ABSTRACT
Overall, adverse events reported with latanoprost therapy are mild and reversible upon treatment discontinuation. In comparative studies with timolol, the ocular tolerability profiles were comparable, with 90% or more of patients having no or a minimal detectable increase in conjunctival hyperemia.92,93 The incidence of ocular adverse events was similar in short-term trials comparing latanoprost with bimatoprost50 or unoprostone.56,59 Both bimatoprost and travoprost produced substantially higher rates of ocular adverse events (for example conjuctival hyperemia) compared to latanoprost.6,51 In the study by Parrish and colleagues,53 latanoprost exhibited greater ocular tolerability compared to bimatoprost, including significantly fewer reported ocular adverse events (p < 0.001), fewer reported cases of hyperemia (p 0.001), and lower average hyperemia scores after 12 weeks of treatment (p 0.001). Iridial darkening has been reported in 5% to 25% of those treated with latanoprost, particularly in those with hazel eyes, with no marked pathological changes observed in iris specimens.94,95
Systemic adverse events are infrequent with latanoprost therapy, an effect much different to that of timolol.92 Gandolfi51 found significantly more increased eyelash growth in those who received bimatoprost compared to latanoprost, although headache was reported more frequently in latanoprost-compared with bimatoprost-treated patients. Respiratory disorders, which may be aggravated by b-blocker therapy,96 are unlikely with selective prostaglandin F2a therapies such as latanoprost. Clinical studies of latanoprost found no significant effects on peak expiratory flow, forced expiratory volume in 1 second, forced ventilatory capacity, asthma symptoms, or asthma medication requirements.96,97 In clinical trials of latanoprost, upper respiratory tract infection/cold/flu was the most common systemic adverse event, occurring at a rate of approximately 4%. Other systemic events, each with an incidence of less than 2%, included chest pain/angina, muscle/joint/back pain and rash/allergic skin reaction.98
