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latanoprostene BUNOD (Vyzulta)

Indications: - treatment of open angle glaucoma Contraindications: - caution: - use with contact lens - use in patients with aphakia Dosage: - one drop OU QD - 0.24 mg/mL 2.5 mL, 5 mL Storage: - unopened bottle: 2-8 C - opened bottle: 2-25 C for 8 weeks Adverse effects: - pigmentation - eyelash changes - intraocular inflammation (iritis, uveitis) - macular edema, cystoid macular edema - bacterial keratitis Mechanism of action: - novel nitric oxide (NO)-donating prostaglandin F2-alpha analog - metabolizes into two moieties: latanoprost acid & butanediol mononitrate - enhances aqueous humor outflow (dual action) - enhances uveoscleral (unconventional) outflow by upregulating matrix metalloproteinase expression - remodeling of the ciliary muscle's extracellular matrix - linked to an NO-donating moiety that enhances trabecular meshwork/Schlemm's canal (conventional) outflow by inducing cytoskeletal relaxation via the soluble guanylyl cyclase- cGMP signaling pathway - intraocular pressure reduction 25% [6] Notes: - CVS price Dec 2017 $425/5mL

General

ophthalmic agent (eyedrops) prostaglandin analog; prostanoid

Database Correlations

PUBCHEM cid=11156438

References

  1. RxNorm
  2. Kaufman PL. Latanoprostene bunod ophthalmic solution 0.024% for IOP lowering in glaucoma and ocular hypertension. Expert Opin Pharmacother. 2017 Mar;18(4):433-444. PMID: 28234563
  3. Weinreb RN, Ong T, Scassellati Sforzolini B et al A randomised, controlled comparison of latanoprostene bunod and latanoprost 0.005% in the treatment of ocular hypertension and open angle glaucoma: the VOYAGER study. Br J Ophthalmol. 2015 Jun;99(6):738-45. PMID: 25488946 Free PMC Article
  4. Medeiros FA, Martin KR, Peace J et al Comparison of Latanoprostene Bunod 0.024% and Timolol Maleate 0.5% in Open-Angle Glaucoma or Ocular Hypertension: The LUNAR Study. Am J Ophthalmol. 2016 Aug;168:250-259. Epub 2016 May 20. PMID: 27210275 Free Article
  5. Weinreb RN, Scassellati Sforzolini B et al Latanoprostene Bunod 0.024% versus Timolol Maleate 0.5% in Subjects with Open-Angle Glaucoma or Ocular Hypertension: The APOLLO Study. Ophthalmology. 2016 May;123(5):965-73. Epub 2016 Feb 11. PMID: 26875002 Free Article
  6. Windle ML. FDA New Drug and Biologic Approvals -- 2017 Year-in-Review Medscape - Jan 11, 2018. https://reference.medscape.com/viewarticle/890871 - U.S. Food and Drug Administration. Novel Drug Approvals for 2017. https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DrugInnovation/ucm537040.htm
  7. Dalton M, Bacharach J, Roberts C. New glaucoma therapy offers first drug option in years. Latanoprostene bunod increases outflow through the trabecular meshwork and Schlemm's canal. Ophthalmology Times. Jan 7, 2018 http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/new-glaucoma-drug-offers-first-new-option-years