Latanoprostene bunod, known by its brand name Vyzulta, is a prescription eye drop medication. It is formulated to address high pressure inside the eye, a condition often associated with open-angle glaucoma or ocular hypertension. This medication reduces elevated intraocular pressure (IOP), a primary risk factor for vision loss. Vyzulta offers a targeted approach to lowering eye pressure.
How Latanoprostene Bunod Works
Latanoprostene bunod functions through a dual mechanism to lower intraocular pressure. Upon administration, the medication is rapidly broken down by enzymes within the cornea into two active components: latanoprost acid and butanediol mononitrate. These components work independently to improve the eye’s fluid drainage.
The first active component, latanoprost acid, is a prostaglandin F2-alpha analog. It increases the outflow of aqueous humor through the uveoscleral pathway, a secondary drainage route for the eye’s fluid. Latanoprost acid achieves this by promoting the remodeling of the extracellular matrix in the ciliary muscle, facilitating fluid movement.
The second active component, butanediol mononitrate, releases nitric oxide (NO) within the eye. In the eye, it acts on cells within the trabecular meshwork, the eye’s primary drainage system. By relaxing these cells, nitric oxide allows aqueous humor to flow out more easily.
The synergy between these two components distinguishes latanoprostene bunod. By simultaneously targeting both the uveoscleral (secondary) and trabecular meshwork (primary) outflow pathways, the medication achieves a more pronounced reduction in eye pressure. This comprehensive approach to fluid drainage manages elevated intraocular pressure.
Proper Use and Administration
The typical dosage of latanoprostene bunod is one drop into the conjunctival sac of the affected eye or eyes once daily. Evening administration is recommended, as it contributes to a more effective reduction of nocturnal intraocular pressure.
When applying the eye drops, wash your hands thoroughly. Tilt your head back and gently pull down your lower eyelid to create a small pocket. Carefully squeeze the bottle to release a single drop into this pocket, ensuring the tip does not touch your eye, eyelid, or any other surface to prevent contamination.
After instilling the drop, gently close your eye for one to two minutes without blinking, and apply light pressure to the inner corner of your eye near the nose. This helps the medication absorb into the eye and prevents it from draining too quickly. If you wear contact lenses, remove them before applying the drops and wait at least 15 minutes before reinserting them. If you are using other topical ophthalmic medications, wait at least five minutes between applications to ensure each medication is properly absorbed.
Do not administer latanoprostene bunod more than once a day, as more frequent use of prostaglandin analogs can lessen their pressure-lowering effect. If a dose is missed, skip that dose and resume the regular once-daily evening schedule the following evening. Do not double up on doses. Unopened bottles should be stored in a refrigerator, but once opened, they can be kept at room temperature for up to six weeks.
Managing Side Effects
Latanoprostene bunod can cause side effects, most of which are localized to the eye. The most commonly observed side effect is conjunctival hyperemia, which presents as eye redness. Patients may also experience a temporary stinging, burning, or discomfort immediately after instilling the drops, along with a sensation of having something in the eye.
Prostaglandin analog medications, including latanoprostene bunod, can cause changes in eye appearance. A gradual and potentially permanent darkening of the iris color can occur, particularly in individuals with mixed-color irises. This change is due to increased melanin content in the melanocytes of the iris. Patients may also observe increased length, thickness, and darkness of their eyelashes, which is usually reversible upon discontinuing the medication. Darkening of the eyelid skin can also occur, and this change is reversible.
While less common, some side effects warrant prompt medical attention. These include blurred vision, eye inflammation, or macular edema, especially in individuals with a history of these conditions. Sudden changes in vision, severe eye pain, or signs of an eye infection, such as discharge or crusting, should also be reported to a healthcare provider immediately. Though rare, severe allergic reactions involving symptoms like rash, hives, or swelling of the face, lips, or throat require emergency medical assistance.