Advertisement

Drugs & Aging

, Volume 9, Issue 5, pp 363–378 | Cite as

Latanoprost

A Review of its Pharmacological Properties, Clinical Efficacy and Tolerability in the Management of Primary Open-Angle Glaucoma and Ocular Hypertension
  • Sanjay S. Patel
  • Caroline M. Spencer
Drug Evaluation

Abstract

Synopsis

Latanoprost is an ester prodrug analogue of prostaglandin F2α which effectively reduces intraocular pressure (IOP) by increasing uveoscleral outflow rather than altering conventional (trabeculo-canalicular) aqueous outflow. The IOP-lowering effect of latanoprost lasts for 20 to 24 hours after a single dose, which allows a single daily dosage regimen.

Data from 4 randomised double-masked multicentre studies indicate that a once daily dose of topical latanoprost 0.005% is as effective as timolol 0.5% twice daily in the treatment of patients with primary open-angle glaucoma or ocular hypertension. A number of studies also demonstrate that latanoprost enhances IOP-lowering effects when applied in combination with other antiglaucoma agents.

Latanoprost is well tolerated with no, or barely detectable, conjunctival hyperaemia, and, unlike timolol, is not associated with systemic adverse effects. However, 3 to 10% of patients treated with latanoprost 0.005% have shown increased iris pigmentation after 3 to 4.5 months’ treatment.

In summary, the available data show that latanoprost is a potent IOP-lowering agent with a number of positive features including a single daily dosage regimen, a novel mechanism of action that enhances the IOP-lowering effect of contemporary agents, and a lack of systemic adverse effects. These properties suitably poise latanoprost for a prominent position in the management of patients with primary open-angle glaucoma and ocular hypertension.

Pharmacodynamic Properties

Latanoprost is an ester prodrug analogue of prostaglandin F2α with high selectivity for the FP subtype of prostanoid receptors. Unlike contemporary antiglaucoma agents, latanoprost reduces intraocular pressure (IOP) by increasing uveoscleral outflow, with little or no alteration of conventional (trabeculo-canalicular) aqueous outflow and no effects on retinal vasculature or permeability of the blood-aqueous barrier.

The reduction in IOP produced by latanoprost is dose-dependent. The IOP-lowering effects after a single dose of latanoprost 0.006% last for up to 20 to 24 hours. Long term (6 months) application of latanoprost is not associated with morphological alterations to the ciliary muscle or trabecular meshwork, according to animal data. Furthermore, other body systems (brain, cardiovascular, respiratory) do not appear to be significantly affected by latanoprost at concentrations up to 10-fold greater than those used clinically for topical application.

Pharmacokinetic Properties

Latanoprost is more lipophilic than its parent prostaglandin and therefore better able to penetrate the cornea. After uptake by the cornea, latanoprost is completely hydrolysed; the drug does not seem to be metabolised by other means in the eye. In monkeys, the highest drug concentrations were observed in the cornea after topical administration; the acid of latanoprost was then released from the cornea into the anterior eye. The drug had an elimination half-life of 3 to 4 hours from the eye tissues.

Drug that is systemically absorbed has a short plasma elimination half-life. The major metabolic pathway is by β-oxidation and the metabolites are excreted primarily via the kidneys. Recovery of radiolabelled drug appears to be complete.

Clinical Evaluation

Dose-ranging studies show that a once daily topical dose of latanoprost (optimal concentration of 0.005 or 0.006%) effectively produces a decrease in IOP in patients with primary open-angle glaucoma or ocular hypertension. Single daily application of latanoprost is at least as effective as a twice daily dose.

Three of 4 long term (3 or 6 months) randomised, double-masked, multicentre studies indicated that once daily latanoprost 0.005% was more effective than timolol 0.5% twice daily in reducing IOP. A number of clinical studies have also shown that latanoprost applied in combination with other antiglaucoma agents produces enhanced IOP-lowering effects.

