Xalatan: Effective Intraocular Pressure Reduction for Glaucoma Management
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Synonyms | |||
Xalatan (latanoprost ophthalmic solution) 0.005% is a prostaglandin analogue prescription medication specifically formulated 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 the outflow of aqueous humor through the uveoscleral pathway, providing consistent 24-hour IOP control with a once-daily dosing regimen. Its well-established efficacy, favorable safety profile, and compatibility with other antiglaucoma medications make it a cornerstone in modern ophthalmological practice for preserving visual field and preventing optic nerve damage.
Features
- Active ingredient: Latanoprost 50 mcg/mL (0.005%)
- Pharmacological class: Prostaglandin F2α analogue
- Formulation: Sterile, isotonic, buffered ophthalmic solution
- Preservative: Benzalkonium chloride 0.02%
- pH: Approximately 6.7
- Packaging: 2.5 mL translucent low-density polyethylene bottle with controlled dropper tip
Benefits
- Provides significant reduction in intraocular pressure—demonstrated mean IOP reductions of 25–35% from baseline in clinical trials
- Sustained 24-hour efficacy with single daily administration, supporting consistent therapeutic coverage
- Convenient evening dosing regimen that aligns with natural physiological rhythms
- Demonstrates excellent long-term control with maintained efficacy over multiyear treatment periods
- Compatible with most systemic medications and many topical ophthalmic preparations
- Proven effectiveness in diverse patient populations including various ethnicities and age groups
Common use
Xalatan is primarily indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma and ocular hypertension. It is frequently prescribed as initial monotherapy due to its potent efficacy and generally favorable tolerability profile. Ophthalmologists may also utilize it as part of combination therapy when additional IOP reduction is required beyond what single agents can provide. The medication is particularly valuable for patients requiring once-daily dosing convenience and those who may have contraindications to other classes of antiglaucoma medications.
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 on proper instillation technique: wash hands thoroughly before use, avoid touching the dropper tip to any surface to prevent contamination, tilt head back slightly and pull down lower eyelid to create a pouch, instill one drop into the conjunctival sac, close eyes gently for 1–2 minutes, and apply gentle pressure to the nasolacrimal duct for approximately 1 minute to minimize systemic absorption. If using other topical ophthalmic medications, allow at least 5 minutes between applications.
Precautions
Patients should be advised that Xalatan may gradually increase brown pigmentation of the iris, which may be permanent. Eyelid skin darkening may also occur and may be reversible upon discontinuation. The medication may gradually change eyelashes and vellus hair in the treated eye, including increased length, thickness, pigmentation, and number of lashes. Patients should be monitored for intraocular inflammation and macular edema, particularly in aphakic patients, pseudophakic patients with torn posterior lens capsule, or patients with known risk factors for macular edema. Contact lens wearers should remove lenses prior to administration and wait at least 15 minutes before reinsertion due to benzalkonium chloride content.
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 iritis or uveitis. The medication is not recommended for use in pediatric patients as safety and effectiveness have not been established. Patients with a history of herpetic keratitis should use with caution and only under close supervision due to potential reactivation of herpes simplex virus.
Possible side effects
The most frequently reported ocular adverse reactions (5–15%) include blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, increased iris pigmentation, and punctate epithelial keratopathy. Less common ocular effects (1–4%) include eye pain, lid discomfort, conjunctival edema, dryness, photophobia, lacrimation disorder, and eyelash changes. Rare but serious ocular events include intraocular inflammation (iritis/uveitis), macular edema including cystoid macular edema, and corneal epithelial defects. Systemic side effects may include upper respiratory tract infection, chest pain, and skin reactions.
Drug interaction
Although specific drug interaction studies have not been conducted, theoretical interactions exist with other prostaglandin analogues, which may reduce the IOP-lowering effect. The concomitant use of two or more prostaglandin analogues is not recommended. Thimerosal-preserved eye drops may cause precipitation when used concurrently; separate administration by at least 5 minutes. Cholinergic agonists may theoretically decrease uveoscleral outflow, potentially reducing Xalatan’s efficacy. Systemic medications that affect intraocular pressure should be monitored closely when initiating Xalatan therapy.
Missed dose
If a dose is missed, patients should administer it as soon as possible on the same day. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not instill two drops to make up for a missed dose. Consistency in evening administration is important for maintaining optimal IOP control, but occasional missed doses are unlikely to significantly impact long-term pressure management.
Overdose
Topical overdose is unlikely to produce serious effects due to limited systemic absorption. If accidentally ingested orally, symptomatic treatment should be provided. Ocular overdose may result in conjunctival or episcleral hyperemia, eye irritation, or temporary visual disturbances. The eyes should be rinsed with warm water if multiple drops are accidentally instilled. Systemic effects from ocular overdose are improbable due to rapid metabolism, but patients experiencing symptoms such as nausea, dizziness, or headache should seek medical attention.
Storage
Store unopened bottle under refrigeration 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 provided for educational purposes only and does not constitute medical advice. Xalatan is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Patients should not initiate, discontinue, or change dosage without consulting their ophthalmologist. Individual results may vary based on patient-specific factors including disease severity, concomitant conditions, and other medications. Full prescribing information should be consulted before use.
Reviews
Clinical studies demonstrate that Xalatan maintains consistent efficacy with 70–80% of patients achieving target IOP reduction. Ophthalmologists report high satisfaction with its predictable response and patient compliance due to once-daily dosing. Patients appreciate the convenience compared to multiple-daily regimens, though some note initial ocular irritation that typically diminishes with continued use. Long-term follow-up studies confirm maintained efficacy over 2+ years of treatment with stable safety profile. The medication receives particular praise for its effectiveness in patients who have responded inadequately to other antiglaucoma therapies.