Latanoprost Indications
Latanoprost is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension. 1
Primary FDA-Approved Indication
- Latanoprost ophthalmic solution is specifically approved for reducing elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension 1
Position as First-Line Therapy
- The American Academy of Ophthalmology recommends prostaglandin analogs, including latanoprost, as among the most efficacious first-line medications for lowering IOP in open-angle glaucoma and ocular hypertension 2
- Latanoprost provides superior IOP reduction compared to alternative agents, achieving an 8.5 mmHg reduction from baseline versus 5.6 mmHg with dorzolamide 3
- As a prostaglandin analog class, latanoprost demonstrates 22-39% IOP reduction over 1-12 months of treatment, making it the most effective monotherapy regimen 4, 5
Mechanism Supporting Its Use
- Latanoprost works by increasing uveoscleral outflow rather than affecting conventional trabecular outflow or aqueous production, providing a unique mechanism of action 6, 7
- The IOP-lowering effect lasts 20-24 hours after a single dose, allowing convenient once-daily dosing (preferably in the evening) 5, 8
Role in Combination Therapy
- Fixed combination therapy of latanoprost with timolol provides better IOP-lowering effects than either component alone for patients requiring multiple medications 2, 4
- Latanoprost produces clinically significant additive IOP reduction when combined with timolol, pilocarpine, acetazolamide, dipivefrin, dorzolamide, or brimonidine 9, 5
- When using combination therapy, space administration of different eye drops by at least 5 minutes to prevent washout 3, 4
Limited Evidence for Other Glaucoma Types
- Preliminary data suggest latanoprost may be effective in angle-closure glaucoma patients with elevated IOP after iridotomy, showing superior efficacy to timolol over 12 weeks 5
- However, wider clinical experience is required to define latanoprost's role in angle-closure glaucoma 5
Key Clinical Advantages
- Latanoprost has a favorable tolerability profile compared to other prostaglandin analogs 2
- Unlike beta-blockers such as timolol, latanoprost induces minimal systemic adverse events and does not produce cardiopulmonary effects 5, 6
- The once-daily dosing regimen improves patient adherence compared to twice-daily alternatives 2, 3
Important Caveat
- Latanoprost causes permanent iris pigmentation (increased iris darkening) in 2-10% of patients, particularly those with heterochromatic (hazel) iris color, though this has not been associated with ocular complications 5, 8
- The American Academy of Ophthalmology notes Pregnancy Category C rating; most ophthalmologists avoid prostaglandins during pregnancy due to theoretical risk of premature labor 2