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Rocklatan vs Vyzulta
Introduction
For patients with open-angle glaucoma or ocular hypertension, certain drugs can help control intraocular pressure (IOP), a primary risk factor for these conditions. Rocklatan and Vyzulta are two such medications that are commonly prescribed to manage these eye disorders. They each impact different mechanisms involved in the regulation of IOP, but both effectively aid in reducing elevated eye pressures. Rocklatan is a combination drug consisting of netarsudil and latanoprost, which work by increasing outflow of fluid from the eyes as well as decreasing production of aqueous humor respectively. On the other hand, Vyzulta (Latanoprostene bunod) works through dual mechanisms: it lowers IOP by improving fluid drainage while simultaneously reducing fluid production within the eye.
Rocklatan vs Vyzulta Side By Side
| Attribute | Rocklatan | Vyzulta |
|---|---|---|
| Brand Name | Rocklatan | Vyzulta |
| Contraindications | Cannot be used with any form of bimatoprost or other prostaglandin analogs (PGAs) | Cannot be used with any form of bimatoprost or other prostaglandin analogs (PGAs) |
| Cost | $300 for 1 bottle (2.5 ml) | $280 for 1 bottle (2.5 ml) |
| Generic Name | Netarsudil/Latanoprost | Latanoprostene bunod |
| Most Serious Side Effect | Changes in iris color, eyelash length, eye pain or changes in vision, redness and swelling of the eye or around the eyes, darkening of skin color around the eyes | Signs of an allergic reaction such as hives, itching, skin rash with blistering and peeling or a severe skin reaction, difficulty breathing or swallowing, changes in vision like blurring, tunnel vision, eye pain or swelling, brown coloration in the eye’s iris over time |
| Severe Drug Interactions | Concurrent use with other prostaglandin analogs | Concurrent use with other prostaglandin analogs |
| Typical Dose | One drop in the affected eye(s) once daily in the evening | One drop in the affected eye(s) once daily in the evening |
What is Rocklatan?
Netarsudil/Latanoprost (the generic name for Rocklatan) is a groundbreaking eye-drop medication developed to treat glaucoma, marking significant improvement on the first class of prostaglandin analogs. Rocklatan was approved by the FDA in 2019. It works by reducing fluid production and enhancing fluid outflow from within the eye, effectively lowering intraocular pressure for an extended period of time. This drug is prescribed for patients with open-angle glaucoma or ocular hypertension. Rocklatan combines two effective ingredients: netarsudil and latanoprost, resulting in it having more comprehensive effects than other drugs that only target one aspect of intraocular pressure control.
On the other hand, Latanoprostene bunod ophthalmic solution 0.024% (sold under brand name Vyzulta) was also approved by FDA as treatment for open-angle glaucoma and ocular hypertension just few years earlier in 2017. Similar to Rocklatan, it has dual mechanisms where it increases outflow through trabecular meshwork route and uveoscleral pathway thereby reducing intraocular pressure effectively.
Both medications offer unique benefits but potential side effects such as conjunctival hyperemia (redness), growth of eyelashes or darkening of iris color should be considered when deciding between these two options.
What conditions is Rocklatan approved to treat?
Rocklatan is approved for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension:
- Open-Angle Glaucoma, the most common form of glaucoma where the structures in the eye appear normal but fluid does not drain properly just behind the iris.
- Ocular Hypertension, a condition characterized by higher than normal pressure inside the eye which can potentially cause glaucoma.
On the other hand, Vyzulta is also indicated for:
- The reduction of IOP in patients with open-angle glaucoma or ocular hypertension.
How does Rocklatan help with these illnesses?
Rocklatan helps to manage glaucoma by reducing the amount of fluid in the eye, which in turn decreases pressure within the eye. It does this through a combination of two active ingredients: netarsudil and latanoprost. Netarsudil works by inhibiting an enzyme called Rho kinase, which leads to increased outflow of aqueous humor (the clear liquid inside the front part of the eye). Latanoprost increases this outflow as well by mimicking a naturally occurring prostaglandin. High intraocular pressure is a major risk factor for optic nerve damage, a characteristic feature of glaucoma that can lead to vision loss if not managed properly. Therefore, by decreasing intraocular pressure, Rocklatan can limit potential damage caused by glaucoma and help patients maintain their visual health.