Tolerability

Data from phase III clinical studies indicate that topical latanoprost 0.005% once daily application is, overall, as well tolerated as timolol 0.5% twice daily. At clinically effective doses, no or a barely detectable increase in conjunctival hyperaemia was noted in at least 90% of latanoprost or timolol recipients. In contrast to timolol, latanoprost is not associated with systemic adverse effects.

On the other hand, increased iridial pigmentation has been noted in 3 to 10% of patients after 3 to 4.5 months’ continuous treatment with latanoprost 0.005%. It occurred only in patients with mixed colour irises (green-brown or blue/grey-brown); freckles or naevi in the iris were not affected.

Dosage and Administration

Once-daily topical instillation of latanoprost 0.005% is the recommended dosage regimen for the treatment of patients with primary open-angle glaucoma or ocular hypertension. If used in combination with other topical antiglaucoma agents, the drugs should be instilled at least 5 minutes apart.

Keywords

Glaucoma Intraocular Pressure Timolol Latanoprost Ocular Hypertension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Stjernschantz J, Resul B. Phenyl substituted prostaglandin analogs for glaucoma treatment. Drugs Future 1992 Aug; 17: 691–704Google Scholar
  2. 2.
    Resul B, Stjernschantz J. Structure-activity relationships of prostaglandin analogues as ocular hypotensive agents. Curr Opin Ther Pat 1993; 3(6): 781–95CrossRefGoogle Scholar
  3. 3.
    Resul B, Stjernschantz J, No K, et al. Phenyl-substituted prosta-glandins: potent and selective antiglaucoma agents. J Med Chem 1993 Jan; 36(2): 243–8PubMedCrossRefGoogle Scholar
  4. 4.
    Liljebris C, Selén G, Resul B, et al. Derivatives of 17-phenyl-18,19,20-trinorprostaglandin F2α isopropyl ester: potential antiglaucoma agents. J Med Chem 1995; 38: 289–304PubMedCrossRefGoogle Scholar
  5. 5.
    Villumsen J, Alm A. Prostaglandin F2α-isopropylester eye drops: effects in normal human eyes. Br J Ophthalmol 1989; 73: 419–26PubMedCrossRefGoogle Scholar
  6. 6.
    Villumsen J, Alm A, Söderström M. Prostaglandin F2α isopropylester eye drops: effects on intraocular pressure in open angle glaucoma. Br J Ophthalmol 1989; 73: 975–9PubMedCrossRefGoogle Scholar
  7. 7.
    Camras CB, Siebold EC, Lustgarten JS, et al. Maintained reduction of intraocular pressure by prostaglandin F2α-1 -isopropyl ester applied in multiple doses in ocular hypertensive and glaucoma patients. Ophthalmology 1989; 96: 1329–36PubMedGoogle Scholar
  8. 8.
    Kerstetter JR, Brubaker RF, Wilson SE, et al. Prostaglandin F2α 1 -isopropylester lowers intraocular pressure without decreasing aqueous humor flow. Am J Ophthalmol 1988; 105: 30–4PubMedGoogle Scholar
  9. 9.
    Lee P-Y, Shao H, Xu L, et al. The effect of prostaglandin F2α on intraocular pressure in normotensive human subjects. Invest Ophthalmol Vis Sci 1988 Oct; 29(10): 1474–7PubMedGoogle Scholar
  10. 10.
    Camras CB, Schumer RA, Marsk A, et al. Intraocular pressure reduction with PhXA34, a new prostaglandin analogue, in patients with ocular hypertension. Arch Ophthalmol 1992 Dec; 110: 1733–8PubMedCrossRefGoogle Scholar
  11. 11.
