Latanoprost

About Latanoprost

Latanoprost is a prostaglandin analog; MedlinePlus says it lowers pressure in the eye by increasing the flow of natural eye fluids out of the eye. Xalatan, its generics and Iyuzeh are labeled to reduce elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension, and the Xalatan and Iyuzeh labels say safety and effectiveness in children have not been established. The dose is one drop in the affected eye or eyes once daily in the evening. The Xalatan label says the dose should not exceed once daily, because giving these drugs more often may decrease the pressure-lowering effect or cause paradoxical rises in pressure; that combining two or more prostaglandin drops is not recommended; and that other eye drops are given at least five minutes apart.

There is no boxed warning. Latanoprost must not be used by anyone hypersensitive to it, to benzalkonium chloride (the preservative in Xalatan) or to another ingredient. It increases brown pigmentation of the iris, which is likely to be permanent and may not be noticeable for months to years, and can darken the eyelid skin and eyelashes, which has been reversible in some patients; lashes in a treated eye can grow longer, thicker and more numerous, which can make the two eyes look different. It should generally not be used with active inflammation inside the eye and should be avoided with active herpes simplex keratitis, and macular edema has been reported. Bacterial keratitis has been linked to contaminated multi-dose containers, so the tip should not touch the eye. Blurred vision, burning and stinging, redness of the eye, a foreign body sensation, itching, increased iris pigmentation and punctate keratitis are the most common side effects.

The Xalatan label says contact lenses come out before the drop and can go back in 15 minutes later, because its preservative may be absorbed by lenses; the preservative-free Iyuzeh label gives the same timing. Unopened bottles are kept in the refrigerator. Iyuzeh comes in single-dose containers, and each one is thrown away after use. Drugs@FDA lists Xelpros, an emulsion preserved with potassium sorbate, as discontinued, and MedlinePlus says it is no longer on the market; Rocklatan, which combines netarsudil with latanoprost, is a separate product. The Xalatan label reports no adequate and well-controlled studies in pregnant women and says it is not known whether latanoprost or its metabolites pass into breast milk.

Taking Latanoprost

How to take it

One drop in the affected eye or eyes once a day in the evening, and no more often. Wash your hands, tilt your head back, pull down the lower lid and squeeze out one drop without letting the tip touch the eye; then close the eye for 2 to 3 minutes. Open a new Iyuzeh container each time and throw it away after use.

If you miss a dose

If you miss a dose, continue with the next dose as normal; do not double up.

Storage

Keep unopened bottles in the refrigerator (Xalatan: 36 to 46°F), protected from light; an opened bottle may be kept at room temperature up to 77°F for 6 weeks. Keep Iyuzeh at 59 to 77°F in its original foil pouch, and use the containers within 30 days of opening the pouch.

Interactions to know about

Give other eye drops at least 5 minutes apart; drops containing thimerosal can form a precipitate when mixed with Xalatan. Remove contact lenses before each dose. Tell the prescriber about eye inflammation, past herpes infection of the eye, or risk factors for macular edema.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Latanoprost differs from pharmacy to pharmacy

Generic latanoprost bottles rated to Xalatan come from several makers, so quotes for the same bottle differ by each pharmacy’s fee and markup and by whether latanoprost is on its flat-price generic list. A prescription that names Xalatan and blocks substitution is filled with the brand.

Iyuzeh is a preservative-free brand with no rated generic, sold in cartons of single-dose containers, so it is quoted as its own product; a pharmacist does not swap it for a bottle, or a bottle for it, without the prescriber. The number of bottles or cartons written also shapes each quote: how long a bottle lasts depends on whether one or both eyes are treated, and an opened bottle keeps 6 weeks at room temperature.

Ways to pay less for Latanoprost without insurance

• Ask whether latanoprost is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Check that the prescription allows a generic, unless the prescriber has a reason to require Xalatan.
• Once your treatment is stable, ask the prescriber for a ninety-day supply, and keep unopened bottles in the refrigerator.
• If Iyuzeh is prescribed, ask the prescriber whether a preserved generic bottle would suit you, or ask the maker whether a savings program applies to someone paying cash.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Latanoprost

1. 1.How do I put in the drop without the tip touching my eye?
2. 2.How should I store my unopened and opened bottles?
3. 3.How far apart should I space latanoprost and my other eye drops?
4. 4.When can I put my contact lenses back in?

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