Latanoprostene Bunod 0.024% Eye Drops

How it works

It is metabolised in the eye to latanoprost acid, a prostaglandin analogue that increases uveoscleral outflow, and to butanediol mononitrate, which releases nitric oxide to enhance trabecular meshwork outflow, together reducing intraocular pressure.

Prescribing in practice

• Like other prostaglandin analogues it can cause permanent changes in iris colour and periorbital tissue and increased eyelash growth, which should be discussed before starting, and it is for once-daily evening use only.
• Use with caution in patients with active intraocular inflammation, aphakia or known risk factors for macular oedema.
• Remove contact lenses before instillation and reinsert after the recommended interval; if other intraocular pressure-lowering drops are used, separate their administration.

Monitoring

Monitor intraocular pressure regularly to assess treatment response and review the eye for iris or periorbital pigmentary changes and any signs of intraocular inflammation.

Counselling the patient

• Use one drop in the affected eye(s) in the evening and do not exceed once-daily dosing, as more frequent use may reduce the pressure-lowering effect.
• Be aware that darkening of the iris and eyelid skin and longer, darker eyelashes can occur, and iris colour change may be permanent.

Evidence & guidelines

Prostaglandin analogues are recommended first-line for lowering intraocular pressure in open-angle glaucoma and ocular hypertension by NICE guidance (NG81).