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Netarsudil

Generic name: netarsudil ophthalmic

Brand names: Rhopressa

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic:

Rhopressa: 0.02% (2.5 mL) [contains benzalkonium chloride]

Pharmacology

Mechanism of Action

Although the exact mechanism of action of netarsudil, a rho kinase inhibitor, is unknown, it may reduce IOP by increasing the outflow of aqueous humor through the trabecular meshwork route.

Pharmacokinetics/Pharmacodynamics

Metabolism

Metabolized by esterases in the eye to active metabolite AR-13503.

Use: Labeled Indications

Elevated intraocular pressure (IOP): Reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension

Contraindications

There are no contraindications listed in the manufacturer's labeling

Dosage and Administration

Dosing: Adult

Elevated intraocular pressure: Ophthalmic: Instill 1 drop into affected eye(s) once daily in the evening (maximum: 1 drop into affected eye(s) once daily).

Dosing: Geriatric

Refer to adult dosing.

Administration

Ophthalmic: For ophthalmic use only. May be used with other eye drops to lower intraocular pressure. If using more than 1 ophthalmic product, wait at least 5 minutes in between application of each medication. Remove contact lenses prior to administration and wait at least 15 minutes (after administration) before reinserting. Avoid touching the dropper tip with fingers, eyes, eyelids, or surrounding areas to minimize contamination of the dropper tip.

Storage

Store at 2°C to 8°C (36°F to 46°F) until opened. After opening, may store refrigerated at 2°C to 8°C (36°F to 46°F) until the manufacturer's expiration date or at ≤25°C (≤77°F) for ≤6 weeks. During shipment, may maintain at temperatures ≤40°C (≤104°F) for ≤14 days.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

>10%:

Local: Application site pain (20%)

Ophthalmic: Conjunctival hyperemia (53%), conjunctival hemorrhage (20%), corneal deposits (20%; verticillata)

1% to 10%:

Dermatologic: Erythema of eyelid (5% to 10%)

Local: Application site erythema (5% to 10%)

Ophthalmic: Blurred vision (5% to 10%), corneal staining (5% to 10%), decreased visual acuity (5% to 10%), increased lacrimation (5% to 10%)

Warnings/Precautions

Concerns related to adverse effects:

  • Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.

Special populations:

  • Contact lens wearers: Contains benzalkonium chloride, which may be absorbed by soft contact lenses. Remove contact lens prior to instillation; may reinsert 15 minutes following administration.

Monitoring Parameters

Intraocular pressure

Pregnancy

Pregnancy Considerations

Adverse events were not observed in animal reproduction studies following clinically relevant systemic exposure. Systemic absorption is minimal following ophthalmic application. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples 1988).

Patient Education

What is this drug used for?

  • It is used to treat glaucoma.
  • It is used to lower high eye pressure.

Frequently reported side effects of this drug

  • Blurred vision
  • Watery eyes

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

  • Vision changes
  • Eye pain
  • Severe eye irritation
  • Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Source: Wolters Kluwer Health. Last updated February 7, 2020.