Latanoprost Fahrenheit Special Precautions

Benzalkonium chloride, which is commonly used as preservative in ophthalmic products, has been reported to cause punctate keratopathy and/or toxic ulcerative keratopathy. Since this drug contains benzalkonium chloride, close monitoring is required with frequent or prolonged use in dry eye patients, or in conditions where the cornea is compromised.
Contact Lenses: Patients should be advised not to wear a contact lens if their eye is red. This drug should not be used to treat contact lens related irritation. The preservative in this drug, benzalkonium chloride, may be absorbed by soft contact lenses. Patients who wear soft contact lenses and whose eyes are not red should be instructed to wait at least ten minutes after instilling this drug before they insert their contact lenses.
Latanoprost may gradually change the eye color by increasing the amount of brown pigment in the iris. This effect has predominantly been seen in patients with mixed coloured irides, i.e. blue-brown, grey-brown, green-brown or yellow-brown, and is due to increased melanin content in the stromal melanocytes of the iris. A permanent heterochromia can happen. Typically the brown pigmentation around the pupil spreads concentrically towards the periphery in affected eyes, but the entire iris or parts of it may become more brownish. In patients with homogeneously blue, grey, green or brown eyes, the change has only rarely been seen during two years of treatment.
The change in iris colour occurs slowly and may not be noticeable for several months to years. It has not been associated with any symptom or pathological changes. No further increase in brown iris pigment has been observed after discontinuation of treatment, but the resultant colour change may be permanent. Until further long term data is obtained, it is recommended that in patients with mixed coloured irides only those who are intolerant or insufficiently responsive to another intraocular pressure lowering medication be treated.
Neither naevi nor freckles of the iris have been affected by the treatment. Accumulation of pigment in the trabecular meshwork or elsewhere in the anterior chamber has not been observed, but until further long term experience about increased iris pigmentation is available, patients should be examined regularly and depending on the clinical situation, treatment may be stopped if increased iris pigmentation ensues.
Before treatment is instituted patients should be informed of the possibility of a change in eye colour. Unilateral treatment can result in permanent heterochromia.
There is no experience of Latanoprost in inflammatory, neovascular, angle closure or congenital glaucoma and only limited experience in open angle glaucoma of pseudophakic patients and in pigmentary glaucoma. Latanoprost has no or little effect on the pupil, but there is no experience in acute attacks of closed angle glaucoma. Therefore, it is recommended that Latanoprost should be used with caution in these conditions until more experience is obtained.
Macular oedema, including cystoid macular oedema, has been reported during treatment with Latanoprot. These reports have mainly occurred in aphakic patients, in pseudophakic patients with torn posterior lens capsule, or in patients with known risk factors for macular oedema. Latanoprost should be used with caution in these patients.
Latanoprost contains benzalkonium chloride which may be absorbed by contact lenses. The contact lenses should be removed before instillation of the eye drops and maybe reinserted after 15 minutes. Latanoprost should not be administered while wearing contact lenses. Latanoprost has not been studied in patients with renal or hepatic impairment and should therefore be used with caution in such patients.
Latanoprost should be used with caution in patients with history of herpetic keratitis and should be avoided in cases of active herpes simplex keratitis and in patients with a history of recurrent herpetic keratitis specially associated with prostaglandin analogues.
Effect on ability to drive and use machine: In common with other preparations, instillation of eye drops may cause transient blurring of vision. Until this has resolved, patients should not drive or use machines.