    Villumsen J, Alm A. PhXA34 - a prostaglandin F2 alpha analogue. Effect on intraocular pressure in patients with ocular hypertension. Br J Ophthalmol 1992 Apr; 76: 214–7PubMedCrossRefGoogle Scholar
  12. 12.
    Alm A, Villumsen J. PhXA34, a new potent ocular hypotensive drug. A study on dose-response relationship and on aqueous humor dynamics in healthy volunteers. Arch Ophthalmol 1991 Nov; 109: 1564–8PubMedCrossRefGoogle Scholar
  13. 13.
    Hotehama Y, Mishima HK. Clinical efficacy of PhXA34 and PhXA41, two novel prostaglandin F2α-isopropyl ester analogues for glaucoma treatment. Jpn J Ophthalmol 1993; 37(3): 259–69PubMedGoogle Scholar
  14. 14.
    Lesar TS. Glaucoma. In: DiPiro JT, Talbert RL, Hayes PE, et al., editors. Pharmacotherapy: a pathophysiologic approach. 2nd ed. Norwalk, CT: Appleton & Lange, 1993: 1363–76Google Scholar
  15. 15.
    Tucker JB. Screening for open-angle glaucoma. Am Fam Physician 1993 Jul; 48: 75–80PubMedGoogle Scholar
  16. 16.
    Capino DG, Leibowitz HM. Glaucoma: screening, diagnosis, and therapy. Hosp Pract 1990 May; 25: 73–91Google Scholar
  17. 17.
    Jay JL. The management of patients with glaucoma. Prescr J 1989 Aug; 29: 124–31Google Scholar
  18. 18.
    Quigley HA. Open-angle glaucoma. N Engl J Med 1993 Apr; 328(15): 1097–106PubMedCrossRefGoogle Scholar
  19. 19.
    Dreyer EB. Preserving eyesight with foresight. Harvard Health Lett 1994 Oct; 19: 4–6Google Scholar
  20. 20.
    Stjernschantz J, Selén G, Sjöquist B, et al. Preclinical pharmacology of latanoprost, a phenyl-substituted PGF2α analogue. In: Samuelsson B et al, editors. Advances in prostaglandin, thromboxane, and leukotriene research, v. 23. New York: Raven Press Ltd, 1995: 513–8Google Scholar
  21. 21.
    Karlsson M, Selén G, Stjernschantz J, et al. Receptor profile of PhXA41, a new phenyl substituted prostaglandin ester [abstract no. 11]. Proceedings of the 10th International Congress of Eye Research; 1992 Sep; Stresa, Italy, 155.Google Scholar
  22. 22.
    Giuffrè G. The effects of prostaglandin F2α in the human eye. Graefes Arch Clin Exp Ophthalmol 1985; 222(3): 139–41PubMedCrossRefGoogle Scholar
  23. 23.
    Gabelt BT, Kaufman PL. Prostaglandin F2α increases uveoscle-ral outflow in the cynomolgus monkey. Exp Eye Res 1989; 49: 389–402PubMedCrossRefGoogle Scholar
  24. 24.
    Nilsson SFE, Samuelson M, Bill A, et al. Increased uveoscleral outflow as a possible mechanism of ocular hypotension caused by prostaglandin F2α-1 -isopropylester in the cynomolgus monkey. Exp Eye Res 1989; 48: 707–16PubMedCrossRefGoogle Scholar
  25. 25.
    Toris CB, Camras CB, Yablonski ME. Effects of PhXA41, a new prostaglandin F2α analog, on aqueous humor dynamics in human eyes. Ophthalmology 1993 Sep; 100: 1297–304PubMedGoogle Scholar
  26. 26.
    Bill A. Conventional and uveo-scleral drainage of aqueous humour in the cynomolgus monkey (Macaca irus) at normal and high intraocular pressures. Exp Eye Res 1966; 5: 45–54PubMedCrossRefGoogle Scholar
  27. 27.
    Bill A. Uveoscleral drainage of aqueous humor: physiology and pharmacology. In: Bito LZ, Stjernschantz J, editors. The ocular effects of prostaglandins and other eicosanoids. v. 312. New York: Alan R Liss Inc., 1989: 417–27Google Scholar
