Latanoprostene Bunod (Vyzulta) is a prescription eye drop used to lower intraocular pressure (IOP) in adults with open-angle glaucoma or ocular hypertension. It works by increasing the drainage of fluid from the eye through two different pathways. While effective, patients should be aware of the potential side effects, which can vary in severity and longevity.
Common Ocular Side Effects
Clinical trials have identified several common ocular side effects experienced by patients using Latanoprostene Bunod. Many of these are mild and may lessen over time as the eyes adjust to the medication.
- Conjunctival Hyperemia (Eye Redness): This is the most frequently reported side effect and occurs due to the dilation of blood vessels in the eye. It is often most noticeable at the beginning of treatment and may decrease with continued use. Administering the drops at bedtime can help mitigate the visibility of this side effect.
- Eye Irritation and Pain: A feeling of stinging, burning, or discomfort upon instillation of the drops is common. Some patients may also report a sensation of a foreign body in the eye.
- Blurred Vision: Some users experience temporary blurring of vision after applying the drops. Patients should be cautious when driving or operating machinery until their vision clears.
- Eyelid Changes: Darkening of the skin around the eyes (periorbital tissue) can occur and is typically reversible upon stopping treatment. Some patients may also experience puffiness of the eyelids.
Potential Pigmentation and Eyelash Changes
One of the most notable side effects of prostaglandin analogs like Latanoprostene Bunod involves changes to pigmented tissues.
- Iris Pigmentation: The medication can cause a gradual increase in the brown pigmentation of the iris, the colored part of the eye. This change is most common in individuals with mixed-color irises, such as blue-brown, yellow-brown, or green-brown. This effect typically occurs slowly over several months to years and is often permanent, even if the medication is discontinued. If only one eye is being treated, this can result in a cosmetic difference between the two eyes.
- Eyelash Changes: Latanoprostene Bunod can cause changes to eyelashes in the treated eye. These changes can include increased length, thickness, and number of lashes, as well as darkening of their color. Unlike iris pigmentation, eyelash changes are usually reversible after treatment is stopped.
Less Common but Serious Side Effects
While less frequent, certain side effects of Latanoprostene Bunod can be serious and require immediate medical attention.
- Macular Edema: Swelling of the macula, the central part of the retina, has been reported with prostaglandin analogs. This is more likely in patients with specific risk factors, such as those with a torn posterior lens capsule or a missing lens (aphakia). Symptoms include blurred or distorted vision.
- Intraocular Inflammation (Iritis/Uveitis): Latanoprostene Bunod should be used with caution in patients with a history of intraocular inflammation and is generally not recommended for those with active inflammation, as it may exacerbate the condition.
- Allergic Reactions: Signs of a severe allergic reaction can include hives, rash, itching, and swelling of the face, lips, tongue, or throat. Difficulty breathing or wheezing may also occur.
- Bacterial Keratitis: Contamination of the eye drop bottle can lead to bacterial keratitis, a serious eye infection. Patients should be careful not to touch the tip of the dropper to the eye or any other surface.
Important Warnings and Precautions
Proper usage and monitoring are crucial when taking Latanoprostene Bunod.
- Contact Lenses: The medication contains benzalkonium chloride, a preservative that can be absorbed by soft contact lenses. Patients must remove their contact lenses before application and wait at least 15 minutes before reinserting them.
- Contamination: Improper handling of the dropper can lead to contamination and potential eye infections. Always wash hands before use and avoid touching the dropper tip.
- Medical Conditions: Inform your doctor if you have a history of eye inflammation, eye injury, or if you are at risk for macular edema.
Comparing Common and Serious Side Effects
| Side Effect Type | Common Side Effects | Less Common / Serious Side Effects |
|---|---|---|
| Appearance | Eye redness, darkened eyelid skin, longer/thicker eyelashes | Permanent iris color change, bacterial keratitis |
| Sensation | Eye irritation, stinging, foreign body sensation, mild pain | Severe eye pain, itching, or swelling |
| Vision | Temporary blurred vision | Sudden vision changes, loss of vision, macular edema |
| Onset | Often starts early in treatment | Can occur over months to years (pigmentation) or suddenly (allergic reaction) |
| Duration | May subside with time (irritation, redness) | Permanent (iris pigmentation) or requires immediate medical intervention (allergic reaction, infection) |
When to Seek Medical Advice
It is important to maintain regular check-ups with your eye doctor to monitor your progress and check for unwanted effects. You should contact your doctor immediately if you experience a severe or persistent reaction, sudden changes in vision, new eye conditions, or signs of an infection. For symptoms of a serious allergic reaction, such as difficulty breathing, seek emergency medical care.
Conclusion
Latanoprostene Bunod ophthalmic solution is a vital tool in managing glaucoma and ocular hypertension by effectively lowering intraocular pressure. However, like all medications, it comes with a range of potential side effects, from common, manageable irritations to rare but serious complications. Being well-informed about these potential reactions, especially the possibility of permanent iris pigmentation and temporary eyelash changes, is crucial for anyone beginning treatment. Regular follow-ups with your eye care provider are essential for monitoring your eye health and managing any adverse effects that may arise.
