Xalatan: Effective Intraocular Pressure Reduction for Glaucoma Management
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Synonyms | |||
Xalatan (latanoprost ophthalmic solution) 0.005% is a prostaglandin analog ophthalmic solution indicated 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 uveoscleral outflow, offering a mechanistically distinct approach to IOP control. Its once-daily dosing regimen supports patient adherence, while its well-established efficacy profile makes it a cornerstone in glaucoma management protocols worldwide. This product card provides comprehensive information for eye care professionals regarding the appropriate use, pharmacology, and clinical considerations of Xalatan.
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 of approximately 6.7
- supplied in 2.5 mL polyethylene bottle with controlled-drop tip
- Stable at refrigerated temperatures (2-8°C) until opened, then stable at room temperature for 6 weeks
- Mechanism of action: selective FP prostaglandin receptor agonist
Benefits
- Provides significant IOP reduction ranging from 25-35% from baseline measurements
- Offers 24-hour IOP control with single daily administration, supporting treatment adherence
- Demonstrates excellent safety profile with minimal systemic absorption or cardiovascular effects
- Shows maintained efficacy throughout long-term treatment without tachyphylaxis
- Reduces dependency on multiple glaucoma medications through potent monotherapy efficacy
- Minimizes visual field progression by achieving consistent target pressure goals
Common use
Xalatan is primarily prescribed for the management of open-angle glaucoma and ocular hypertension where elevated intraocular pressure presents risk to optic nerve integrity. It is frequently initiated as first-line therapy due to its efficacy, safety profile, and convenient dosing schedule. Ophthalmologists may prescribe Xalatan as monotherapy or in combination with other IOP-lowering agents when additional pressure reduction is required. The medication is suitable for long-term management, with many patients continuing treatment for years under regular monitoring. Clinical studies have demonstrated its effectiveness across diverse patient populations 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 may decrease the IOP-lowering effect. Patients should be instructed to remove contact lenses prior to administration and wait at least 15 minutes before reinsertion. Proper administration technique includes gentle pressure applied to the lacrimal sac for one minute to minimize systemic absorption. The solution should be inspected for discoloration or particulate matter before use. If using more than one ophthalmic medication, patients should wait at least 5 minutes between installations.
Precautions
Patients should be advised about potential permanent changes in iris pigmentation, eyelid skin darkening, and increased eyelash growth. Regular monitoring of IOP and optic nerve status remains essential throughout treatment. Caution is advised in patients with intraocular inflammation, aphakic patients, pseudophakic patients with torn posterior lens capsule, or patients at risk for macular edema. The preservative benzalkonium chloride may cause eye irritation and discoloration of soft contact lenses. Patients should be instructed to avoid contaminating the dropper tip to prevent ocular infections.
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 intraocular inflammation such as uveitis. The medication is contraindicated in patients with history of herpes simplex keratitis and should be used with extreme caution in those with active herpes simplex keratitis. Pregnancy category C: should not be used during pregnancy unless potential benefit justifies potential risk to fetus.
Possible side effect
Common ocular adverse reactions (5-15% incidence) include conjunctival hyperemia, growth of eyelashes, and ocular irritation. Less frequent reactions (1-4%) include blurred vision, burning and stinging, foreign body sensation, itching, increased iris pigmentation, and punctate epithelial keratopathy. Rare side effects (<1%) include macular edema, iritis/uveitis, eyelid skin darkening, and corneal edema. Systemic side effects are uncommon but may include headache, dizziness, and muscle/joint pain. Patients should report any ocular symptoms, particularly conjunctivitis or eyelid reactions.
Drug interaction
Concomitant use with other prostaglandin analogs is not recommended due to potential decreased efficacy. Additive effect occurs when used with beta-blockers, alpha agonists, carbonic anhydrase inhibitors, or miotics. No clinically significant interactions have been observed with systemic medications. The precipitation of medications may occur if multiple eye drops containing thimerosal are used concurrently. Pharmaceutically incompatible with eye drops containing high concentrations of polyvalent cations.
Missed dose
If a dose is missed, patients should apply the next dose at the regular time the following evening. Doubling the dose should be avoided. Patients should not administer more than one drop if they cannot recall whether they already instilled the medication. Establishing a consistent evening routine helps minimize missed doses. If multiple doses are missed, patients should contact their ophthalmologist as IOP may return to pretreatment levels.
Overdose
Ocular overdose may result in conjunctival or episcleral hyperemia, eyelid erythema, or ocular irritation. Systemic absorption following ocular administration is minimal, making systemic overdose unlikely. If accidentally ingested orally, symptomatic treatment should be provided. Hemodialysis is not expected to enhance elimination due to high protein binding. In case of ocular overdose, the eye should be rinsed with warm water. Medical attention should be sought if symptoms persist or worsen.
Storage
Unopened bottles should be stored refrigerated at 2-8°C (36-46°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. Do not freeze. Keep the container tightly closed when not in use. Discard any remaining solution after 6 weeks of opening to prevent contamination or reduced efficacy. Keep out of reach of children and pets.
Disclaimer
This information is intended for healthcare professionals and should not replace professional medical advice, diagnosis, or treatment. Always seek the advice of your ophthalmologist or qualified health provider with any questions regarding medical conditions. Full prescribing information should be consulted before initiating therapy. Individual results may vary based on patient-specific factors and disease severity.
Reviews
Clinical studies demonstrate consistent IOP reduction with 85% of patients achieving target pressure goals. Ophthalmologists report high satisfaction with Xalatan’s efficacy profile and patient adherence rates. Clinical trial data shows mean IOP reduction of 8-9 mmHg from baseline throughout 24-month studies. Patient surveys indicate preference for once-daily dosing compared to multiple daily regimens. Long-term extension studies confirm maintained efficacy with 92% of patients continuing therapy at 5-year follow-up. Real-world evidence supports reduction in glaucoma progression rates when target IOP is maintained.