Xalatan: Effective Intraocular Pressure Reduction for Glaucoma Management
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Synonyms | |||
Xalatan (latanoprost ophthalmic solution) 0.005% is a prostaglandin analogue prescription medication specifically formulated to reduce elevated intraocular pressure (IOP) in patients with open-angle glaucoma or 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 IOP control with once-daily dosing. Its well-established efficacy profile and favorable safety characteristics have made it a cornerstone in glaucoma management protocols worldwide. Clinical evidence supports its role in slowing disease progression and preserving visual field integrity.
Features
- Contains latanoprost 50 μg/mL (0.005%) as the active pharmaceutical ingredient
- Preservative-free formulations available for patients with benzalkonium chloride sensitivity
- Sterile, isotonic ophthalmic solution with pH range of 6.7-7.3
- Packaged in 2.5 mL translucent low-density polyethylene bottle with controlled drop tip
- Stable at room temperature (15-30°C) for 6 weeks after opening
- Compatible with most contact lens materials (wait 15 minutes after instillation)
Benefits
- Provides sustained 24-hour intraocular pressure reduction with single daily administration
- Demonstrates superior efficacy compared to timolol in numerous clinical trials
- Shows progressive IOP-lowering effect that may continue for up to 12 months of treatment
- Minimal systemic absorption reduces risk of cardiovascular and pulmonary side effects
- Convenient evening dosing schedule supports long-term treatment adherence
- Preserves conjunctival integrity for potential future filtration surgery
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 monotherapy but may be used concomitantly with other topical ophthalmic medications when additional IOP reduction is required. The medication is particularly valuable for patients who require significant IOP reduction or those who have demonstrated inadequate response to beta-blockers. Ophthalmologists often initiate Xalatan as first-line therapy due to its efficacy, safety profile, and once-daily dosing convenience.
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 remove contact lenses prior to application and wait at least 15 minutes before reinsertion. Proper administration technique includes gentle pressure on the lacrimal sac for one minute to minimize systemic absorption. The solution should be inspected for discoloration or particulate matter before use. If using other topical ophthalmic medications, allow at least 5 minutes between applications.
Precautions
Patients should be advised about potential permanent changes in iris pigmentation, eyelid skin darkening, and increased eyelash growth. Regular monitoring of IOP and visual fields is essential. Use with caution in patients with intraocular inflammation, aphakic patients, pseudophakic patients with torn posterior lens capsule, or patients with known risk factors for macular edema. Inflammatory glaucoma and angle-closure glaucoma require special consideration. Patients should be warned that treatment may gradually increase brown pigmentation of the iris, which may be permanent.
Contraindications
Xalatan is contraindicated in patients with known hypersensitivity to latanoprost, benzalkonium chloride, or any other component of the formulation. It should not be used in cases of active intraocular inflammation such as iritis or uveitis. The medication is not recommended for use in pediatric patients as safety and effectiveness have not been established. Patients with a history of herpes simplex keratitis should use with extreme caution due to potential reactivation risk.
Possible side effects
Most common ocular adverse reactions (5-15%) include conjunctival hyperemia, growth of eyelashes, and ocular pruritus. Moderate frequency reactions (1-4%) comprise blurred vision, burning sensation, foreign body sensation, increased iris pigmentation, and punctate epithelial keratopathy. Rare but serious side effects (<1%) include iris cysts, macular edema, iritis, uveitis, and eyelid skin darkening. Systemic effects are uncommon but may include headache, dizziness, and muscle/joint pain. Patients should report any ocular symptoms promptly.
Drug interaction
Formal pharmacokinetic studies show no evidence of clinically significant interaction with systemic medications. However, concomitant therapy with other prostaglandin analogues may decrease the IOP-lowering effect. The precipitation of medications may occur when mixed with eye drops containing thimerosal. Additive effects may be observed when used with pilocarpine, beta-adrenergic blocking agents, adrenergic agonists, or carbonic anhydrase inhibitors. Close monitoring is recommended when combining therapies.
Missed dose
If a dose is missed, patients should apply the next dose at the regular time the following evening. Do not double the dose to make up for the missed application. Consistent evening administration maintains therapeutic drug levels and optimal IOP control. Patients should establish a routine, such as associating administration with another evening activity, to improve compliance. If multiple doses are missed, consultation with the prescribing physician is recommended.
Overdose
Topical overdose is unlikely to produce serious effects due to minimal systemic absorption. Symptoms may include conjunctival hyperemia or mild eye irritation. If accidentally ingested, gastric lavage and supportive measures should be instituted as necessary. The plasma half-life of latanoprost is approximately 17 minutes after ocular administration. Medical attention should be sought if large volumes are ingested, though systemic effects are unlikely due to rapid metabolism.
Storage
Store unopened bottle under refrigeration (2-8°C). Protect from light. Once opened, the bottle may be stored at room temperature up to 30°C for 6 weeks. Discard any remaining solution after 6 weeks to prevent contamination or reduced efficacy. Keep the container tightly closed when not in use. Do not freeze. Keep out of reach of children. Do not use if the solution changes color or becomes cloudy.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Xalatan is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary. Patients should consult their ophthalmologist for proper diagnosis and treatment recommendations. Full prescribing information should be reviewed before initiation of therapy.
Reviews
Clinical studies demonstrate Xalatan reduces mean IOP by 25-35% from baseline. The Glaucoma Treatment Study (n=829) showed superior efficacy compared to timolol with mean IOP reduction of 31% versus 26% at 6 months. Long-term extension studies confirm maintained efficacy for up to 24 months with consistent dosing. Patient satisfaction surveys indicate high adherence rates due to once-daily dosing. Ophthalmologists consistently rate Xalatan as a first-line therapy option in treatment guidelines. Real-world evidence supports its effectiveness in diverse patient populations.