latanoprost + netarsudil mesylate: clinical use

Prescribing considerations

• Initiation should be by an ophthalmologist or suitably qualified ophthalmic clinician.
• Licensed only for adults whose pressure response to a prostaglandin or netarsudil alone is insufficient.
• Safety and efficacy are not established in people under 18 years.
• Efficacy has not been studied beyond 12 months.
• Use caution with dry eye, compromised cornea, previous ocular surgery, aphakia, relevant pseudophakia, macular-oedema risk, uveitis risk or asthma.
• Avoid in active herpes simplex keratitis and recurrent keratitis linked to prostaglandin analogues.

Contraindications and cautions

• Hypersensitivity to latanoprost, netarsudil or any excipient.

Monitoring

• Intraocular pressure and visual function
• Ocular surface and corneal changes
• New eye pain or reduced vision
• Iris pigmentation and unilateral colour difference
• Inflammation, macular oedema and herpetic keratitis in susceptible patients
• Respiratory symptoms in patients with asthma

Clinical pharmacology

Latanoprost is an ester prodrug converted in the cornea to its active acid and mainly increases uveoscleral outflow. Netarsudil and its active metabolite inhibit Rho kinase, increasing trabecular outflow and reducing episcleral venous pressure; systemic exposure after ocular use is negligible.

Formulation and product differences

• Clear, colourless, preserved multidose eye-drop solution.
• Contains benzalkonium chloride and is not preservative-free.
• Unopened bottles require refrigerated, light-protected storage. After opening, follow the pack instructions for storage and disposal.

Eye drops

Route: Ophthalmic

Strengths: 50 micrograms/mL + 200 micrograms/mL