
Ophthalmic: Wash hands before use.
Solution (eg, Xalatan): Unscrew the cap by turning in the direction of the arrows on top of the cap. Pull lower eyelid down slightly to form a pocket for the eye drop and tilt head back; administer 1 drop. Apply gentle pressure to lacrimal sac immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration to decrease systemic absorption of ophthalmic drops (Ref). Avoid contact of bottle tip with skin or eye; remove contact lenses prior to administration and wait at least 15 minutes after instillation before reinserting soft contact lenses. If more than one topical ophthalmic drug is being used, separate administration by at least 5 minutes.
Elevated intraocular pressure: Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.
Latanoprost may be confused with Lantus
Xalatan may be confused with Lantus, Travatan, Xalacom, Zarontin
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Nonsteroidal Anti-Inflammatory Agents: May diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents may also enhance the therapeutic effects of Prostaglandins (Ophthalmic). Risk C: Monitor therapy
Nonsteroidal Anti-Inflammatory Agents (Ophthalmic): May diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents (Ophthalmic) may enhance the therapeutic effect of Prostaglandins (Ophthalmic). Risk C: Monitor therapy
Prostaglandins (Ophthalmic): The concomitant use of Prostaglandins (Ophthalmic) and Latanoprost may result in increased intraocular pressure. Risk X: Avoid combination
Ophthalmic prostaglandins, such as latanoprost, have a theoretical risk of miscarriage. To decrease this risk, agents other than latanoprost may be preferred for the treatment of glaucoma in patients planning to become pregnant (Strelow 2020).
Information related to latanoprost use in pregnancy is limited (DeSantis 2004).
Ophthalmic prostaglandins, such as latanoprost, are generally avoided during pregnancy due to a theoretical risk of miscarriage and premature labor. Agents other than latanoprost may be preferred for the treatment of glaucoma during pregnancy, especially during the first trimester. In general, if ophthalmic agents are needed in pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease exposure to the fetus (Belkin 2020; Prum 2016; Strelow 2020).
It is not known if latanoprost is present in breast milk.
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. Due to their short half-lives, ophthalmic prostaglandins, such as latanoprost, are considered compatible with breastfeeding; administering after breastfeeding may help decrease potential exposure to the infant via breast milk (Belkin 2020; Prum 2016; Strelow 2020).
Monitor IOP; regularly examine patients who develop increased iris pigmentation.
Latanoprost is a prostaglandin F2-alpha analog believed to reduce intraocular pressure by increasing the outflow of the aqueous humor
Onset of action: 3 to 4 hours
Peak effect: Maximum: 8 to 12 hours
Absorption: Through the cornea where the isopropyl ester prodrug is hydrolyzed by esterases to the biologically active acid. Peak concentration is reached in 2 hours after topical administration in the aqueous humor.
Distribution: Vd: 0.16 ± 0.02 L/kg
Metabolism: Primarily hepatic via fatty acid beta-oxidation
Half-life elimination: 17 minutes
Excretion: Urine (as metabolites)
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