Latanoprost dosing

Figure 10-1 Effect of latanoprost 0.005% applied once daily at 8 00 pm and timolol 0.5% applied twice daily at 8 00 am and 8 00 PM on intraocular pressure (lOP) as determined at 8 00 am (12 hours after last dose) in patients with ocular hypertension or glaucoma. Asterisks signify a significant further reduction of lOP by latanoprost compared with timolol. (Adapted from Camras CB. Comparison of latanoprost and timolol in patients with ocular hypertension and glaucoma. Ophthalmology 1996 103 138-147.)...

It is recognized that many patients treated for glaucoma require a second concomitant medication to lower lOP. The appeal of a combination product stems from the belief that adherence to complex multiple medical regimens is improved with simplified dosing schedules. The two most common ocular hypotensive medications are in the prostaglandin and P-blocker classes. Several combination products are presently available worldwide that combine various prostaglandin analogues with a non-selective P-blocker.These products include a combination of latanoprost or travoprost with timolol. Studies have demonstrated comparable efficacy and in the case of the travoprost-timolol combination, a favorable lOP reduction between the combination product and the separate compounds administered concomitantly. At the present time, neither combination product is available in the United States. 

Brimonidine s efficacy has been compared with that of prostaglandin analogues, topical CAIs, and P-blockers. Results in patients with glaucoma and ocular hypertension indicate that the peak ocnlar hypotensive effect of 0.2% brimonidine is comparable with that of 0.5% timolol (Figure 10-11). When dosed twice daily, 0.2% brimonidine is less effective than latanoprost 0.005% administered once daily. Brimonidine 0.15% with Purite is similar to dorzolamide 2% when used twice daily fc>r treatment of primary open-angle glaucoma or ocular hypertension. 

E Due to her concomitant disease states, AK should avoid beta-blockers, adrenergic agents, and sulfa medications. Pilocarpine is not a good choice for AK due to its bothersome local side effects. Latanoprost is a good initial choice for AK due to its convenient once daily dosing and mild local and systemic side effects. 

Kahook MY. Comparison of corneal and conjunctival changes after dosing of travoprost preserved with sofZia, latanoprost with 0.02% benzalkonium chloride, and preservative-free artificial tears. Cornea 2008 27 339-343. 

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