Latanoprost
Antiglaucoma agents
Antiglaucoma agents
A prostaglandin eye drop that lowers eye pressure by helping fluid drain out of the eye. A first-choice drug for open-angle glaucoma.
Quick facts
- Group
- Antiglaucoma agents
- Target
- Prostaglandin F2α receptor (FP)
- Used for
- Open-angle glaucoma · Ocular hypertension
- Key effects
- Red eye · Burning · Blurred vision
- Monitor
- Intraocular pressure
- ATC
- S01EE01
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows latanoprost acid, the active form released in the cornea, bound to the human FP receptor (cryo-EM, receptor–Gq complex).
Latanoprost is an inactive ester (prodrug). Esterases in the cornea turn it into latanoprost acid, an analogue of prostaglandin F2α that activates the FP receptor. The main effect is more outflow of aqueous humour through the uveoscleral route (between the ciliary muscle fibres), so intraocular pressure falls without reducing fluid production.
- Corneal esterases turn the prodrug into latanoprost acid
- The acid activates the prostaglandin FP receptor
- More aqueous humour leaves by the uveoscleral route
- Intraocular pressure falls
Indications
- Open-angle glaucoma Open-angle glaucoma →
- Ocular hypertension (high eye pressure without nerve damage yet)
Adverse effects
Common
- Red eye (conjunctival hyperaemia)
- Burning, stinging, itching or a foreign-body feeling
- Blurred vision
- Longer, thicker and darker eyelashes
- Punctate keratitis
Contraindications
- Hypersensitivity to latanoprost, benzalkonium chloride or another ingredient
- Generally avoided in active intraocular inflammation (iritis, uveitis)
- Avoided during active herpes simplex keratitis
Key interactions
- Eye drops containing thimerosal
- They can form a precipitate when mixed with latanoprost; the drops are spaced at least 5 minutes apart
- Other prostaglandin analogues
- Combining them, or using latanoprost more often than once a day, can weaken the effect or even raise eye pressure
What is monitored
- Intraocular pressure
- Iris colour and eyelids at each eye examination
- Vision and macula in eyes at risk of macular oedema
Administration and safety
- Contact lenses come out before the drop (benzalkonium chloride is absorbed by soft lenses) and go back in no sooner than 15 minutes later.
- Other eye drops are given at least 5 minutes apart.
- The dropper tip must not touch the eye or eyelids, to avoid contaminating the bottle.
- More frequent use than prescribed does not lower pressure more; it can reduce the effect.
Pregnancy and breastfeeding
There are no adequate studies in pregnant women; intravenous latanoprost harmed the fetus in animal studies, so it is used only if the benefit justifies the risk.
Nursing care
- Ask about uveitis, herpes keratitis, cataract surgery or eye infections before starting.
- Explain that the iris may turn browner and that this change can be permanent, more visible if only one eye is treated.
- Teach the patient to report eye pain, light sensitivity, eyelid swelling or a change in vision.
- Stress that the drops control glaucoma but do not cure it, so they continue even without symptoms.
Pharmacokinetics
- Absorption
- Absorbed through the cornea, where it is hydrolysed to the active acid
- Metabolism
- The small amount that reaches the blood is broken down in the liver by beta-oxidation
- Elimination
- Metabolites leave mainly in the urine
- Half-life
- Very short in plasma (about 17 minutes for the acid)
- Onset and duration
- Pressure starts to fall after 3–4 hours, is lowest at 8–12 hours and stays down for at least 24 hours
Test yourself
Think of the answer, then tap the question to see it.
Through which pathway does latanoprost lower intraocular pressure?
Mainly by increasing uveoscleral outflow of aqueous humour.
Which cosmetic change from latanoprost may be permanent?
Brown darkening of the iris.
Why is latanoprost called a prodrug?
It is an ester that corneal esterases convert into the active latanoprost acid.
In which eyes is latanoprost used with caution because of macular oedema?
Aphakic eyes, pseudophakic eyes with a torn posterior capsule and eyes with other risk factors.
Connections
← Back to the class: Antiglaucoma agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - LATANOPROST solution/ drops (DailyMed (U.S. National Library of Medicine), 2024); Latanoprost Ophthalmic: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); RCSB PDB - 8IUL: Cryo-EM structure of the latanoprost-bound human PTGFR-Gq complex (RCSB Protein Data Bank, 2026).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.