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LATANOPROST is a brand name for Latanoprost. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Reduction of elevated intraocular pressure (IOP) • in patients with open angle glaucoma and ocular hypertension – in adults (including the elderly). • in paediatric patients with elevated (IOP) and paediatric glaucoma.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Adults (including the elderly) Recommended therapy is one eye drop in the affected eye(s) once daily. Optimal effect is obtained if latanoprost eye drops is administered in the evening. The dosage of latanoprost eye drops should not exceed once daily since it has been shown that more frequent administration decreases the IOP lowering effect.
If one dose is missed, treatment should continue with the next dose as normal. Paediatric population Latanoprost eye drops may be used in paediatric patients at the same posology as in adults. No data are available for preterm infants (less than 36 weeks gestational age).
1). Method of administration As with any eye drops, to reduce possible systemic absorption, it is recommended that the lachrymal sac is compressed at the medial canthus (punctal occlusion) for one minute. This should be performed immediately following the instillation of each drop.
Contact lenses should be removed before instillation of the eye drops and may be reinserted after 15 minutes. If more than one topical ophthalmic medicinal product is being used, the medicinal products should be administered at least five minutes apart.
8. Periorbital skin discolouration has been observed, the majority of reports being in Japanese patients. Experience to date shows that periorbital skin discolouration is not permanent and in some cases has reversed while continuing treatment with latanoprost.
Latanoprost may gradually change eyelashes and vellus hair in the treated eye and surrounding areas; these changes include increased length, thickness, pigmentation, number of lashes or hairs and misdirected growth of eyelashes. Eyelash changes are reversible upon discontinuation of treatment.
Use of contact lenses Latanoprost eye drops contains benzalkonium chloride, which is commonly used as a preservative in ophthalmic products. Benzalkonium chloride may be absorbed by soft contact lenses and may change the colour of the contact lenses.
2). Benzalkonium chloride From the limited data available, there is no difference in the adverse event profile in children compared to adults. Generally, however, eyes in children show a stronger reaction for a given stimulus than the adult eye.
Irritation may have an effect on treatment adherence in children. Benzalkonium chloride has been reported to cause eye irritation, symptoms of dry eyes and may affect the tear film and corneal surface. Should be used with caution in dry eye patients, and in patients where the cornea may be compromised.
Patients should be monitored in case of prolonged use. . 1). No data are available for preterm infants (less than 36 weeks gestational age). g. trabeculotomy/goniotomy) remains the first line treatment. 5 Interaction with other medicinal products and other forms of interaction Definitive drug interaction data are not available.
There have been reports of paradoxical elevations in IOP following the concomitant ophthalmic administration of two prostaglandin analogues. Therefore, the use of two or more prostaglandins, prostaglandin analogues or prostaglandin derivatives is not recommended.
Latanoprost eye drops may gradually change eye colour by increasing the amount of brown pigment in the iris. Before treatment is instituted, patients should be informed of the possibility of a permanent change in eye colour. Unilateral treatment can result in permanent heterochromia.
e. blue-brown, grey-brown, yellow-brown and green-brown. In studies with latanoprost, the onset of the change is usually within the first 8 months of treatment, rarely during the second or third year, and has not been seen after the fourth year of treatment.
The rate of progression of iris pigmentation decreases with time and is stable for five years. The effect of increased pigmentation beyond five years has not been evaluated. 8). The iris colour change is slight in the majority of cases and often not observed clinically.
The incidence in patients with mixed colour irises ranged from 7 to 85%, with yellow-brown irises having the highest incidence. In patients with homogeneously blue eyes, no change has been observed and in patients with homogeneously grey, green or brown eyes, the change has only rarely been seen.
The colour change is due to increased melanin content in the stromal melanocytes of the iris and not to an increase in number of melanocytes. Typically, the brown pigmentation around the pupil spreads concentrically towards the periphery in affected eyes, but the entire iris or parts of it may become more brownish.
No further increase in brown iris pigment has been observed after discontinuation of treatment. It has not been associated with any symptom or pathological changes in clinical trials to date. Neither naevi nor freckles of the iris have been affected by treatment.
Accumulation of pigment in the trabecular meshwork or elsewhere in the anterior chamber has not been observed in clinical trials. Based on 5 years clinical experience, increased iris pigmentation has not been shown to have any negative clinical sequelae and latanoprost eye drops can be continued if iris pigmentation ensues.
1.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Paediatric population Interaction studies have only been performed in adults. 6 Fertility, pregnancy and lactation Pregnancy The safety of this medicinal product for use in human pregnancy has not been established. It has potential hazardous pharmacological effects with respect to the course of pregnancy, to the unborn or the neonate.
Therefore, Latanoprost eye drops should not be used during pregnancy. Breast-feeding Latanoprost and its metabolites may pass into breast milk and Latanoprost eye drops should therefore not be used in breast-feeding women or breast feeding should be stopped.
3). 7 Effects on ability to drive and use machines Latanoprost eye drops has minor influence on the ability to drive and use machines. In common with other eye preparations, instillation of eye drops may cause transient blurring of vision.
