Prostaglandin analogs for glaucoma

Examples

Generic Name	Brand Name
bimatoprost	Lumigan
latanoprost	Xalatan
travoprost	Travatan

How It Works

Prostaglandin analogs reduce pressure inside the eye (intraocular pressure, or IOP) by increasing the removal of fluid (aqueous humor) from the eye.

These medications are given in eyedrop form.

Why It Is Used

Prostaglandin analogs are used to reduce intraocular pressure in people who have open-angle glaucoma or high intraocular pressure (ocular hypertension). They can be used alone or in combination with other glaucoma medications.

How Well It Works

All the prostaglandin analogs have been shown to be effective in lowering the pressure inside the eye, decreasing the risk of damage to the optic nerve. In studies, latanoprost alone was able to reduce IOP by 30% to 35%; an additional reduction in IOP occurred when latanoprost was taken in combination with another medication such as the beta-blocker timolol or the adrenergic agonist dipivefrin.¹

A recent study shows that bimatoprost is even more effective at lowering IOP than latanoprost.²

Prostaglandin analogs are a relatively new class of medications, and studies comparing the long-term safety and effectiveness of these medications are in progress.

Side Effects

Side effects of prostaglandin analogs include:

• Blurred vision or other decrease in visual acuity.
• Dry eyes.
• Itching, burning, and stinging after using the drops.
• Increased coloring of the colored part (iris) of the eye. This mostly occurs in people with hazel eyes. The change in eye color may be permanent. Prostaglandin analogs may also cause increased coloring in the eyelid (darkening of the skin) and darkening and increased growth of the eyelashes. These changes may be permanent.
• Skin rash or allergic skin reaction.
• Inflammation in the front part of the eye (anterior chamber).
• Upper respiratory tract infections, colds, and flu (uncommon).

The American Academy of Ophthalmology states that there have been no whole-body (systemic) side effects associated with prostaglandin medications for glaucoma. Latanoprost has no effect on blood pressure or heart rate.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

People who wear contact lenses need to take their contacts out before putting these eyedrops into their eyes. The contacts can be reinserted 15 minutes after using the eyedrops.

If you are putting in more than one type of eyedrop at the same time, wait 5 minutes between medications.

Prostaglandin analogs should be used with caution by people who have infections in the eye (such as herpes keratitis) or inflammation (uveitis), who have had cataract surgery or other problems with the lens of the eye, or who are at risk for swelling in the macula at the back of the eye.

Bimatoprost and travoprost should not be used by women during pregnancy or by women who are trying to become pregnant. They should be used with caution by women who are breast-feeding.

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Author:	Robin Parks, MS	Last Updated: July 7, 2006
Medical Review:	Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Carol L. Karp, MD - Ophthalmology
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