|Xalatan ophthalmic solution
|Drugs search, click the first letter of a drug name:
| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home
Generic Name: latanoprost
Dosage Form: Ophthalmic solution
Latanoprost is a prostaglandin F2α analogue. Its chemical name is isopropyl-(Z)-7 [(1R,2R,3R,5S) 3,5-dihydroxy-2-[(3R)-3-hydroxy-5-phenylpentyl]cyclopentyl]-5-heptenoate. Its molecular formula is C26H40O5 and its chemical structure is:
Latanoprost is a colorless to slightly yellow oil that is very soluble in acetonitrile and freely soluble in acetone, ethanol, ethyl acetate, isopropanol, methanol and octanol. It is practically insoluble in water.
Xalatan Sterile Ophthalmic Solution (latanoprost ophthalmic solution) is supplied as a sterile, isotonic, buffered aqueous solution of latanoprost with a pH of approximately 6.7 and an osmolality of approximately 267 mOsmol/kg. Each mL of Xalatan contains 50 micrograms of latanoprost. Benzalkonium chloride, 0.02% is added as a preservative. The inactive ingredients are: sodium chloride, sodium dihydrogen phosphate monohydrate, disodium hydrogen phosphate anhydrous and water for injection. One drop contains approximately 1.5 µg of latanoprost.
Xalatan - Clinical Pharmacology
Mechanism of Action
Latanoprost is a prostanoid selective FP receptor agonist that is believed to reduce the intraocular pressure (IOP) by increasing the outflow of aqueous humor. Studies in animals and man suggest that the main mechanism of action is increased uveoscleral outflow. Elevated IOP represents a major risk factor for glaucomatous field loss. The higher the level of IOP, the greater the likelihood of optic nerve damage and visual field loss.
Latanoprost is absorbed through the cornea where the isopropyl ester prodrug is hydrolyzed to the acid form to become biologically active. Studies in man indicate that the peak concentration in the aqueous humor is reached about two hours after topical administration.Distribution
The distribution volume in humans is 0.16 ± 0.02 L/kg. The acid of latanoprost can be measured in aqueous humor during the first 4 hours, and in plasma only during the first hour after local administration.Metabolism
Latanoprost, an isopropyl ester prodrug, is hydrolyzed by esterases in the cornea to the biologically active acid. The active acid of latanoprost reaching the systemic circulation is primarily metabolized by the liver to the 1,2-dinor and 1,2,3,4-tetranor metabolites via fatty acid β-oxidation.Excretion
The elimination of the acid of latanoprost from human plasma is rapid (t1/2 =17 min) after both intravenous and topical administration. Systemic clearance is approximately 7 mL/min/kg. Following hepatic β-oxidation, the metabolites are mainly eliminated via the kidneys. Approximately 88% and 98% of the administered dose is recovered in the urine after topical and intravenous dosing, respectively.
In monkeys, latanoprost has been shown to induce increased pigmentation of the iris. The mechanism of increased pigmentation seems to be stimulation of melanin production in melanocytes of the iris, with no proliferative changes observed. The change in iris color may be permanent.
Ocular administration of latanoprost at a dose of 6 µg/eye/day (4 times the daily human dose) to cynomolgus monkeys has also been shown to induce increased palpebral fissure. This effect was reversible upon discontinuation of the drug.
Indications and Usage for Xalatan
Xalatan Sterile Ophthalmic Solution is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.
Patients with mean baseline intraocular pressure of 24 – 25 mmHg who were treated for 6 months in multi-center, randomized, controlled trials demonstrated 6 –8 mmHg reductions in intraocular pressure. This IOP reduction with Xalatan Sterile Ophthalmic Solution 0.005% dosed once daily was equivalent to the effect of timolol 0.5% dosed twice daily.
A 3-year open-label, prospective safety study with a 2-year extension phase was conducted to evaluate the progression of increased iris pigmentation with continuous use of Xalatan once-daily as adjunctive therapy in 519 patients with open-angle glaucoma. The analysis was based on observed-cases population of the 380 patients who continued in the extension phase.
