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 the study 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. Progression of the iris pigmentation decreased with time and stabilized after 5 years. 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, prevailing 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 composition of the drug Latanoprost-Teva is 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 absorbed by soft contact lenses and discolored. 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 the drug, it is necessary to remove contact lenses and re-install them not earlier than 15 minutes after instillation (see also section "Dosing and Administration").
There were cases of discoloration of the skin of the periorbital region, which in some patients were reversible in the continuation of latanoprost therapy.
In connection with the use of latanoprost, cases of reversible darkening of the skin of the eyelids are described. 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 the eyelashes. The eyelash changes are reversible and pass after the cessation of treatment. The use of eye drops can cause a transient blurred vision.
The experience of using the drug Latanoprost-Teva in chronic closed-angle glaucoma,open-angle glaucoma in patients with pseudophakia, aphakia, inflammatory, neovascular glaucoma, as well as in patients with cataracts undergoing surgical treatment, is limited, so use the drug Latanoprost-Teva in these patient groups with caution.
There have been reports of cases of development of macular edema in patients with aphakia, pseudoafacies, with a rupture of the posterior capsule of the lens, as well as with known risk factors for macular edema, therefore, Latanoprost-Teva should be used with caution in these patient groups.
In patients with risk factors for the development of iritis, uveitis, as well as with a history of herpetic keratitis, bronchial asthma, Latanoprost-Teva should be used with caution.
Children
Data on efficacy and safety in children in the age group <1 year are limited. Data of latanoprost in preterm infants (less than 36 weeks of gestational age) are not available. Information about the safety of long-term use of latanoprost in children is absent.
In children aged 0 to 3 years with primary congenital glaucoma, surgical treatment (eg trabeculotomy / goniotomy) is still the method of choice.