Xalatan: Effective Intraocular Pressure Reduction for Glaucoma Management
Xalatan
| Product dosage: 2.5ml | |||
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Synonyms | |||
Xalatan (latanoprost ophthalmic solution) 0.005% is a prostaglandin analog prescription medication specifically formulated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. As a first-line therapeutic agent, it works by increasing the outflow of aqueous humor through the uveoscleral pathway, offering a targeted mechanism of action with once-daily dosing convenience. Its well-established efficacy profile and favorable safety characteristics have made it a cornerstone in ophthalmologic practice for long-term intraocular pressure management.
Features
- Active ingredient: latanoprost 50 μg/mL (0.005%)
- Pharmaceutical form: sterile, isotonic, buffered ophthalmic solution
- Preservative: benzalkonium chloride 0.02%
- pH: approximately 6.7
- Osmolality: approximately 267 mOsmol/kg
- Primary mechanism: prostaglandin F2α analog that increases uveoscleral outflow
- Administration: topical ocular use only
- Packaging: 2.5 mL translucent low-density polyethylene bottle with controlled drop tip
Benefits
- Demonstrates significant intraocular pressure reduction of 25-35% from baseline measurements
- Provides consistent 24-hour IOP control with single daily administration
- Shows excellent tolerability profile with minimal systemic absorption
- Offers convenient evening dosing that aligns with natural circadian rhythm of aqueous production
- Maintains efficacy throughout long-term treatment without developing tachyphylaxis
- Reduces dependency on multiple glaucoma medications through potent monotherapy effect
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 first-line therapy due to its efficacy, safety profile, and dosing convenience. Ophthalmologists may initiate Xalatan monotherapy or combine it with other IOP-lowering medications when additional pressure reduction is required. The medication is suitable for long-term management, with many patients maintaining treatment for several years. Clinical studies have demonstrated its effectiveness across various patient demographics, including elderly populations and those with pigmentary or pseudoexfoliative glaucoma.
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 involves tilting the head backward, pulling the lower eyelid down to form a pouch, instilling one drop, and closing the eye gently for 1-2 minutes while applying pressure to the nasolacrimal duct 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 that Xalatan may gradually increase brown pigmentation of the iris, which may be permanent. Eyelid skin darkening may also occur, which might be reversible upon discontinuation. There is potential for increased length, thickness, pigmentation, and number of eyelashes, which may be reversible upon treatment cessation. Use with caution in patients with active intraocular inflammation, aphakic patients, pseudophakic patients with torn posterior lens capsule, or patients with known risk factors for macular edema. Patients should be monitored for bacterial keratitis, which can occur with any topical ophthalmic product containing a preservative. The preservative benzalkonium chloride may be absorbed by soft contact lenses.
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 herpes simplex keratitis or varicella-zoster virus keratitis. Contraindicated in patients with history of allergic reactions to prostaglandin analogs. Not recommended for use in pediatric patients as safety and effectiveness have not been established. Should be avoided in patients with history of acute iritis or uveitis. Not indicated for angle-closure glaucoma unless accompanied by appropriate iridotomy.
Possible side effects
The most common ocular adverse reactions (5-15%) include blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, and increased iris pigmentation. Less frequent reactions (1-4%) include eye pain, lid edema, lid discomfort, photophobia, conjunctival edema, and dry eye. Rare but serious side effects include macular edema, iritis/uveitis, keratitis, and eyelid skin darkening. Systemic side effects are uncommon but may include upper respiratory tract infection, chest pain, and skin rash. Patients may experience temporary visual disturbances that could affect the ability to drive or operate machinery immediately after installation.
Drug interaction
Concomitant use with other prostaglandin analogs may decrease the therapeutic effect of Xalatan and is not recommended. The IOP-lowering effect may be additive when used with beta-adrenergic blocking agents, carbonic anhydrase inhibitors, alpha-adrenergic agonists, or miotics. Benzalkonium chloride may inactivate sodium sulfacetamide preparations. No clinically significant interactions have been observed with systemic medications including antihypertensives, oral hypoglycemics, or anticoagulants. However, caution is advised when using with medications that affect coagulation due to theoretical increased bleeding risk from prostaglandin-mediated vasodilation.
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 is important for maintaining stable intraocular pressure control. Patients should establish a routine to minimize missed doses, such as associating administration with another evening activity. If multiple doses are missed, patients should contact their ophthalmologist for guidance, as intraocular pressure may increase requiring additional monitoring.
Overdose
Topical overdose is unlikely to produce serious symptoms due to minimal systemic absorption. If accidentally ingested, symptomatic treatment should be instituted if necessary. Ocular overdose may result in conjunctival or episcleral hyperemia, eye irritation, or temporary visual disturbances. In case of accidental oral ingestion, gastrointestinal symptoms such as nausea, vomiting, or diarrhea might occur. Patients should rinse the mouth with water if solution is accidentally ingested. Medical attention should be sought if large volumes are ingested or if symptoms persist. No specific antidote exists; treatment should be supportive and symptomatic.
Storage
Store unopened bottle under refrigeration at 2°C to 8°C (36°F to 46°F). Once opened, the bottle may be stored at room temperature up to 25°C (77°F) for 6 weeks. Protect from light and excessive heat. Keep the container tightly closed when not in use. Do not freeze. Discard any remaining solution after 6 weeks of opening to prevent contamination and ensure potency. Keep out of reach of children and pets. 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, treatment recommendations, and monitoring. The complete prescribing information should be reviewed before initiating therapy. Not all possible interactions, side effects, or precautions are listed here.
Reviews
Clinical studies involving over 2,800 patients demonstrated that Xalatan produced significant IOP reduction from baseline throughout the 6-month to 2-year study periods. In comparative trials, Xalatan showed superior efficacy to timolol in reducing diurnal IOP measurements. Long-term extension studies have confirmed maintained efficacy for up to 5 years of continuous treatment. Patient satisfaction surveys indicate high adherence rates due to once-daily dosing and generally favorable side effect profile. Ophthalmologists consistently rate Xalatan as a first-line treatment option based on its proven efficacy, safety record, and patient compliance characteristics.