Results showed that the onset of noticeable increased iris pigmentation occurred within the first year of treatment for the majority of the patients who developed noticeable increased iris pigmentation. Patients continued to show signs of increasing iris pigmentation throughout the five years of the study. Observation of increased iris pigmentation did not affect the incidence, nature or severity of adverse events (other than increased iris pigmentation) recorded in the study. IOP reduction was similar regardless of the development of increased iris pigmentation during the study.
Known hypersensitivity to latanoprost, benzalkonium chloride or any other ingredients in this product.
Xalatan Sterile Ophthalmic Solution has been reported to cause changes to pigmented tissues. The most frequently reported changes have been increased pigmentation of the iris, periorbital tissue (eyelid) and eyelashes, and growth of eyelashes. Pigmentation is expected to increase as long as Xalatan is administered. After discontinuation of Xalatan, pigmentation of the iris is likely to be permanent while pigmentation of the periorbital tissue and eyelash changes have been reported to be reversible in some patients. Patients who receive treatment should be informed of the possibility of increased pigmentation. The effects of increased pigmentation beyond 5 years are not known.
Xalatan Sterile Ophthalmic Solution may gradually increase the pigmentation of the iris. The eye color change is due to increased melanin content in the stromal melanocytes of the iris rather than to an increase in the number of melanocytes. This change may not be noticeable for several months to years (see WARNINGS). Typically, the brown pigmentation around the pupil spreads concentrically towards the periphery of the iris and the entire iris or parts of the iris become more brownish. Neither nevi nor freckles of the iris appear to be affected by treatment. While treatment with Xalatan can be continued in patients who develop noticeably increased iris pigmentation, these patients should be examined regularly.
During clinical trials, the increase in brown iris pigment has not been shown to progress further upon discontinuation of treatment, but the resultant color change may be permanent.
Eyelid skin darkening, which may be reversible, has been reported in association with the use of Xalatan (see WARNINGS).
Xalatan may gradually change eyelashes and vellus hair in the treated eye; these changes include increased length, thickness, pigmentation, the number of lashes or hairs, and misdirected growth of eyelashes. Eyelash changes are usually reversible upon discontinuation of treatment.
Xalatan should be used with caution in patients with a history of intraocular inflammation (iritis/uveitis) and should generally not be used in patients with active intraocular inflammation.
Macular edema, including cystoid macular edema, has been reported during treatment with Xalatan. These reports have mainly occurred in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema. Xalatan should be used with caution in patients who do not have an intact posterior capsule or who have known risk factors for macular edema.
There is limited experience with Xalatan in the treatment of angle closure, inflammatory or neovascular glaucoma.
There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface (see PRECAUTIONS, Information for Patients).
Contact lenses should be removed prior to the administration of Xalatan, and may be reinserted 15 minutes after administration (see PRECAUTIONS, Information for Patients).
Information for Patients
Patients should be advised about the potential for increased brown pigmentation of the iris, which may be permanent. Patients should also be informed about the possibility of eyelid skin darkening, which may be reversible after discontinuation of Xalatan.
Patients should also be informed of the possibility of eyelash and vellus hair changes in the treated eye during treatment with Xalatan. These changes may result in a disparity between eyes in length, thickness, pigmentation, number of eyelashes or vellus hairs, and/or direction of eyelash growth. Eyelash changes are usually reversible upon discontinuation of treatment.
Patients should be instructed to avoid allowing the tip of the dispensing container to contact the eye or surrounding structures because this could cause the tip to become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.
Patients also should be advised that if they develop an intercurrent ocular condition (e.g., trauma, or infection) or have ocular surgery, they should immediately seek their physician"s advice concerning the continued use of the multiple-dose container.
Patients should be advised that if they develop any ocular reactions, particularly conjunctivitis and lid reactions, they should immediately seek their physician"s advice.
Patients should also be advised that Xalatan contains benzalkonium chloride, which may be absorbed by contact lenses. Contact lenses should be removed prior to administration of the solution. Lenses may be reinserted 15 minutes following administration of Xalatan.
If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes apart.
In vitro studies have shown that precipitation occurs when eye drops containing thimerosal are mixed with Xalatan. If such drugs are used they should be administered at least five (5) minutes apart.