Until this has resolved, patients should not drive or use machines. 8 Undesirable effects Summary of the safety profile The majority of adverse reactions relate to the ocular system. 4). Other ocular adverse reactions are generally transient and occur on dose administration.
Tabulated list of adverse reactions Adverse reactions are categorized by frequency as follows: very common (≥ 1/10), common (≥ 1/100 to < 1/10), uncommon (≥ 1/1,000 to < 1/100), rare (≥ 1/10,000 to < 1/1,000) and very rare (< 1/10,000), not known (frequency cannot be estimated from the available data).
System Organ Class Frequency Adverse reaction Infections and infestations Rare Herpetic keratitis1,2. Nervous system disorders Uncommon Headache1; dizziness1. Very common Iris hyperpigmentation; mild to moderate conjunctival hyperaemia; eye irritation (burning grittiness, itching, stinging and foreign body sensation); eyelash and vellus hair changes of the eyelid (increased length, thickness, pigmentation and number of eyelashes).
Common Punctate keratitis, mostly without symptoms; blepharitis; eye pain; photophobia; conjunctivitis1. Eye disorders Uncommon Eyelid oedema; dry eye; keratitis1; vision blurred; macular oedema including cystoid macular oedema1; uveitis1.
Rare Iritis1; corneal oedema1; corneal erosion; periorbital oedema; trichiasis1; distichiasis; iris cyst1,2; localised skin reaction on the eyelids; darkening of the palpebral skin of the eyelids; pseudopemphigoid of ocular conjunctiva1,2.
Very rare Periorbital and lid changes resulting in deepening of the eyelid sulcus. Cardiac disorders Very rare Angina unstable. Respiratory, thoracic and mediastinal disorders Rare Asthma exacerbation. Skin and subcutaneous tissue disorders Rare Pruritus.
Musculoskeletal and connective tissue disorders Uncommon Myalgia1; arthralgia1. General disorders and administration site conditions Uncommon Chest pain1. 1 ADR identified post-marketing. 2 ADR frequency estimated using “The rule of 3”.
Phosphate buffers Cases of corneal calcification have been reported very rarely in association with the use of phosphate containing eye drops in some patients with significantly damaged corneas. Description of selected adverse reactions No information is provided.
Paediatric population In two short term clinical trials (≤ 12 weeks), involving 93 (25 and 68) paediatric patients the safety profile was similar to that in adults and no new adverse events were […]
However, patients should be monitored regularly and if the clinical situation warrants, latanoprost eye drops treatment may be discontinued. There is limited experience of latanoprost in chronic angle closure glaucoma, open angle glaucoma of pseudophakic patients and in pigmentary glaucoma.
There is no experience of latanoprost in inflammatory and neovascular glaucoma or inflammatory ocular conditions. Latanoprost eye drops has no or little effect on the pupil, but there is no experience in acute attacks of closed angle glaucoma.
Therefore, it is recommended that latanoprost eye drops should be used with caution in these conditions until more experience is obtained. There are limited study data on the use of latanoprost during the peri-operative period of cataract surgery.
Latanoprost eye drops should be used with caution in these patients. Latanoprost eye drops should be used with caution in patients with a history of herpetic keratitis, and should be avoided in cases of active herpes simplex keratitis and in patients with a history of recurrent herpetic keratitis specifically associated with prostaglandin analogues.
8) mainly in aphakic patients, in pseudophakic patients with torn posterior lens capsule or anterior chamber lenses, or in patients with known risk factors for cystoid macular oedema (such as diabetic retinopathy and retinal vein occlusion).
Latanoprost eye drops should be used with caution in aphakic patients, in pseudophakic patients with torn posterior lens capsule or anterior chamber lenses, or in patients with known risk factors for cystoid macular oedema. In patients with known predisposing risk factors for iritis/uveitis, latanoprost eye drops can be used with caution.
There is limited experience from patients with asthma, but some cases of exacerbation of asthma and/or dyspnoea were reported in post marketing experience. 8. Periorbital skin discolouration has been observed, the majority of reports being in Japanese patients.
Experience to date shows that periorbital skin discolouration is not permanent and in some cases has reversed while continuing treatment with latanoprost. Latanoprost may gradually change eyelashes and vellus hair in the treated eye and surrounding areas; these changes include increased length, thickness, pigmentation, number of lashes or hairs and misdirected growth of eyelashes.
Eyelash changes are reversible upon discontinuation of treatment. Use of contact lenses Latanoprost eye drops contains benzalkonium chloride, which is commonly used as a preservative in ophthalmic products. Benzalkonium chloride may be absorbed by soft contact lenses and may change the colour of the contact lenses.
2). Benzalkonium chloride From the limited data available, there is no difference in the adverse event profile in children compared to adults. Generally, however, eyes in children show a stronger reaction for a given stimulus than the adult eye.
Irritation may have an effect on treatment adherence in children. Benzalkonium chloride has been reported to cause eye irritation, symptoms of dry eyes and may affect the tear film and corneal surface. Should be used with caution in dry eye patients, and in patients where the cornea may be compromised.
Patients should be monitored in case of prolonged use. . 1). No data are available for preterm infants (less than 36 weeks gestational age). In […]