Adult: As 0.024% solution: Instil 1 drop into the conjunctival sac of the affected eye(s) once daily in the evening. Max: 1 drop once daily. Child: >16 years Same as adult dose.
Contraindications
Active intraocular inflammation.
Special Precautions
Patient with history of intraocular inflammation (e.g. uveitis, iritis), aphakia, pseudophakia with torn posterior lens capsule, known risk factors for macular oedema. Pregnancy and lactation.
Adverse Reactions
Significant: Change or increase in the brown pigmentation of the iris and eyelid skin; change or increase in the pigmentation, length, number or thickness of eyelashes (reversible); intraocular inflammation; macular oedema, including cystoid macular oedema; bacterial keratitis (when the multiple-dose container used is inadvertently contaminated). Eye disorders: Conjunctival hyperaemia, eye irritation or pain, instillation site pain, conjunctival oedema, blurred vision, punctate keratitis, foreign body sensation.
Patient Counseling Information
Remove contact lenses prior to administration and reinsert after 15 minutes.
Description: Latanoprostene bunod is a nitric oxide-donating synthetic analogue of naturally occurring prostaglandin F2α. It is a prodrug and thought to increase the outflow of aqueous humour through both the trabecular meshwork (conventional route mediated by nitric oxide) and uveoscleral pathway (nonconventional route mediated by latanoprost acid), thus lowering the intraocular pressure. Onset: Reduction of intraocular pressure: Approx 1-3 hours; 11-13 hours (max effect). Pharmacokinetics: Absorption: Time to peak plasma concentration: Approx 5 minutes (latanoprost acid). Metabolism: Rapidly metabolised in the eye to latanoprost acid (active metabolite; F2α prostaglandin analogue) and butanediol mononitrate. Latanoprost acid is further metabolised mainly in the liver after reaching the systemic circulation via fatty acid β-oxidation to 1,2-dinor and 1,2,3,4-tetranor metabolites. Butanediol mononitrate is metabolised to 1,4-butanediol and nitric oxide; 1,4-butanediol undergoes further oxidation to form succinic acid and enters tricarboxylic acid (TCA) cycle.
Chemical Structure
Latanoprostene bunod Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 11156438, Latanoprostene BUNOD. https://pubchem.ncbi.nlm.nih.gov/compound/Latanoprostene-BUNOD. Accessed Feb. 22, 2021.
Storage
Store unopened bottle between 2-8°C. Once opened, may store between 2-25°C for up to 8 weeks. Do not freeze. Protect from light.