The drug atlas
Ophthalmology/Prostaglandin analogue (glaucoma)
Prostaglandin analogues
also: latanoprost · travoprost · bimatoprost · PGA · glaucoma
Overview
FIRST-LINE for primary open-angle glaucoma — most effective IOP-lowering eye drop, once daily, works by increasing outflow. The cosmetic side effects are distinctive and examinable.
Mechanism
Prostaglandin F₂α analogues → increase UVEOSCLERAL outflow of aqueous humour → lower intra-ocular pressure. (Contrast the production-reducers: β-blockers, CAIs, α₂-agonists.)
Indications
- Primary open-angle glaucoma / ocular hypertension (first-line topical)
The agents
LatanoprostPGA
once daily (evening)
Most-used first-line.
Travoprost / bimatoprostPGA
OD
Adverse effects
Iris/periocular brown pigmentationclassic
Permanent iris colour change — counsel (esp. unilateral use).
Eyelash lengthening/thickening, periorbital fat atrophyclassic
Conjunctival hyperaemia, ocular irritationcommon
Cautions & contraindications
Active uveitis / macular oedema (caution)all
Interactions
- —
Monitoring & kinetics
IOP response; document iris colour
Topical once daily. Minimal systemic effect (vs β-blocker drops).
Source: NICE NG81 — Glaucoma · BNF — Prostaglandin analogues (eye)