Pharmacological properties Xalatan Eye Drops:
Xalatan Eye Drops latanoprost (isoprene-(Z) -7 [(1R, 2R, 3R, 5S) 3,5-dihydroxy-2-[(3R)-3-hydroxy-5-phenyl-1-pentyl] cyclopentyl] – 5 geptenoat) – analogue of prostaglandin F2b, a selective receptor agonist prostanoids FP. Lowers intraocular pressure by increasing outflow of aqueous humor eyes, has no significant effect on the production of aqueous humor, does not affect the blood aqueous barrier.
The main mechanism of action is associated with an increase in uveoscleral outflow, as there is a slight decrease in outflow resistance.
Reduction of intraocular pressure starts approximately 3-4 hours after drug administration, maximum effect within 8-12 hours duration of action – at least 24 h.
Latanoprost in therapeutic doses has no effect on intraocular blood flow, as well as cardiovascular and respiratory systems. When applied topically, or may develop conjunctival hyperemia episkleralnaya (from mild to srednevyrazhennoy).
In the short course of treatment in patients with psevdoafakiey latanoprost did not cause penetration of fluorescein into the posterior segment of the eye.
Latanoprost (molecular weight 432.58 daltons) is the isopropyl ester is a prodrug and that, after hydrolysis with the formation of acid of latanoprost becomes biologically active. It penetrates through the cornea, while the drug is hydrolyzed to the biologically active form. The maximum concentration in the aqueous humor eye reached approximately 2 hours after topical drug application. Distributed primarily in the anterior segment of the conjunctiva and eyelids, only a small amount of drug reaching the posterior segment eye.
In the tissues of the eye is practically not metabolized; metabolism occurs primarily in the liver. In humans, the half-life of latanoprost is 17 minutes. The main metabolites (1,2-Dinora-and 1,2,3,4-tetranor metabolites) does not possess or have low biological activity and appear mainly in the urine.
INDICATIONS Xalatan Eye Drops:
reduction of elevated intraocular pressure in patients with open angle glaucoma and elevated IOP.
USE Xalatan Eye Drops:
Adults (including elderly) to designate a drop in patient eye 1 per day. The optimum effect is achieved if Xalatan buried in the evening. Frequency of Xalatan should not exceed 1 times a day, since established that the more frequent instillation of efficacy with regard to its impact on intraocular pressure is reduced.
If you forget doses of the following must be entered in normal mode (1 drop of the drug).
Xalatan can be used for mono-and combination therapy.
In the appointment of combination therapy other eye drops should be instilled with an interval of at least 5 minutes.
Safety and efficacy of the drug in children has not been established.
CONTRAINDICATIONS Xalatan Eye Drops:
Hypersensitivity to any component of Xalatan .
SIDE EFFECTS Xalatan Eye Drops:
Approximately 10% of patients who receive treatment with constantly, there is a slight redness of the conjunctiva, approximately 1% – srednevyrazhennaya. In some patients the epithelial erosion point (in most cases are asymptomatic), increased pigmentation of the iris, in rare cases – macular edema (mainly in patients with aphakia or psevdoafakiey, with the lens in the anterior chamber of the eye). In a few cases were observed during treatment skin rash of unknown etiology.
SPECIAL INSTRUCTIONS Xalatan Eye Drops:
Xalatan can cause a gradual change in eye color by increasing the amount of brown pigment in the iris. This effect occurs mainly in patients with mixed color of the iris, such as blue-brown, gray-brown, greenish-brown or yellowish-brown, due to increased melanin content in melanocytes of the iris. Usually brown pigmentation around the pupil spreads concentrically towards the periphery of the iris, with all or part of the shell could become more intense brown color. Results of a clinical trial showed that patients with a uniformly colored eyes of blue, gray, green or brown eye color change after 2 years of treatment were observed very rarely.
Changes in the color of the iris develops slowly and can remain unnoticed for months or even years. In clinical trials confirmed that the color change is not accompanied by any clinical symptoms or pathological changes. After the drug was observed to further increase the number of brown pigment, but already developed color change may be irreversible. Until then, pending the results of long-term studies, patients with mixed color of the iris is recommended to prescribe the drug only if other medicines that reduce intraocular pressure, not effective or poorly tolerated.
In the presence of nevi or lentigines on the iris were observed to change under the influence of latanoprost therapy.
In clinical trials revealed no accumulation of pigment in the trabecular meshwork or in any other department of the anterior chamber.
Prior to treatment patients should be informed about the possibility of changing eye color. Treatment of only one eye can lead to permanent heterochromia.
There is currently no data on the use Xalatan eye inflammatory diseases, and inflammatory, neovascular, congenital glaucoma and closed-, there is little experience with open-angle glaucoma Xalatan in patients with psevdoafakiey, as well as pigmentary glaucoma. Xalatan not have or has a negligible effect on the pupil, but no evidence on the effects of the drug at the time of an acute attack of angle-closure glaucoma with. So until then, until the accumulated enough clinical experience in these states Xalatan recommended be used with caution.
Xalatan contains benzalkonium chloride, which can be absorbed by contact lenses. Before burying Xalatan contact lenses should be removed; wear lenses can be just 15 minutes after instillation.
The drug can be used during pregnancy only if the potential benefit clearly outweighs the potential risk to the fetus.
Latanoprost and its metabolites can cross into breast milk, so breastfeeding Xalatan be used with caution.
In applying Xalatan (and other ophthalmic preparations) may develop transient feeling veil before the eyes that must be considered in the management of vehicles and working with potentially dangerous machinery.
INTERACTION Xalatan Eye Drops:
latanoprost has an additive effect on lowering intraocular pressure when used in combination with a-adrenergic blocker (timolol), agonists (epinephrine, dipivalil), carbonic anhydrase inhibitors (acetazolamide) and a partial additive effect when used in combination with holinomimetikami (pilocarpine) .
In vitro studies revealed that, when mixed with Xalatan eye drops containing thimerosal, is precipitation. Therefore, eye drops containing these substances should be applied at intervals of not less than 5 minutes.
OVERDOSE Xalatan Eye Drops:
If overdose Xalatan observed eye irritation and redness of the conjunctiva, other side effects from the eye were noted.
In case of accidental admission Xalatan inside should be kept in mind that a bottle contains 125 mcg of latanoprost. Over 90% metabolized during the initial passage through the liver. I / v infusion of latanoprost at a dose of 3 mg / kg to healthy volunteers did not cause the development of any symptoms, but when administered in a dose of 5-10 mg / kg of nausea, abdominal pain, dizziness, headache, weakness, flushing to face and sweating. In the application of latanoprost in doses 7 times greater than therapeutic, in patients with asthma were no effects on respiratory function, heart rate or blood pressure. If necessary, symptomatic treatment.