Carcinogenesis, Mutagenesis, Impairment of Fertility
Latanoprost was not mutagenic in bacteria, in mouse lymphoma or in mouse micronucleus tests.
Chromosome aberrations were observed in vitro with human lymphocytes.
Latanoprost was not carcinogenic in either mice or rats when administered by oral gavage at doses of up to 170 µg/kg/day (approximately 2,800 times the recommended maximum human dose) for up to 20 and 24 months, respectively.
Additional in vitro and in vivo studies on unscheduled DNA synthesis in rats were negative. Latanoprost has not been found to have any effect on male or female fertility in animal studies.
Pregnancy Category C
Reproduction studies have been performed in rats and rabbits. In rabbits an incidence of 4 of 16 dams had no viable fetuses at a dose that was approximately 80 times the maximum human dose, and the highest nonembryocidal dose in rabbits was approximately 15 times the maximum human dose. There are no adequate and well-controlled studies in pregnant women. Xalatan should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
It is not known whether this drug or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Xalatan is administered to a nursing woman.
Safety and effectiveness in pediatric patients have not been established.
No overall differences in safety or effectiveness have been observed between elderly and younger patients.
Adverse events referred to in other sections of this insert
Eyelash changes (increased length, thickness, pigmentation, and number of lashes); eyelid skin darkening; intraocular inflammation (iritis/uveitis); iris pigmentation changes; and macular edema, including cystoid macular edema (see WARNINGS and PRECAUTIONS).
Controlled Clinical Trials
The ocular adverse events and ocular signs and symptoms reported in 5 to 15% of the patients on Xalatan Sterile Ophthalmic Solution in the three 6-month, multi-center, double-masked, active-controlled trials were blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, increased pigmentation of the iris, and punctate epithelial keratopathy.
Local conjunctival hyperemia was observed; however, less than 1% of the patients treated with Xalatan required discontinuation of therapy because of intolerance to conjunctival hyperemia.
In addition to the above listed ocular events/signs and symptoms, the following were reported in 1 to 4% of the patients: dry eye, excessive tearing, eye pain, lid crusting, lid discomfort/pain, lid edema, lid erythema, and photophobia.
The following events were reported in less than 1% of the patients: conjunctivitis, diplopia and discharge from the eye.
During clinical studies, there were extremely rare reports of the following: retinal artery embolus, retinal detachment, and vitreous hemorrhage from diabetic retinopathy.
The most common systemic adverse events seen with Xalatan were upper respiratory tract infection/cold/flu, which occurred at a rate of approximately 4%. Chest pain/angina pectoris, muscle/joint/back pain, and rash/allergic skin reaction each occurred at a rate of 1 to 2%.
The following events have been identified during postmarketing use of Xalatan in clinical practice. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. The events, which have been chosen for inclusion due to either their seriousness, frequency of reporting, possible causal connection to Xalatan, or a combination of these factors, include: asthma and exacerbation of asthma; corneal edema and erosions; dyspnea; eyelash and vellus hair changes (increased length, thickness, pigmentation, and number); eyelid skin darkening; herpes keratitis; intraocular inflammation (iritis/uveitis); keratitis; macular edema, including cystoid macular edema; misdirected eyelashes sometimes resulting in eye irritation; and toxic epidermal necrolysis.
Apart from ocular irritation and conjunctival or episcleral hyperemia, the ocular effects of latanoprost administered at high doses are not known. Intravenous administration of large doses of latanoprost in monkeys has been associated with transient bronchoconstriction; however, in 11 patients with bronchial asthma treated with latanoprost, bronchoconstriction was not induced. Intravenous infusion of up to 3 µg/kg in healthy volunteers produced mean plasma concentrations 200 times higher than during clinical treatment and no adverse reactions were observed. Intravenous dosages of 5.5 to 10 µg/kg caused abdominal pain, dizziness, fatigue, hot flushes, nausea and sweating.
If overdosage with Xalatan Sterile Ophthalmic Solution occurs, treatment should be symptomatic.
Xalatan Dosage and Administration
The recommended dosage is one drop (1.5 µg) in the affected eye(s) once daily in the evening.