  28. 28.
    McClellan K. Topical eye preparations: optimum use. Curr Ther 1995 Jan; 36: 61–6Google Scholar
  29. 29.
    Camras CB. Mechanism of the prostaglandin-induced reduction of intraocular pressure in humans. In: Samuelsson B et al., editors. Advances in prostaglandin, thromboxane, and leukotriene research, v. 23. New York: Raven Press Ltd, 1995: 519–25Google Scholar
  30. 30.
    Ziai N, Dolan JW, Kacere RD, et al. The effects on aqueous dynamics of PhXA41, a new prostaglandin F2α analogue, after topical application in normal and ocular hypertensive human eyes. Arch Ophthalmol 1993 Oct; 111: 1351–8PubMedCrossRefGoogle Scholar
  31. 31.
    Rulo A, Greve E, Hoyng P, et al. A study of the effect of latanoprost on the intraocular pressure and retinal vasculature in pseudophakic patients [abstract no. 1059]. Proceedings of the Association for Research in Vision and Ophthalmology, 1994 May 1-6; Sarasota, Florida, USA.Google Scholar
  32. 32.
    Friström B, Nilsson SEG. Interaction of PhXA41, a new prostaglandin analogue, with pilocarpine. A study on patients with elevated intraocular pressure. Arch Ophthalmol 1993 May; 111: 662–5PubMedCrossRefGoogle Scholar
  33. 33.
    Rulo AH, Greve EL, Hoyng PF. Additive effect of latanoprost, a prostaglandin F2α analogue, and timolol in patients with elevated intraocular pressure. Br J Ophthalmol 1994 Dec; 78: 899–902PubMedCrossRefGoogle Scholar
  34. 34.
    Nagasubramanian S, Sheth GP, Hitchings RA, et al. Intraocular pressure-reducing effect of PhXA41 in ocular hypertension: comparison of dose regimens. Ophthalmology 1993 Sep; 100: 1305–11PubMedGoogle Scholar
  35. 35.
    Alm A, Villumsen J, Törnquist P, et al. Intraocular pressure-reducing effect of PhXA41 in patients with increased eye pressure: a one-month study. Ophthalmology 1993 Sep; 100: 1312–7PubMedGoogle Scholar
  36. 36.
    Rácz P, Ruzsonyi MR, Nagy ZT, et al. Maintained intraocular pressure reduction with once-a-day application of a new pros-taglandin F2α analogue (PhXA41). An in-hospital, placebo-controlled study. Arch Ophthalmol 1993 May; 111: 657–61PubMedCrossRefGoogle Scholar
  37. 37.
    Alm A, Villumsen J, Törnquist P, et al. Intraocular pressure reducing effect of PhXA41 in ocular hypertensive patients -a placebo controlled double masked dose finding study [abstract no. 2773]. Proceedings of the Association for Research in Vision and Ophthalmology Meeting; 1992 May 3–8; Sarasota, Florida, USA.Google Scholar
  38. 38.
    Kjellgren D, Douglas D, Mikelberg FS, et al. The short-time effect of latanoprost on the intraocular pressure in normal pressure glaucoma. Acta Ophthalmol Scand 1995; 73: 233–6PubMedCrossRefGoogle Scholar
  39. 39.
    Kiuchi Y, Takamatsu M, Mishima HK. PhXA41, a prostaglan-din F2α analogue reduced the intraocular pressure (IOP) in human volunteers during day and night [abstract no. 4273-43]. Proceedings of the Association for Research in Vision and Ophthalmology; 1994 May 1–6; Sarasota, Florida, USA.Google Scholar
  40. 40.
    Rácz P, Ruzsonyi MR, Nagy ZT, et al. Around-the-clock intraocular pressure reduction with once-daily application of latanoprost by itself or in combination with timolol. Arch Ophthalmol 1996 Mar; 114: 268–73PubMedCrossRefGoogle Scholar
