Netarsudil 0.02% Eye Drops

How it works

It inhibits Rho kinase and noradrenaline transporter activity, increasing aqueous humour outflow through the trabecular meshwork and lowering episcleral venous pressure to reduce intraocular pressure.

Prescribing in practice

• Conjunctival hyperaemia is the most common adverse effect and other characteristic effects include corneal verticillata (vortex keratopathy) and small conjunctival haemorrhages.
• It is administered once daily, usually in the evening, and is intended for chronic pressure control rather than acute use.
• Contact lenses should be removed before instillation and reinserted after a short interval.

Monitoring

Intraocular pressure and the corneal surface should be monitored periodically to confirm efficacy and detect characteristic ocular changes.

Counselling the patient

• Use the drops once daily at the time advised, typically in the evening, and continue even though glaucoma usually causes no symptoms.
• Redness of the eye is common and is not usually harmful, but report persistent discomfort or visual change.
• Remove contact lenses before instilling and wait before putting them back in.

Evidence & guidelines

Netarsudil's intraocular-pressure-lowering efficacy was demonstrated in randomised controlled trials and is reflected in the SPC.