The FDA has approved two new ophthalmic drugs for reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: latanoprostene bunod (Vyzulta – Bausch and Lomb), a modified prostaglandin analog, and netarsudil (Rhopressa – Aerie), the first Rho kinase inhibitor to be approved in the US.

STANDARD TREATMENT — A prostaglandin analog such as latanoprost (Xalatan, and generics) is generally the drug of choice for initial treatment of glaucoma. Dosed once daily in the evening, prostaglandin analogs typically lower IOP by 25-30% throughout the night and following day. They are generally well tolerated and have few, if any, systemic effects.

Topical beta blockers such as timolol (Timoptic, and others) are also commonly used; they lower IOP by 20-25% with once- or twice-daily dosing, but their use as ... more      

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