Latanoprost adverse effects

Topical PGE2 and PGF2qi significantly reduce intraocular pressure for at least 24 hours and are used in the treatment of glaucoma. Derivatives of the isopropyl ester of PGF2qi appear to be the most effective. Transient ocular adverse effects include conjunctival hyperemia, local irritation, intermittent photophobia, and pain in the eye (66-68). Newer derivatives, such as latanoprost, travoprost, and bimatoprost, appear to be better tolerated, with less severe and less frequent adverse effects (69). They reduce intraocular pressure by increasing uveoscleral outflow. 

The ocular adverse effects of latanoprost include conjunctival hyperemia, iris pigmentation, periocular skin color changes, anterior uveitis, and cystoid macular edema in pseudophakic patients (77,78). H. simplex dendritic keratitis has been reported after treatment with latanoprost (79). In patients with uveitic glaucoma, latanoprost can cause increased intraocular pressure and recurrence of inflammation (80). 

Peak AS, Sutton BM. Systemic adverse effects associated with topically applied latanoprost. Ann Pharmacother 1998 32(4) 504—5. 

Avakian A, Renier SA, Butler PJ. Adverse effects of latanoprost on patients with medically resistant glaucoma. Arch Ophthalmol 1998 116(5) 679-S0. 

The use of unoprostone in the treatment of open-angle glaucoma and ocular hypertension has been reviewed (1). Most of the literature is in Japanese. The adverse effects of unoprostone are similar to those of latanoprost conjunctival hyperemia, iris pigmentation, hypertrichosis and hyperpigmentation of eyelashes, and rarely systemic effects (1). 

The success of latanoprost has stimulated development of similar prostanoids with ocular hypotensive effects, and bimatoprost, travaprost, and unoprostone are now available. These drugs act at the FP receptor and are administered as drops into the conjunctival sac once or twice daily. Adverse effects include irreversible brown pigmentation of the iris and eyelashes, drying of the eyes, and conjunctivitis. 

Until recently, very few systemic drug therapies were implicated in ocular adverse effects in the episclera, sclera, and uvea. Topical ocular medications such as beta-blockers, latanoprost, and corticosteroids as well as other topical ocnlar medications have been associated with uveitis. 

Safety assessments in travoprost studies have included evaluation of visual acuity, pupil diameter, iris color, anterior chamber flare, conjunctival hyperemia, pulse, blood pressure, blood chemistry profiles, and urinalysis values. The observed adverse events have generally been mild to moderate and have resolved without treatment. Most of the side effects seen with latanoprost can occur with travoprost treatment. Conjunctival hyperemia induced by travoprost is clinically insignificant but generally more than that observed with latanoprost. 

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