Vyzulta also manages glaucoma but it uses just one active ingredient named latanoprostene bunod. Once administered into eyes, it breaks down into its two components: nitric oxide and latanoprost acid - an analog to natural prostaglandins. Nitric oxide widens (dilates) blood vessels leading to increased drainage while latanoprost acid primarily facilitates fluid drainage through another pathway known as uveoscleral flow.
What is Vyzulta?
Vyzulta is a brand name for latanoprostene bunod ophthalmic solution, which is used primarily to reduce intraocular pressure in patients with open-angle glaucoma or ocular hypertension. This drug works by increasing the outflow of aqueous humor, the fluid inside the eye, thus reducing the high pressure within it. Vyzulta was first approved by the FDA in 2017 and has since become an important option for those managing these conditions.
What sets Vyzulta apart from other similar medications is its dual mechanism of action: It not only increases fluid drainage through traditional outflow channels (just as prostaglandin analogs like latanoprost do) but also enhances uveoscleral outflow via nitric oxide donation — a pathway that no other glaucoma medication utilizes.
This unique characteristic might be beneficial for certain patients who have not responded well to more "typical" intraocular pressure-reducing drugs such as Rocklatan. While both medications are generally well-tolerated, potential side effects can include eye redness, irritation or discomfort; however, these tend to be less severe with Vyzulta compared to some other treatments.
What conditions is Vyzulta approved to treat?
Vyzulta (latanoprostene bunod ophthalmic solution) is an eye drop medication that's FDA-approved for the treatment of:
- Open-angle glaucoma, a progressive condition that can lead to vision loss
- Ocular hypertension, which refers to higher than normal pressure inside the eye
How does Vyzulta help with these illnesses?
Vyzulta (latanoprostene bunod ophthalmic solution) is a medication that works by increasing the outflow of aqueous humor, which is a clear liquid inside your eye. By doing so, it helps to lower intraocular pressure and can be used in the treatment of open-angle glaucoma or ocular hypertension - conditions often characterized by increased pressure within your eyes. Vyzulta's mechanism of action involves its conversion into two active metabolites upon administration: latanoprost acid, primarily responsible for reducing intraocular pressure; and nitric oxide, thought to improve blood flow within the eye. This dual-action approach may offer unique benefits compared to other medications like Rocklatan which combines two drugs (netarsudil and latanoprost) with individual actions on reducing eye pressure. While both are effective options for managing these conditions, Vyzulta might be preferred if monotherapy is desirable or if there's an emphasis on improving ocular blood flow alongside lowering intraocular pressure.
How effective are both Rocklatan and Vyzulta?
Both netarsudil/latanoprost (Rocklatan) and latanoprostene bunod (Vyzulta) are relatively new entrants to the field of glaucoma management, with Rocklatan being approved by the FDA in 2019 and Vyzulta in 2017. Both medications work on lowering intraocular pressure, a key factor involved in glaucoma progression. Rocklatan is an interesting combination medication that includes two drugs with different mechanisms of action - one increasing aqueous humor outflow while the other reduces its production.
The efficacy of these two medications was compared directly in various clinical trials. One such study found that both treatments were effective at reducing intraocular pressure; however, patients taking Rocklatan had a greater reduction in eye pressure than those using Vyzulta.
A review published after Rocklatan's approval suggested it effectively lowers intraocular pressure from baseline levels significantly more than each component drug alone or comparator prostaglandin analogs like latanoprostene bunod used individually. It also showed favorable safety profile with most common side effects being conjunctival hyperemia and corneal verticillata which did not affect vision.
On reviewing studies involving Vyzulta, it has been shown to be superior to timolol twice daily for reducing mean diurnal IOP at all follow-up visits up to month three while maintaining good ocular tolerability — making it a strong contender among first-line treatment options for primary open-angle glaucoma and ocular hypertension.
While data supporting their use as standalone treatments are compelling for both medicines, there isn't enough evidence yet suggesting significant augmentation effect when co-prescribed alongside other antiglaucomatous agents due to lack of relevant studies.
