Tafluprost

How it works

As a selective prostaglandin F2-alpha receptor agonist it lowers intraocular pressure mainly by increasing uveoscleral outflow of aqueous humour.

Prescribing in practice

• It can cause gradual, often permanent changes including increased brown iris pigmentation, eyelid skin darkening and eyelash lengthening, which should be explained particularly when only one eye is treated.
• Prostaglandin analogues may cause or worsen intraocular inflammation and should be used with caution in patients with active uveitis or risk of macular oedema.
• Tafluprost is available in preservative-free form, which is useful for patients with ocular surface disease or preservative intolerance.

Monitoring

Intraocular pressure should be monitored to confirm response, with periodic assessment for iris/periocular pigmentary change and ocular surface tolerability.

Counselling the patient

• Instil once daily, usually in the evening, and use it regularly even though glaucoma has no symptoms.
• Iris colour, eyelid skin and eyelashes may darken or change, especially if only one eye is treated.
• Vision may blur briefly after instillation.

Evidence & guidelines

Prostaglandin analogues are recommended by NICE as a first-line option for lowering intraocular pressure in open-angle glaucoma and ocular hypertension.