Netarsudil
Antiglaucoma agents
Antiglaucoma agents
A Rho kinase inhibitor eye drop that opens the eye's main drain (trabecular meshwork) to lower pressure in glaucoma. Red eye is common.
Quick facts
- Group
- Antiglaucoma agents
- Target
- Rho-associated protein kinases (ROCK1 and ROCK2)
- Used for
- Open-angle glaucoma · Ocular hypertension
- Key effects
- Conjunctival hyperaemia · Burning · Tearing
- Monitor
- Intraocular pressure
- ATC
- S01EX05
No doses: the clinician sets them by the current guideline.
Mechanism of action
Netarsudil inhibits Rho kinase, a serine-threonine kinase that controls the cytoskeleton. In the trabecular meshwork this relaxes the cells and increases conventional outflow of aqueous humour, so intraocular pressure falls. Rho kinase inhibition also dilates conjunctival vessels, which explains the frequent red eye.
- Netarsudil inhibits Rho kinase in the trabecular meshwork
- Meshwork cells relax; outflow increases
- Intraocular pressure falls
Indications
- Open-angle glaucoma Open-angle glaucoma →
- Ocular hypertension
Adverse effects
Common
- Conjunctival hyperaemia (red eye), the most common effect
- Small bleeds under the conjunctiva
- Burning, stinging or pain after the drop
- Tearing, blepharitis
Contraindications
- Hypersensitivity to netarsudil or any component
Key interactions
- Other eye drops
- Given at least 5 minutes apart so one does not wash out the other
What is monitored
- Intraocular pressure
- Redness and corneal changes at eye examination
Administration and safety
- Contact lenses come out before the drop and go back in about 15 minutes later.
- Other eye drops are spaced at least 5 minutes apart.
- Also available combined with latanoprost in one bottle; the exact product is checked.
Pregnancy and breastfeeding
Human data are lacking; it is used in pregnancy only if the benefit justifies the risk.
Nursing care
- Warn that red eyes are common and often settle.
- Teach to report eye pain, vision changes or eyelid infection.
- Tell the eye surgeon about netarsudil before eye surgery.
Pharmacokinetics
- Absorption
- Acts locally in the eye
Test yourself
Think of the answer, then tap the question to see it.
Which enzyme does netarsudil inhibit?
Rho kinase (ROCK).
Through which pathway does it increase outflow?
The trabecular (conventional) outflow pathway.
What is its most common adverse effect?
Conjunctival hyperaemia (red eye).
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: Netarsudil Ophthalmic: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.