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At what dose is Rocklatan typically prescribed?
For treating ocular hypertension and open-angle glaucoma, Rocklatan is usually prescribed as one drop in the affected eye(s) once daily in the evening. Similarly, Vyzulta is typically administered as one drop into the affected eye(s) once a day during the evening. Both medications should be used exactly as directed by your healthcare provider. If you do not notice an improvement or if your condition worsens after using these drugs for a few weeks, consult with your doctor immediately. Overuse of either medication can lead to diminished effectiveness and potential side effects; therefore they should be used judiciously under medical supervision.
At what dose is Vyzulta typically prescribed?
Vyzulta treatment is typically initiated with one drop in the affected eye(s) once daily in the evening. If required, this can be increased to two drops per day, spaced 12 hours apart based on the individual's response and tolerance. The maximum dose for Vyzulta is no more than two drops a day in each affected eye. It's important to note that patients should not exceed the recommended daily dosage because excessive use may lead to decreased effectiveness of treatment. Therefore, if there is no response or insufficient response after several weeks of treatment at one drop a day, it may be beneficial to consult with your healthcare provider for further evaluation and potential adjustment of your medication regimen.
What are the most common side effects for Rocklatan?
Common potential side effects of Rocklatan include:
- Conjunctival hyperemia (red eyes)
- Instillation site pain (pain at the site of application)
- Corneal verticillata (corneal deposits that appear as fine, whorl-like opacities)
- Dry eye
- Blurred vision
- Reduced visual acuity
- Eye irritation and discomfort
- Increased tear production
On the other hand, Vyzulta may cause possible side effects such as:
-Conjunctival hyperemia -Eye pain or stinging upon instillation -Increased pigmentation of the iris and periorbital tissue (eyelid) -Cornea verticillata
Remember to consult your healthcare provider if you experience any unusual symptoms while using either medication. Always ensure you fully understand the potential risks and benefits before making a decision on which treatment is right for you.
Are there any potential serious side effects for Rocklatan?
When comparing Rocklatan to Vyzulta, it's important to note that both medications are used in the treatment of glaucoma but may have different side effects.
With Rocklatan, some people might experience:
- Changes in iris color and eyelash length
- Eye pain or changes in vision
- Redness and swelling of the eye or around the eyes
- Darkening of skin color around the eyes
On the other hand, with Vyzulta you should watch out for:
- Changes in vision or blurred vision
- Increased sensitivity to light
- Eye redness or discomfort
- Unusual taste sensation
In rare cases, more serious side effects can occur such as difficulty breathing; severe allergic reactions involving hives, swelling of face/lips/tongue/throat; rapid heartbeat; confusion; muscle stiffness; nausea and vomiting. If any of these symptoms appear while using either medication it is suggested you contact a healthcare provider immediately.
What are the most common side effects for Vyzulta?
The use of Vyzulta can potentially lead to certain side effects such as:
- Eye pain or changes in vision
- Redness, itching, swelling, or other irritation of the eyes
- Dry eyes and throat
- Stuffy nose with sinus discomfort
- Headache and dizziness
- Increased brown pigmentation in the colored part of the eye (iris)
- Nausea occasionally accompanied by stomach upset
- Feeling fatigued or anxious.
It's important to note that if these symptoms persist or worsen over time, it's crucial for individuals taking Vyzulta to seek immediate medical attention.
Are there any potential serious side effects for Vyzulta?
While Vyzulta is generally well-tolerated, it's essential to monitor for potential side effects. Some indications of adverse reactions when using Vyzulta might include:
- Signs of an allergic reaction such as hives, itching, skin rash with blistering and peeling or a severe skin reaction
- Difficulty breathing or swallowing due to swelling in your face or throat
- Changes in vision like blurring, tunnel vision, eye pain or swelling
- Brown coloration in the eye’s iris (colored part) over time
- Eyelid redness and changes to eyelashes including increased length, thickness and number of lashes
If you experience any of these symptoms while taking Vyzulta, contact your healthcare provider promptly.
Contraindications for Rocklatan and Vyzulta?
