Prostaglandin analogs for glaucoma

Examples

Generic Name Brand Name
bimatoprost Lumigan
latanoprost Xalatan
travoprost Travatan

How It Works

Prostaglandin analogs reduce pressure inside the eye (intraocular pressure, or IOP) by increasing the removal of fluid (aqueous humor) from the eye.

These medicines are given in eyedrop form.

Why It Is Used

Prostaglandin analogs are used to reduce intraocular pressure in people who have open-angle glaucoma or high intraocular pressure (ocular hypertension). They can be used alone or in combination with other glaucoma medicines.

How Well It Works

All the prostaglandin analogs have been shown to be effective in lowering the pressure inside the eye, lowering the risk of damage to the optic nerve. In studies, prostaglandin analogs were able to reduce IOP by 30% to 35%; an additional drop in IOP occurred when these medicines were taken in combination with another medicine such as the beta-blocker timolol or the adrenergic agonist dipivefrin.1

Prostaglandin analogs are a relatively new class of medicines, and studies comparing the long-term safety and effectiveness of these medicines are in progress.

Side Effects

Side effects of prostaglandin analogs include:

  • Blurred vision or other decrease in visual acuity.
  • Dry eyes.
  • Itching, burning, and stinging after using the drops.
  • Increased coloring of the colored part (iris) of the eye. This mostly occurs in people with hazel eyes. The change in eye color may be permanent. Prostaglandin analogs may also cause increased coloring in the eyelid (darkening of the skin) and darkening and increased growth of the eyelashes. These changes also may be permanent.
  • Skin rash or allergic skin reaction.
  • Inflammation in the front part of the eye (anterior chamber).
  • Upper respiratory tract infections, colds, and flu (uncommon).

The American Academy of Ophthalmology states that there have been no whole-body (systemic) side effects associated with prostaglandin medicines for glaucoma. Latanoprost has no effect on blood pressure or heart rate.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

People who wear contact lenses need to take their contacts out before putting these eyedrops into their eyes. The contacts can be reinserted 15 minutes after using the eyedrops.

If you are putting in more than one type of eyedrop at the same time, wait 5 minutes between medicines.

Prostaglandin analogs should be used with caution by people who have infections in the eye (such as herpes keratitis) or inflammation (uveitis), who have had cataract surgery or other problems with the lens of the eye, or who are at risk for swelling in the macula at the back of the eye.

Bimatoprost and travoprost should not be used by women during pregnancy or by women who are trying to become pregnant. They should be used with caution by women who are breast-feeding.

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References

Citations

  1. Schuman JS (2000). Antiglaucoma medications: A review of safety and tolerability issues related to their use. Clinical Therapeutics, 22(2): 167–208.

Last Updated: May 23, 2008

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