The dosage of Xalatan Sterile Ophthalmic Solution should not exceed once daily since it has been shown that more frequent administration may decrease the intraocular pressure lowering effect.
Reduction of the intraocular pressure starts approximately 3 to 4 hours after administration and the maximum effect is reached after 8 to 12 hours.
Xalatan may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes apart.
How is Xalatan Supplied
Xalatan Sterile Ophthalmic Solution is a clear, isotonic, buffered, preserved colorless solution of latanoprost 0.005% (50 µg/mL). It is supplied as a 2.5 mL solution in a 5 mL clear low density polyethylene bottle with a clear low density polyethylene dropper tip, a turquoise high density polyethylene screw cap, and a tamper-evident clear low density polyethylene overcap.
2.5 mL fill, 0.005% (50 µg/mL)
Package of 1 bottle NDC 0013-8303-04
Protect from light. Store unopened bottle(s) under refrigeration at 2° to 8°C (36° to 46°F). During shipment to the patient, the bottle may be maintained at temperatures up to 40°C (104°F) for a period not exceeding 8 days. Once a bottle is opened for use, it may be stored at room temperature up to 25°C (77°F) for 6 weeks.
Where can I get more information about Xalatan ophthalmic solution ? We recommend to use www.Drugs.com
Typical mistypes for Xalatan ophthalmic solution
zalatan ophthalmic solution, calatan ophthalmic solution, dalatan ophthalmic solution, salatan ophthalmic solution, xzlatan ophthalmic solution, xslatan ophthalmic solution, xwlatan ophthalmic solution, xqlatan ophthalmic solution, xakatan ophthalmic solution, xapatan ophthalmic solution, xaoatan ophthalmic solution, xalztan ophthalmic solution, xalstan ophthalmic solution, xalwtan ophthalmic solution, xalqtan ophthalmic solution, xalaran ophthalmic solution, xalafan ophthalmic solution, xalagan ophthalmic solution, xalayan ophthalmic solution, xala6an ophthalmic solution, xala5an ophthalmic solution, xalatzn ophthalmic solution, xalatsn ophthalmic solution, xalatwn ophthalmic solution, xalatqn ophthalmic solution, xalatab ophthalmic solution, xalatam ophthalmic solution, xalataj ophthalmic solution, xalatah ophthalmic solution, xalatan iphthalmic solution, xalatan kphthalmic solution, xalatan lphthalmic solution, xalatan pphthalmic solution, xalatan 0phthalmic solution, xalatan 9phthalmic solution, xalatan oohthalmic solution, xalatan olhthalmic solution, xalatan o-hthalmic solution, xalatan o0hthalmic solution, xalatan opgthalmic solution, xalatan opbthalmic solution, xalatan opnthalmic solution, xalatan opjthalmic solution, xalatan oputhalmic solution, xalatan opythalmic solution, xalatan ophrhalmic solution, xalatan ophfhalmic solution, xalatan ophghalmic solution, xalatan ophyhalmic solution, xalatan oph6halmic solution, xalatan oph5halmic solution, xalatan ophtgalmic solution, xalatan ophtbalmic solution, xalatan ophtnalmic solution, xalatan ophtjalmic solution, xalatan ophtualmic solution, xalatan ophtyalmic solution, xalatan ophthzlmic solution, xalatan ophthslmic solution, xalatan ophthwlmic solution, xalatan ophthqlmic solution, xalatan ophthakmic solution, xalatan ophthapmic solution, xalatan ophthaomic solution, xalatan ophthalnic solution, xalatan ophthalkic solution, xalatan ophthaljic solution, xalatan ophthalmuc solution, xalatan ophthalmjc solution, xalatan ophthalmkc solution, xalatan ophthalmoc solution, xalatan ophthalm9c solution, xalatan ophthalm8c solution, xalatan ophthalmix solution, xalatan ophthalmiv solution, xalatan ophthalmif solution, xalatan ophthalmid