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 long-term glaucoma management strategies, helping to preserve visual field and prevent optic nerve damage associated with progressive disease.

Features

• Contains latanoprost 50 mcg/mL (0.005%) as the active pharmaceutical ingredient
• Preservative-free formulation available in addition to standard benzalkonium chloride-preserved solution
• Clear, isotonic ophthalmic solution with pH approximately 6.7
• Supplied in 2.5 mL translucent white low-density polyethylene bottle with controlled drop tip and turquoise polypropylene cap
• Stable at refrigerated temperatures (2-8°C) until opened, then stable at room temperature (up to 25°C) for 6 weeks
• Demonstrated mean IOP reduction of 25-35% from baseline in clinical trials

Benefits

• Provides consistent 24-hour IOP control with single daily administration
• Demonstrates excellent trough efficacy maintaining pressure reduction throughout dosing interval
• Shows minimal systemic absorption and limited systemic side effects
• Offers convenient evening dosing schedule that may improve patient adherence
• Presents progressive efficacy with continued use, often achieving maximum effect within 8-12 weeks
• Maintains long-term IOP control without evidence of tachyphylaxis in most patients

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 also be used concomitantly with other intraocular pressure-lowering medications when additional pressure reduction is required. The medication is particularly valuable for patients who require substantial IOP reduction or those who have demonstrated inadequate response to beta-blockers or other first-line agents. Clinical studies have shown effectiveness across various patient demographics, including those with pigmentary glaucoma and 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 is not recommended as it may decrease the IOP-lowering effect. If using more than one topical ophthalmic medication, they should be administered at least 5 minutes apart. Contact lenses should be removed prior to instillation and may be reinserted 15 minutes after administration. Proper administration technique involves gentle pressure on the lacrimal sac for 1 minute following instillation to minimize systemic absorption. The solution should be inspected for discoloration or particulate matter before use.

Precautions

Patients should be advised that Xalatan may gradually increase brown pigmentation of the iris, which may be permanent. Eyelid skin darkening may occur and may be reversible upon discontinuation. There may be gradual changes to eyelashes and vellus hair in the periorbital region, including increased length, thickness, pigmentation, and number of lashes. Patients should be monitored for intraocular inflammation and macular edema, particularly in aphakic patients, pseudophakic patients with torn posterior lens capsule, or patients with known risk factors for macular edema. Use with caution in patients with active intraocular inflammation, history of herpes simplex keratitis, or significant renal or hepatic impairment.

Contraindications

Xalatan is contraindicated in patients with known hypersensitivity to latanoprost, benzalkonium chloride (in preserved formulation), or any other component of the product. It should not be used in cases of active ocular inflammation unless the potential benefits outweigh the risks. The medication is not recommended for use in pediatric patients as safety and effectiveness have not been established. Contraindication extends to patients with angle-closure glaucoma unless accompanied by iridotomy. Women who are pregnant or attempting to become pregnant should generally avoid use unless clearly necessary.

Possible side effects

The most frequently reported ocular adverse reactions (5-15%) include blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, increased iris pigmentation, and punctate epithelial keratopathy. Less common reactions (1-4%) include eye pain, lid crusting, dryness, photophobia, conjunctival edema, eyelid erythema, and eyelash changes. Rare but serious side effects include intraocular inflammation (iritis/uveitis), cystoid macular edema, corneal edema and erosions, and herpetic keratitis. Iris color change occurs gradually and may not be noticeable for months to years.

Drug interaction

Concomitant therapy with other prostaglandin analogs is not recommended due to potential reduction of IOP-lowering effect and increased adverse reaction profile. Additive IOP reduction may occur when used with pilocarpine, beta-adrenergic blocking agents, adrenergic agonists, or carbonic anhydrase inhibitors. The precipitation of benzalkonium chloride with various chemicals including surfactants may occur if mixed with other eye preparations. Thimerosal may cause precipitation and should not be used concurrently. No clinically significant pharmacokinetic drug interactions have been observed with systemic medications.

Missed dose

If a dose is missed, patients should administer it as soon as they remember. However, if it is almost time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not instill two doses at the same time to make up for a missed dose. Consistent evening administration is recommended to maintain stable intraocular pressure control. Patients should be educated on the importance of adherence while understanding that occasional missed doses, while not ideal, are not typically associated with dangerous IOP spikes when the medication is generally used consistently.

Overdose

Topical overdose is unlikely to produce serious systemic effects due to limited absorption. If accidentally ingested orally, symptoms might include headache, dizziness, tachycardia, bronchospasm, or gastrointestinal upset. Management should be supportive and symptomatic. Ocular overdose may result in conjunctival hyperemia, irritation, or temporary visual disturbance. The eye should be rinsed with warm water if excessive solution is instilled. Medical attention should be sought if unusual symptoms develop. No specific antidote exists, and dialysis is not expected to be effective due to high protein binding.

Storage

Unopened bottles should be stored under refrigeration at 2-8°C (36-46°F). Protect from light and freeze. Once opened, the bottle may be stored at room temperature up to 25°C (77°F) for 6 weeks. After this period, any remaining solution should be discarded. The bottle tip should not touch any surface to avoid contamination. Keep tightly closed when not in use. Do not use if solution changes color or becomes cloudy. Keep out of reach of children and pets. Do not transfer solution to another container.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made by a qualified healthcare professional based on individual patient circumstances. The prescribing physician should be consulted for complete information regarding indications, contraindications, warnings, precautions, and adverse reactions. Patients should not discontinue or change medication without medical supervision. Full prescribing information is available from the manufacturer.

Reviews

Clinical studies demonstrate that Xalatan maintains consistent IOP reduction over 24 months of treatment with mean pressure reduction of 6-8 mmHg from baseline. In comparative trials, latanoprost showed superior efficacy to timolol in diurnal IOP control with better tolerability profile. Patient satisfaction surveys indicate high adherence rates due to once-daily dosing and minimal systemic side effects. Ophthalmologists report reliable performance as both first-line and adjunctive therapy, with particular value in patients requiring substantial pressure reduction. Long-term follow-up studies confirm maintained efficacy without development of tolerance in the majority of patients.