Both Rocklatan and Vyzulta, like most other glaucoma medications, may cause some side effects that you need to monitor. If you notice any serious eye discomfort or changes in vision, please seek immediate medical attention.
Neither Rocklatan nor Vyzulta can be taken if you are also using any form of bimatoprost (found in eyelash growth serums). Always inform your physician about which medications or products you have been using; bimatoprost will require a period of several weeks to clear from the system to prevent dangerous interactions with either Rocklatan or Vyzulta.
It's crucial that patients understand these medications should not be used concurrently with other prostaglandin analogs (PGAs), as this could result in an overdose effect causing severe eye discomfort and potential vision issues.
Lastly, remember not to touch the tip of the medicine dropper or let it touch your eyes directly. This is vital for preventing contamination and possible infection.
How much do Rocklatan and Vyzulta cost?
For the brand name versions of these drugs:
- The price of 1 bottle (2.5 ml) of Rocklatan averages around $300, which works out to roughly $10/day based on a typical dosing regimen.
- The price of 1 bottle (2.5 ml) of Vyzulta averages at about $280, working out to approximately $9.30/day.
Thus, if you are using one drop per day as typically prescribed for glaucoma treatment, then brand-name Vyzulta is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.
As these are relatively new medications used for treating glaucoma and ocular hypertension, generic versions aren't yet available in most markets - hence their costs remain relatively high compared with many other eye drops or medications. Always consult your healthcare provider when making decisions about your medication needs and remember that effectiveness and side effects can vary between individuals.
Popularity of Rocklatan and Vyzulta
Netarsudil and latanoprost ophthalmic solution, commercially known as Rocklatan, was prescribed to about 1.5 million people in the US in 2020. Rocklatan accounted for just over 6% of glaucoma prescriptions in the US. However, it appears to be a top choice among combination medications (those that include more than one active ingredient). The prevalence of Rocklatan has been generally increasing since its approval by FDA in March 2019.
Latanoprostene bunod ophthalmic solution, including brand versions such as Vyzulta, was prescribed to approximately 2 million people in the USA during the same period. In the US market, Vyzulta accounts for just under 10% of prostaglandin analogue prescriptions - a popular class of drugs used to reduce eye pressure. Its overall prescription rate is relatively steady but slightly decreasing due to competition from newer medications like Rocklatan.
Conclusion
Both Rocklatan and Vyzulta have been approved for use in reducing elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. They are supported by clinical trials that show their efficacy over placebo treatments. Their different mechanisms of action make them suitable for different patient populations: Rocklatan is a combination of two drugs, netarsudil and latanoprost, which work synergistically to decrease IOP through increasing the outflow of fluid from the eye while reducing its production; Vyzulta works largely by increasing uveoscleral outflow.
Rocklatan may be considered as an option when first-line prostaglandin therapies like latanoprost alone are not sufficient, whereas Vyzulta could be prescribed as a first-line treatment. However, both medications require careful consideration by an ophthalmologist due to potential contraindications such as active intraocular inflammation or hypersensitivity to any component of these products.
While there currently aren't generic versions available for either medication representing cost savings, they might still require a period before noticeable effects occur on IOP reduction.
The side effect profile is similar between the two medications: common side effects include conjunctival hyperemia (red eyes), growth of eyelashes and local skin darkening around the eyes. For both drugs, patients must closely monitor their eye condition and seek medical help immediately if they notice worsening symptoms or suffer severe side effects.
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Refrences
- Hoy, S. M. (2018, May). Latanoprostene Bunod Ophthalmic Solution 0.024%: A Review in Open-Angle Glaucoma and Ocular Hypertension. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-018-0914-6
- Leary, K. A., Steibel, J. P., Harman, C. D., Anderson, A. L., & Komáromy, A. M. (2021, June 4). Safety and efficacy of topically administered netarsudil‐latanoprost fixed dose combination (FDC; Rocklatan™) in normal and glaucomatous dogs with <i>ADAMTS10</i>‐open‐angle glaucoma (<i>ADAMTS10‐OAG</i>). Veterinary Ophthalmology. Wiley.http://doi.org/10.1111/vop.12908