Latanoprost can gradually change the color of the eyes by increasing the content of brown pigment in the iris. Before starting treatment, patients should be informed of the possible irreversible change in eye color. The use of a drug on one eye can cause irreversible heterochromy.
This change in eye color was predominantly noted in patients with unevenly colored irises, namely: quads-blue, gray-brown, yellow-brown and green-brown. In studies of latanoprost, darkening usually began within the first 8 months of treatment, rarely - during the second or third year and was not observed after four years of treatment. The progression of iris pigmentation decreased with time and stabilized after 5 years. Data on the increase in pigmentation for 5 years are absent.In an open 5-year study of latanoprost safety, pigmentation of the iris developed in 33% of the patients (see the "Side effect" section). In most cases, the change in the color of the iris was insignificant and, often, was not clinically detected. Frequency of occurrence ranged from 7% to 85% in patients with unequal iris, predominating in patients with yellow-brown irises. Changes in patients with uniformly colored irises of blue color were not observed, in rare cases, changes were noted with uniformly colored irises of gray, green and brown color.
The change in eye color is due to an increase in melanin content in the stromal melanocytes of the iris, rather than an increase in the number of melanocytes themselves. In typical cases, brown pigmentation appears around the pupil and concentrates on the periphery of the iris. In this case, the entire iris or its parts acquire a brown color. After the treatment was canceled, no further pigmentation was noted. According to the available clinical data, the color change was not associated with any symptoms or pathological disorders.
The drug does not affect the nevi and lentigo iris.According to the results of 5-year clinical trials, pigment accumulation in the sclerogoric trabecular network or other parts of the anterior chamber of the eye was not noted.
It is shown that iris darkening does not lead to undesirable clinical consequences, therefore, the use of latanoprost in case of such darkening can be continued. Nevertheless, such patients should be under regular supervision and, depending on the clinical situation, treatment may be discontinued.
The experience of Lanotan in the treatment of closed-angle and congenital glaucoma, pigmentary glaucoma, open-angle glaucoma in patients with pseudo-pharmacies is limited.
There is no information on the use of latanoprost in the treatment of secondary glaucoma due to inflammatory eye diseases and neovascular glaucoma.
Latanoprost does not affect the size of the pupil. In connection with the lack of experience with the use of latanoprost in the treatment of an acute attack of closed-angle glaucoma, caution should be used in such patients.
Due to the fact that information about the use of latanoprost in the postoperative period of cataract extraction is limited, care should be taken when using the drug in this category of patients.
Care should be taken when using latanoprost in patients with herpetic keratitis in history. For acute herpetic keratitis, as well as if there is anamnestic information about chronic recurrent herpetic keratitis, it is necessary to avoid the appointment of latanoprost.
Macular edema, including cystic, observed during therapy latanoprost mainly in patients with aphakia, psevdoafakiey, rupture of posterior lens capsule, or in patients with risk factors for cystic macular edema (and particularly in diabetic retinopathy and retinal vein occlusion). Caution must be exercised when applying latanoprost patient with aphakia, psevdoafakiey with rupture of the posterior capsule or anterior chamber intraocular lenses, as well as patients with known risk factors cystic macular edema.
Caution should be exercised when using latanoprost in patients with risk factors for developing iritium / uveitis.
The experience of using latanoprost in patients with bronchial asthma is limited, but in a number of cases, the exacerbation of asthma and / or the appearance of dyspnea have been observed in the post-marketing period.Caution should be exercised when using latanoprost in this category of patients (see also the "Side effect" section).
There were cases of darkening of the skin of the periorbital region, which in a number of patients were reversible in the continuation of latanoprost therapy.
Latanoprost can cause gradual changes in eyelashes and fleece hair, such as lengthening, thickening, increased pigmentation, increased density and a change in the direction of growth of eyelashes. The changes in the eyelashes were reversible and passed after the cessation of therapy.
Lanotan contains benzalkonium chloride, often used as a preservative in ophthalmic drugs. Benzalkonium chloride can cause eye irritation, spot keratopathy and / or toxic ulcer keratopathy, and also be adsorbed by soft contact lenses and discolor them.
It requires careful monitoring of the condition of patients with dry eye syndrome or other corneal diseases with long-term use of latanoprost.
Before using Lanolot, it is necessary to remove contact lenses and re-install them no earlier than 15 minutes after instillation.See also "Method of administration and dose".
Children
Information on the efficacy and safety of latanoprost in children under the age of one year is limited.
There is no experience of using the drug in premature infants (gestational age is less than 36 weeks).
Information about the safety of long-term use of latanoprost in children is absent.
In primary congenital glaucoma in children from 0 to 3 years of age, surgical intervention (goniotomy / trabeculotomy) remains the standard method of treatment.