  41. 41.
    Hotehama Y, Mishima HK, Kitazawa Y, et al. Ocular hypoten-sive effect of phXA41 in patients with ocular hypertension or primary open-angle glaucoma. Jpn J Ophthalmol 1993; 37(3): 270–4PubMedGoogle Scholar
  42. 42.
    Svedbergh B, Forsberg I. A morphological study on the effects of chronic administration of latanoprost (LP) on the ciliary muscle and trabecular meshwork in monkeys [abstract no. 1152-68]. Proceedings of the Association for Research in Vision and Ophthalmology; 1993 May 2–7; Sarasota, Florida, USA.Google Scholar
  43. 43.
    Lütjen-Drecoll E, Kaufman PL. Morphological changes in primate aqueous humor formation and drainage tissues after long-term treatment with antiglaucomatous drugs. J Glaucoma 1993; 2: 316–28PubMedGoogle Scholar
  44. 44.
    Bragadóttir R, Jarkman S. Effects of PhXA41, a prostaglandin analogue, and PGF2α on the corneal and intraretinal d.c. electroretinogram (ERG) of the albino rabbit eye. Curr Eye Res 1995; 14: 1073–80PubMedCrossRefGoogle Scholar
  45. 45.
    Basu S, Sjöquist B, Stjernschantz J, et al. Corneal permeability to and ocular metabolism of phenyl substituted prostaglandin esters in vitro. Prostaglandins Leukot Essent Fatty Acids 1994 Apr; 50: 161–8PubMedCrossRefGoogle Scholar
  46. 46.
    Sjöquist B, Byding P, Resul B, et al. The systemic pharmacoki-netics of latanoprost in man after intravenous and topical administration [abstract no. 4481-33]. Proceedings of The Association for Research in Vision and Ophthalmology; 1994 May 1-6; Sarasota, Florida, USA.Google Scholar
  47. 47.
    Bito LZ, Baroody RA. The ocular pharmacokinetics of eicosanoids and their derivatives. 1. Comparison of ocular eicosanoid penetration and distribution following topical application of PGF2α, PGF2α 1 -methyl ester, and PGF2α-1-iso-propyl ester. Exp Eye Res 1987; 44: 217–26PubMedCrossRefGoogle Scholar
  48. 48.
    Camber O, Edman P, Olsson L-E. Permeability of prostaglandin F2α and prostaglandin F2α esters across cornea in vitro. Int J Pharm 1986; 29: 259–66CrossRefGoogle Scholar
  49. 49.
    Sjöquist B, Johasson A. The ocular pharmacokinetics of latanoprost, a new antiglaucoma drug, studied by autoradiog-raphy [abstract no. 3809]. Invest Ophthalmol Vis Sci 1995 Mar 15; 36(4): S823Google Scholar
  50. 50.
    Alvan G, Calissendorff B, Seideman P, et al. Absorption of ocular timolol. Clin Pharmacokinet 1980; 5: 95PubMedCrossRefGoogle Scholar
  51. 51.
    Hoyng PFJ, Rulo AH, Greve EL. The ocular hypotensive effect of latanoprost in normal pressure glaucoma patients [abstract no 14.24]. Proceedings of the 10th Congress European Society of Ophthalmology; 1995 Jun 25-29; Milan, Italy.Google Scholar
  52. 52.
    Coakes RL, O’Neill E, Potts MJ, et al. Dose-finding study with PhXA41 (latanoprost) in patients with elevated intraocular pressure [abstract]. Proceedings of the Annual Congress of the College of Ophthalmologists; 1993 May 11-14; Birmingham, England.Google Scholar
  53. 53.
