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Prostaglandin Analogue — Glaucoma (Preservative-Free) Pregnancy: Avoid — prostaglandins affect uterine tone; may cause miscarriage

Tafluprost 0.0015% Eye Drops

Brand names: Saflutan

Adult dose

Dose: 1 drop once daily in the evening
Route: Topical (ophthalmic)
Frequency: Once daily at bedtime
Max: 1 drop once daily
Preservative-free unit-dose vials — no benzalkonium chloride (BAK). Preferred alternative to latanoprost in patients with dry eye, contact lens wearers, or those sensitive to preservatives. IOP reduction equivalent to latanoprost 0.005%. Each sachet used once and discarded.

Paediatric dose

Route:
Not licensed for paediatric use — seek specialist opinion

Dose adjustments

Renal

No adjustment — topical use

Hepatic

No adjustment

Clinical pearls

  • BAK-free advantage: benzalkonium chloride (BAK) — the most common ophthalmic preservative — causes corneal epithelial toxicity and trabecular meshwork damage with chronic use; tafluprost unit-dose vials eliminate this; preferred in patients with ocular surface disease, dry eye, or need for multiple topical eye medications
  • Prostaglandin-associated periorbitopathy (PAP): deepening of the upper lid sulcus, enophthalmos, dermatochalasis, and ptosis — class effect for all prostaglandin analogues (latanoprost, travoprost, bimatoprost, tafluprost); reversible on stopping; cosmetically significant and can cause asymmetry in unilateral treatment
  • Switching between prostaglandins: generally equivalent IOP reduction — switch is appropriate for tolerability (preservative side effects, hyperaemia); 2–4 week washout period not required
  • MHRA cosmetic concern: patients should be warned about iris darkening (irreversible), periocular pigmentation, and eyelash changes before initiating any prostaglandin analogue
  • Prostaglandin analogues remain first-line glaucoma treatment in most national guidelines (EGS, NICE) — largest IOP reduction per drop of any class (~25–35%)

Contraindications

  • Hypersensitivity to tafluprost or excipients
  • Active intraocular inflammation (uveitis — prostaglandins may worsen cystoid macular oedema)

Side effects

  • Conjunctival hyperaemia
  • Iris colour change (heterochromia) — as with all prostaglandin analogues
  • Periocular pigmentation and hypertrichosis of lashes
  • Deepening of upper lid sulcus (DUES) and prostaglandin-associated periorbitopathy (PAP)
  • Uveitis/cystoid macular oedema (rare)
  • Systemic: headache, nasopharyngitis

Interactions

  • Other prostaglandin analogues — additive side effects without additional IOP benefit; do not combine
  • NSAIDs — possible reduction in prostaglandin analogue efficacy

Monitoring

  • IOP at 4–8 weeks
  • Iris colour (document baseline photography)
  • Ocular surface assessment
  • Periocular skin and lid changes

Reference: BNFc; BNF 90; NICE NG81 (Glaucoma); EGS Glaucoma Guidelines 2020; Prostaglandin Periorbitopathy Reviews; SPC Saflutan. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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