Xalatan

Xalatan (latanoprost ophthalmic solution) 0.005% is a prostaglandin analogue prescription medication specifically formulated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma and ocular hypertension. As a first-line therapeutic option, it works by increasing the outflow of aqueous humor through the uveoscleral pathway, providing consistent 24-hour pressure control with once-daily dosing. Its well-established efficacy profile and favorable safety tolerance make it a cornerstone in ophthalmologic practice for preserving visual field and preventing optic nerve damage associated with progressive glaucomatous changes.

Features

• Contains latanoprost 50 mcg/mL (0.005%) as the active pharmaceutical ingredient
• Available in 2.5 mL translucent low-density polyethylene bottle with tamper-evident closure
• Preservative-containing formulation (benzalkonium chloride 0.02%)
• pH approximately 6.7 with osmolarity of approximately 290 mOsmol/kg
• Clear, isotonic solution with negligible systemic absorption
• Room temperature storage stability (15-30°C/59-86°F)

Benefits

• Provides significant IOP reduction ranging from 25-35% from baseline measurements
• Maintains consistent 24-hour pressure control with single daily administration
• Demonstrates excellent ocular tolerability with minimal systemic side effects
• Shows progressive efficacy improvement over first several weeks of treatment
• Reduces treatment burden through simplified dosing regimen
• Preserves visual field by preventing progressive optic neuropathy

Common use

Xalatan is primarily indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma and ocular hypertension. It is frequently prescribed as initial monotherapy or in combination with other IOP-lowering agents when target pressure is not achieved with single-agent treatment. The medication is particularly valuable for patients requiring evening dosing due to its physiological peak effect occurring approximately 8-12 hours after administration. Clinical studies demonstrate its effectiveness across various patient demographics, including elderly populations and those with pigmentary or pseudoexfoliative glaucoma.

Dosage and direction

The recommended dosage is one drop in the affected eye(s) once daily in the evening. Administration frequency exceeding once daily may decrease the IOP-lowering effect. Patients should be instructed to remove contact lenses prior to application and wait at least 15 minutes before reinsertion. Proper administration technique includes gentle pressure applied to the lacrimal sac for 1 minute to minimize systemic absorption. The solution should be inspected for discoloration or particulate matter before use, and the bottle tip must not contact any surface to prevent contamination.

Precautions

Patients should be monitored for changes to periocular skin pigmentation, iris color, eyelash characteristics, and eyelid skin darkening, as these changes may be permanent. Use with caution in patients with active intraocular inflammation, aphakic eyes, pseudophakic eyes with torn posterior lens capsule, or known risk factors for macular edema. Inflammatory or neovascular glaucoma may require additional therapeutic considerations. Patients should be advised regarding potential gradual lightening of eye color, particularly in those with mixed-color irides. Regular ophthalmologic examinations are recommended to monitor treatment response and ocular changes.

Contraindications

Xalatan is contraindicated in patients with known hypersensitivity to latanoprost, benzalkonium chloride, or any component of the formulation. Its use should be avoided in cases of active herpes simplex keratitis and other viral diseases of the cornea and conjunctiva. The medication is not recommended for use during pregnancy unless potential benefits justify potential risks to the fetus. Nursing mothers should exercise caution, as it is unknown whether latanoprost is excreted in human milk. Pediatric use should be carefully considered due to limited safety data in children.

Possible side effects

The most frequently reported ocular adverse reactions (5-15%) include blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, and increased iris pigmentation. Less common reactions (1-4%) comprise eye pain, lid margin crusting, lid edema, lid erythema, photophobia, conjunctival edema, and superficial punctate keratitis. Serious side effects requiring immediate medical attention include ocular inflammation, cystoid macular edema, corneal erosion, iritis, uveitis, and herpes simplex keratitis reactivation. Systemic effects are rare but may include upper respiratory tract infection, chest pain, and skin rash.

Drug interaction

Formal drug interaction studies have shown no clinically significant interactions with timolol ophthalmic solution. However, concomitant therapy with other prostaglandin analogues may decrease the IOP-lowering effect and is not recommended. The preservative benzalkonium chloride may be absorbed by soft contact lenses and cause ocular irritation. Additive effects may occur when used with other IOP-lowering medications. Caution is advised when administering with drugs that affect prostaglandin biosynthesis, though clinical significance remains uncertain. Systemic interactions are unlikely due to minimal plasma concentrations achieved following ocular administration.

Missed dose

If a dose is missed, patients should apply the next dose at the regular scheduled time. Doubling the dose to make up for a missed administration is not recommended, as this may decrease efficacy and increase the risk of side effects. Patients should maintain the regular evening dosing schedule without attempting to compensate for missed doses. If multiple doses are missed, consultation with the prescribing physician is advised to determine appropriate management strategy. Treatment efficacy may require several weeks to re-establish following significant interruption of therapy.

Overdose

Ocular overdose may result in conjunctival or episcleral hyperemia, eye irritation, or transient blurred vision. Systemic effects are unlikely due to rapid metabolic degradation following ocular administration. In case of accidental ingestion, gastrointestinal symptoms might occur, though no serious systemic adverse effects have been reported. Management should include symptomatic treatment and supportive care. Ocular irrigation with warm water may be considered for excessive ocular exposure. Medical attention should be sought if concerning symptoms develop, though no specific antidote exists.

Storage

Store unopened bottle under refrigeration (2-8°C/36-46°F). Once opened, the bottle may be stored at room temperature (15-30°C/59-86°F) for up to 6 weeks. Protect from light and excessive heat. Do not freeze. Keep the container tightly closed when not in use. Discard any remaining solution after the completion of therapy or 6 weeks after opening, whichever comes first. Do not use if solution changes color or becomes cloudy. Keep out of reach of children and pets.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made by qualified healthcare professionals based on individual patient circumstances. The prescribing physician should be consulted for complete information regarding indications, contraindications, warnings, precautions, and adverse reactions. Patients should not discontinue or modify treatment without professional medical guidance. Full prescribing information is available from the manufacturer.

Reviews

Clinical studies demonstrate consistent patient satisfaction with Xalatan’s efficacy and convenience. Ophthalmologists frequently report excellent IOP control with once-daily dosing, noting particularly good results in patients who have responded inadequately to beta-blockers. Patients appreciate the minimal systemic side effects, though some report concerns regarding cosmetic changes such as eyelash growth and iris darkening. The medication maintains high adherence rates compared to multiple-daily regimens. Long-term follow-up studies confirm sustained efficacy over several years of continuous use with maintained safety profile.