    Diestelhorst M, Roters S, Krieglstein GK. The effect of latanoprost (PhXA41) on the intraocular pressure and aqueous humor protein concentration: a randomized, double masked comparison of 50 μ/ml vs 15 μ/ml with timolol 0.5% as control [abstract no. 3810]. Invest Ophthalmol Vis Sci 1995 Mar; 36(4) Suppl.: S823Google Scholar
  54. 54.
    Alm A, Widengård I, Kjellgren D, et al. Latanoprost administered once daily caused a maintained reduction of intraocular pressure in glaucoma patients treated concomitantly with timolol. Br J Ophthalmol 1995 Jan; 79: 12–6PubMedCrossRefGoogle Scholar
  55. 55.
    Lusky M, Glovinsky J, Melamed S, et al. Comparison of two dose regimens of latanoprost in patients with open angle glaucoma or ocular hypertension [abstract no. SP576]. Proceedings of the 27th International Congress of Ophthalmology; 1994 Jun 26-30; Toronto, Canada.Google Scholar
  56. 56.
    Mishima H, Masuda K, Kitazawa Y, et al. A comparison of latanoprost and timolol in primary open-angle glaucoma and ocular hypertension: a 12-week study. Arch Ophthalmol 1996 Aug; 114: 929–32PubMedCrossRefGoogle Scholar
  57. 57.
    Alm A, Stjernschantz J, the Scandinavian Latanoprost Study Group. Effects on intraocular pressure and side effects of 0.005% latanoprost applied once daily, evening or morning. Ophthalmology 1995 Dec; 102(12): 1743–52PubMedGoogle Scholar
  58. 58.
    Watson P, Stjernschantz J, the Latanoprost Study Group. A six-month, randomized, double-masked study comparing latanoprost with timolol in open-angle glaucoma and ocular hypertension. Ophthalmology 1996 Jan; 103(1): 126–37PubMedGoogle Scholar
  59. 59.
    Camras CB, the United States Latanoprost Study Group. Comparison of latanoprost and timolol in patients with ocular hypertension and glaucoma. Ophthalmology 1996 Jan; 103(1): 138–47PubMedGoogle Scholar
  60. 60.
    Alm A, Widengård I, Mäpea O. Combination of latanoprost with dipivefrin in patients with open angle glaucoma or ocular hypertension [abstract no. S6T-O4]. Proceedings of the 27th International Congress of Ophthalmology; 1994 Jun 26-30; Toronto, Canada.Google Scholar
  61. 61.
    Watson PG, Barnett F, Parker V. The additive effect of PhXA41 and propine in patients with primary open angle glaucoma [abstract no. 6a]. 1992 Jul; Oxford, England, 32Google Scholar
  62. 62.
    Rulo AH, Greve EL, Hoyng PFJ. Additive ocular hypotensive effect of latanoprost and acetazolamide in glaucoma patients [abstract no. 14.16]. Proceedings of the 10th Congress European Society of Ophthalmology; 1995 Jun 25-29; Milan, Italy.Google Scholar
  63. 63.
    Villumsen J, Alm A. Ocular effects of two different prostaglandin F2α esters: a doublemasked cross-over study on normo-tensive eyes. Acta Ophthalmol 1990; 68: 341–3Google Scholar
  64. 64.
    Nakajima M, Goh Y, Azuma I, et al. Effects of prostaglandin D2 and its analogue, BW245C, on intraocular pressure in humans. Graefes Arch Clin Exp Ophthalmol 1991; 229: 411–3PubMedCrossRefGoogle Scholar
  65. 65.
    Sakurai M, Araie M, Oshika T, et al. Effects of topical application of UF-021, a novel prostaglandin derivative, on aqueous humor dynamics in normal human eyes. Jpn J Ophthalmol 1991; 35(2): 156–65PubMedGoogle Scholar
  66. 66.