solution, xalatan ophthalmic aolution, xalatan ophthalmic zolution, xalatan ophthalmic xolution, xalatan ophthalmic dolution, xalatan ophthalmic eolution, xalatan ophthalmic wolution, xalatan ophthalmic silution, xalatan ophthalmic sklution, xalatan ophthalmic sllution, xalatan ophthalmic splution, xalatan ophthalmic s0lution, xalatan ophthalmic s9lution, xalatan ophthalmic sokution, xalatan ophthalmic sopution, xalatan ophthalmic sooution, xalatan ophthalmic solytion, xalatan ophthalmic solhtion, xalatan ophthalmic soljtion, xalatan ophthalmic solition, xalatan ophthalmic sol8tion, xalatan ophthalmic sol7tion, xalatan ophthalmic solurion, xalatan ophthalmic solufion, xalatan ophthalmic solugion, xalatan ophthalmic soluyion, xalatan ophthalmic solu6ion, xalatan ophthalmic solu5ion, xalatan ophthalmic solutuon, xalatan ophthalmic solutjon, xalatan ophthalmic solutkon, xalatan ophthalmic solutoon, xalatan ophthalmic solut9on, xalatan ophthalmic solut8on, xalatan ophthalmic solutiin, xalatan ophthalmic solutikn, xalatan ophthalmic solutiln, xalatan ophthalmic solutipn, xalatan ophthalmic soluti0n, xalatan ophthalmic soluti9n, xalatan ophthalmic solutiob, xalatan ophthalmic solutiom, xalatan ophthalmic solutioj, xalatan ophthalmic solutioh, alatan ophthalmic solution, xlatan ophthalmic solution, xaatan ophthalmic solution, xaltan ophthalmic solution, xalaan ophthalmic solution, xalatn ophthalmic solution, xalata ophthalmic solution, xalatanophthalmic solution, xalatan phthalmic solution, xalatan ohthalmic solution, xalatan opthalmic solution, xalatan ophhalmic solution, xalatan ophtalmic solution, xalatan ophthlmic solution, xalatan ophthamic solution, xalatan ophthalic solution, xalatan ophthalmc solution, xalatan ophthalmi solution, xalatan ophthalmicsolution, xalatan ophthalmic olution, xalatan ophthalmic slution, xalatan ophthalmic soution, xalatan ophthalmic soltion, xalatan ophthalmic soluion, xalatan ophthalmic soluton, xalatan ophthalmic solutin, xalatan ophthalmic solutio, axlatan ophthalmic solution, xlaatan ophthalmic solution, xaaltan ophthalmic solution, xaltaan ophthalmic solution, xalaatn ophthalmic solution, xalatna ophthalmic solution, xalata nophthalmic solution, xalatano phthalmic solution, xalatan pohthalmic solution, xalatan ohpthalmic solution, xalatan opthhalmic solution, xalatan ophhtalmic solution, xalatan ophtahlmic solution, xalatan ophthlamic solution, xalatan ophthamlic solution, xalatan ophthalimc solution, xalatan ophthalmci solution, xalatan ophthalmi csolution, xalatan ophthalmics olution, xalatan ophthalmic oslution, xalatan ophthalmic sloution, xalatan ophthalmic soultion, xalatan ophthalmic soltuion, xalatan ophthalmic soluiton, xalatan ophthalmic solutoin, xalatan ophthalmic solutino, xxalatan ophthalmic solution, xaalatan ophthalmic solution, xallatan ophthalmic solution, xalaatan ophthalmic solution, xalattan ophthalmic solution, xalataan ophthalmic solution, xalatann ophthalmic solution, xalatan ophthalmic solution, xalatan oophthalmic solution, xalatan opphthalmic solution, xalatan ophhthalmic solution, xalatan ophtthalmic solution, xalatan ophthhalmic solution, xalatan ophthaalmic solution, xalatan ophthallmic solution, xalatan ophthalmmic solution, xalatan ophthalmiic solution, xalatan ophthalmicc solution, xalatan ophthalmic solution, xalatan ophthalmic ssolution, xalatan ophthalmic soolution, xalatan ophthalmic sollution, xalatan ophthalmic soluution, xalatan ophthalmic soluttion, xalatan ophthalmic solutiion, xalatan ophthalmic solutioon, xalatan ophthalmic solutionn, etc.