What are the recommended doses and frequency of Latanoprost (prostaglandin F2 alpha analogue) for therapeutic use?

From the Guidelines

Latanoprost should be prescribed as a 0.005% ophthalmic solution to be administered once daily, preferably in the evening, due to its efficacy in lowering intraocular pressure and its relatively safe profile 1. The standard dosage is one drop in the affected eye(s), and this dosing schedule is supported by the primary open-angle glaucoma preferred practice pattern guidelines, which recommend prostaglandin analogs, such as latanoprost, as the most frequently prescribed initial eye drops for lowering IOP in patients with glaucoma 1. Some key points to consider when prescribing latanoprost include:

• Evening administration is recommended because it provides better intraocular pressure (IOP) reduction compared to morning application
• The medication takes approximately 3-4 weeks to reach its maximum IOP-lowering effect, so consistent daily use is important
• Patients should be advised to wait at least 5 minutes between applying different eye medications and to apply gentle pressure to the inner corner of the eye for 1-2 minutes after administration to minimize systemic absorption
• Common side effects include eye redness, gradual change in eye color, increased eyelash growth, and occasional eye irritation It is essential to monitor patients regularly to assess the effectiveness of the treatment and to adjust the dosage or add other medications if necessary, as recommended by the guidelines 1.

From the FDA Drug Label

The recommended dosage is one drop (1. 5 μg) in the affected eye(s) once daily in the evening. The dosage of latanoprost ophthalmic solution should not exceed once daily; It has been shown that administration of these prostaglandin drug products more than once daily may decrease the intraocular pressure lowering effect or cause paradoxical elevations in IOP.

The recommended dose of latanoprost is 1.5 μg (one drop) in the affected eye(s) and the recommended frequency is once daily in the evening 2.

• The dosage should not exceed once daily.
• Administration of latanoprost more than once daily is not recommended as it may decrease the intraocular pressure lowering effect or cause paradoxical elevations in IOP.

From the Research

Latanoprost Doses and Frequency

• The recommended dose of latanoprost is 0.005% once daily, as it has been shown to be effective in reducing intraocular pressure (IOP) in patients with primary open-angle glaucoma or ocular hypertension 3.
• A study comparing two dose regimens of latanoprost found that 50 microg/ml once daily was more effective than 15 microg/ml twice daily in reducing IOP, with a difference of 1.4 mmHg 4.
• The IOP-lowering effect of latanoprost lasts for 20 to 24 hours after a single dose, allowing for a single daily dosage regimen 3.

Combination Therapies

• Latanoprost can be used in combination with other antiglaucoma agents to enhance its IOP-lowering effects 3.
• Fixed combinations of prostaglandins with timolol are available and have been shown to be effective in reducing IOP, with advantages over multi-drop, multi-bottle therapy in terms of patient convenience and adherence 5, 6.
• Unfixed combinations of prostaglandin analogues with other classes of medications, such as β-adrenoceptor antagonists, carbonic anhydrase inhibitors, or α(2)-adrenoceptor agonists, have also been shown to be effective in reducing IOP 6.

Efficacy and Tolerability

• Latanoprost is well tolerated, with no or barely detectable conjunctival hyperaemia, and is not associated with systemic adverse effects 3.
• The most common adverse effect of latanoprost is increased iris pigmentation, which occurs in 3 to 10% of patients treated with 0.005% latanoprost 3.
• Fixed combinations of prostaglandin analogues with timolol have been shown to be better tolerated than the individual components used separately as monotherapy 6.