OptaProst Special Precautions

General: This product contains benzalkonium chloride, which may be absorbed by contact lenses.
Ocular: Latanoprost eye drops may produce a gradual increase in the amount of brown pigment in the iris, due to increased melanin content of melanocytes. This change in eye colour is most evident in patients with mixed colour irises, and may be permanent in some patients. The onset of iris pigmentation is usually within the first 8 months of treatment, rarely during the second or third year, and has not been seen after the fourth year of treatment.
Treatment with latanoprost can be continued in patients who develop increased iris pigmentation. These patients should be examined regularly and, depending on the clinical situation, treatment may be stopped.
Increase in brown iris pigment has not been shown to progress further upon discontinuation of treatment, but the resultant color change may be permanent.
Darkening of the palpebral skin (eyelid skin) has been reported in association with the use of latanoprost.
Darkening, thickening, and lengthening of eyelashes may occur and are reversible upon stopping treatment.
The potential for heterochromia exists for patients receiving unilateral treatment.
Macular edema, including cystoid macular edema, has been reported during treatment with latanoprost. These have mainly occurred in aphakic patients, in pseudophakic patients with torn posterior lens capsule, or in patients with known risk factors for macular edema. Caution is recommended when using latanoprost in these patients.
Concomitant use with other prostaglandins or prostaglandin analogues not recommended.
Use not recommended in those who have active inflammation; intraocular inflammation (iritis/uveitis).
Use with caution in those who have history of intraocular inflammation (iritis/uveitis).
There is limited experience with latanoprost in the treatment of inflammatory neovascular glaucoma. Therefore, it is recommended that latanoprost should be used with caution in these conditions until more experience is obtained.
Latanoprost should be used with caution in patients with a 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 specifically associated with prostaglandin analogues.
Effects on ability to drive and use machines: Instillation of eye drops may cause transient blurring of vision. Until this has resolved, patients should nor drive or use machines.
Use in Children: Efficacy and safety data in the age group <1 year (4 patients) are very limited. No data are available for preterm infants (less than 36 weeks gestational age).
In children from 0 to <3 years old that mainly suffers from PCG (Primary Congenital Glaucoma), surgery (e.g. trabeculotomy/goniotomy) remains the first line treatment.
Long-term safety in children has not yet been established.