Latanoprost
Latanoprost is a topical prostaglandin F2-alpha analogue used in adults and children for ocular hypertension and open-angle glaucoma. It reduces intraocular pressure once daily and is part of the World Health Organization List of Essential Medicines.
- Chemical formula
- C26H40O5
- CAS number
- 130209-82-4
- ATC code
- S01EE01
- Molecular weight
- 432.59 g/mol
- Drug class
- Prostaglandin analogue
- Also known as
- PHXA-41, Latanoprost
What is it?
Latanoprost was the first prostaglandin analogue approved for clinical use in glaucoma, in 1996. It is supplied as a 0.005% ophthalmic solution, including preservative-free formulations developed to reduce ocular surface intolerance. Latanoprost is dispensed only on prescription in most jurisdictions and is part of the World Health Organization List of Essential Medicines. Multiple authorised generics are now widely available worldwide.
Mechanism of action
Latanoprost is a prodrug ester hydrolysed by corneal esterases to its active free acid, which selectively binds the prostaglandin F (FP) receptor. Activation of FP receptors on uveoscleral tissue increases the outflow of aqueous humour through this non-trabecular pathway, lowering intraocular pressure. Effects on the conventional trabecular outflow pathway also contribute. The selective FP receptor activity distinguishes latanoprost from prostamide analogues such as bimatoprost.
Pharmacokinetics
Topical latanoprost is absorbed through the cornea, where it is rapidly converted to the active free acid. Peak aqueous humour concentrations occur within 1 to 2 hours. Systemic absorption is minimal and the active acid has a plasma half-life of approximately 17 minutes. The intraocular pressure-lowering effect begins within 3 to 4 hours, peaks at 8 to 12 hours and persists for at least 24 hours, supporting once-daily dosing.
Indications
Latanoprost is approved in adults and children for the treatment of ocular hypertension and chronic open-angle glaucoma. According to international guidelines, prostaglandin analogues such as latanoprost are typically first-line therapy for newly diagnosed glaucoma because of their efficacy, once-daily dosing and favourable systemic safety profile. Combination with other agents is considered when the target intraocular pressure is not achieved with monotherapy.
Safety profile
Common adverse effects include conjunctival hyperaemia, ocular irritation, eyelash growth and darkening, and progressive iris pigmentation, which is permanent. Periorbital skin pigmentation is also reported and may be reversible. Less common adverse effects include macular oedema, particularly in aphakic or pseudophakic patients, and reactivation of herpes simplex keratitis. According to the prescribing information, patients should be informed of potential cosmetic changes before initiating therapy.
Products containing this ingredient
Frequently asked questions
How is latanoprost different from bimatoprost or travoprost? ▾
All three are prostaglandin-class glaucoma agents. Latanoprost is a true prostaglandin F2-alpha analogue and travoprost is a related analogue, while bimatoprost is a prostamide analogue. Clinical efficacy is broadly comparable, with bimatoprost producing slightly greater pressure reduction in some studies but more pronounced conjunctival hyperaemia. According to international guidelines, the choice depends on individual response and tolerability, with the prescriber making the final decision.
When should latanoprost be applied? ▾
Latanoprost is applied as one drop in the affected eye(s) once daily, ideally in the evening. According to the prescribing information, this timing aligns with diurnal variation of intraocular pressure and produces optimal pressure control. More frequent dosing reduces rather than enhances the pressure-lowering effect. Multiple ophthalmic medications should be separated by at least 5 minutes.
Why does latanoprost cause iris colour changes? ▾
Prostaglandin analogues stimulate melanogenesis in iris melanocytes, leading to gradual increases in brown pigmentation. The change is most noticeable in patients with mixed-colour irises (blue-brown, green-brown, hazel) and is permanent. According to the prescribing information, patients should be informed of this possibility before initiating therapy. The cosmetic change does not affect ocular function or glaucoma control.
Should latanoprost be refrigerated? ▾
Sealed bottles of standard latanoprost preparations are typically stored refrigerated until first opening, then at room temperature for the duration of use (often up to 4 weeks), depending on the brand and country. Some new preservative-free or preservative-modified formulations have different storage requirements. According to the prescribing information for each product, storage instructions should be followed to maintain potency.
What are the main contraindications for latanoprost? ▾
Latanoprost is contraindicated in known hypersensitivity to latanoprost or its excipients. Caution is required in active intraocular inflammation, in aphakic or pseudophakic patients with disrupted posterior lens capsule (risk of macular oedema), in herpes simplex keratitis history and in pregnancy and breastfeeding. According to the prescribing information, the medical history must be reviewed by a clinician before any prescription, particularly in patients with a history of uveitis.
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.