    Hedner J, Lunde H, Svedmyr N, et al. Respiratory and cardiovascular effects of PhXA41 [abstract no. MT-05]. Proceedings of the 4th Congress of the European Glaucoma Society; 1992 May 20-24; Amsterdam, Holland, 169Google Scholar
  67. 67.
    Bengtsson B. The prevalence of glaucoma. Br J Ophthalmol 1981; 65: 46–9PubMedCrossRefGoogle Scholar
  68. 68.
    Bengtsson B. The incidence of manifest glaucoma. Br J Ophthalmol 1989; 73: 483–7PubMedCrossRefGoogle Scholar
  69. 69.
    Klein BEK, Klein R, Sponsel WE, et al. Prevalence of glaucoma: the Beaver Dam Eye Study. Ophthalmology 1992 Oct; 99(10): 1499–504PubMedGoogle Scholar
  70. 70.
    Tuck M, Crick R. Testing and referral for chronic glaucoma. Health Trend 1989; 21: 131–4Google Scholar
  71. 71.
    Coyle D, Drummond M. The economic burden of glaucoma in the UK. The need for a far-sighted policy. PharmacoEconom-ics 1995; 7(6): 484–9CrossRefGoogle Scholar
  72. 72.
    Rosenberg LF. Glaucoma: early detection and therapy for prevention of vision loss. Am Fam Physician 1995 Dec; 52(8): 2289–98PubMedGoogle Scholar
  73. 73.
    Fujisawa launches unoprostone eye drops in Japan. Scrip Mag 1994 Oct 18 (1967): 27Google Scholar
  74. 74.
    Higginbotham EJ. Dorzolamide: a brief overview. Chibret Int J Ophthalmol 1994; 10(3): 50–3Google Scholar
  75. 75.
    Lichter PR. Another blockbuster glaucoma drug? [editorial]. Ophthalmology 1993 Sep; 100: 1281–2PubMedGoogle Scholar
  76. 76.
    Van Buskirk EM, Cioffi GA. Predicted outcomes from hypo-tensive therapy for glaucomatous optic neuropathy [commentary]. Am J Ophthalmol 1993 Nov; 116: 636–40PubMedGoogle Scholar
  77. 77.
    Nagasubramanian S. Latanoprost: a promising new glaucoma drug [commentary]. Br J Ophthalmol 1995 Jan; 79: 3–4PubMedCrossRefGoogle Scholar
  78. 78.
    Alm A. The potential of prostaglandin derivates in glaucoma therapy. Curr Opin Ophthalmol 1993 Apr; 4: 44–50Google Scholar
  79. 79.
    Bito LZ, Stjernschantz J, Resul B, et al. The ocular effects of prostaglandins and the therapeutic potential of a new PGF2α analog, PhXA41 (latanoprost), for glaucoma management. J Lipid Mediat 1993 Mar-Apr; 6: 535–43PubMedGoogle Scholar
  80. 80.
    Alm A, Villumsen J. Effects of topically applied PGF2α and its isopropylester on normal and glaucomatous human eyes. Prog Clin Biol Res 1989; 312: 447–58PubMedGoogle Scholar
  81. 81.
    Stjernschantz J. Prostaglandins as ocular hypotensive agents; development of an analogue for glaucoma treatment. In: Samuelsson B et al., editors. Advances in prostaglandin, thromboxane, and leukotriene research, v. 23. New York: Raven Press Ltd, 1995: 63–8Google Scholar
  82. 82.
    Fraunfelder FT, Meyer SM. Sexual dysfunction secondary to topical ophthalmic timolol [letter]. JAMA 1985 Jun; 253(21): 3092–3PubMedCrossRefGoogle Scholar
  83. 83.
    Epstein RJ, Allen RC, Lunde MW. Organic impotence associated with carbonic anhydrase inhibitor therapy for glaucoma. Ann Ophthalmol 1987 Feb; 19(2): 48–50PubMedGoogle Scholar

Copyright information

© Adis International Limited 1996

Authors and Affiliations

  • Sanjay S. Patel
    • 1
  • Caroline M. Spencer
    • 1
  1. 1.Adis International LimitedMairangi Bay, Auckland 10New Zealand

Personalised recommendations