Can Prostaglandin Analog Eye Drops Induce Vomiting?
Prostaglandin analog eye drops (such as latanoprost, travoprost, and bimatoprost) do not induce vomiting as a recognized adverse effect. These medications are associated with primarily local ocular side effects rather than systemic gastrointestinal symptoms.
Known Adverse Effects of Prostaglandin Analogs
The documented side effects of prostaglandin analogs are predominantly ocular and do not include nausea or vomiting 1:
Local Ocular Effects
- Conjunctival hyperemia (redness) is the most common adverse effect 2, 3
- Iris pigmentation changes due to increased melanin synthesis in iris melanocytes, most frequently seen in green-brown eyes and likely permanent 4
- Eyelash changes including bristling, lengthening, and increased growth 3
- Eyelid pigmentation and upper eyelid deepening 3
- Eye irritation syndromes including stinging, burning, itching, and discomfort after instillation 1, 5
- Cystoid macular edema at low frequency, predominantly in predisposed eyes 4
Systemic Tolerability Profile
Prostaglandin analogs have a favorable systemic tolerability profile because they reach plasma concentrations below that needed for stimulation of the FP-receptor 4. Notably, no systemic adverse reactions have been linked to prostaglandin analog eye drop usage 3.
Distinguishing from Other Glaucoma Medications
This is in stark contrast to other glaucoma medication classes:
- Beta-blockers frequently cause systemic adverse reactions including bradycardia, decreased blood pressure, irregular pulse, and asthma attacks 3
- Carbonic anhydrase inhibitors (particularly oral formulations) can cause gastrointestinal symptoms
- The evidence specifically notes that prostaglandin analogs are "well tolerated" with systemic effects being minimal 4
Clinical Pitfall to Avoid
Do not attribute gastrointestinal symptoms to prostaglandin analog eye drops 4, 3. If a patient using these drops experiences vomiting, investigate alternative causes including:
- Other medications the patient is taking
- Underlying gastrointestinal conditions
- Systemic illnesses
- Cannabis use (which can cause cyclic vomiting syndrome) 1
The only reference to vomiting in the context of eye medications relates to cannabinoids, where there was "low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to adverse events of cannabinoids" 1—but this is unrelated to prostaglandin analogs.