This page shows what was measured, who it was measured in, and what that does not settle.
What Latanoprost does in the body
Used to lower pressure inside the eye and protect against glaucoma damage.
Fluid inside the eye normally leaves through a mesh drain near the edge of the iris. Latanoprost works on a second, slower route out through the muscle behind that drain. It switches on a receptor there, which makes the cells dismantle some of the connective tissue packing the spaces between the muscle bundles. The gaps widen, fluid leaves faster, and pressure falls.
What happened in people
In 516 people, latanoprost delayed worsening of blind spots over two years compared with a dummy drop.
✓ Reviewed first-read answer
Where this came from
A person wrote this and a reviewer approved it against this exact record. It carries no effect size.
A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.
No source is stored against this line.
The limit that matters most
Studies have not directly counted how many people avoid blindness.
Where it acts
Ciliary muscle and the uveoscleral outflow pathway at the front of the eye, reached through the cornea
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 6Z5B6HVF6O · read 2026-08-29
Its recorded molecular formula is C26H40O5.
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-30
Where each sentence above came from
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
The limit a reviewer approved as the one that matters most here.
The four opening statements run to 93 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Comparator
A comparator is whatever the treatment was measured against.
A picture of it, and where the picture fails
It is like the other runner in a race.
Where that stops being true. A race has one winner. A study can show both arms improved.
What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.
The control condition against which the experimental intervention is assessed.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Absolute difference
An absolute difference is how many more people in a hundred were affected.
A picture of it, and where the picture fails
It is like counting heads in two rooms of a hundred.
Where that stops being true. Heads are easy to count. Study results carry a margin of error too.
What people get wrong. It is confused with a percentage change, which can look far larger.
The arithmetic difference in event rates between arms.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Time to visual field deterioration within 24 months
✓ The study showed what it set out to show
Who was studied
UKGTS (ISRCTN96423140)
How many people
516
Study design
Randomised, triple-masked, placebo-controlled
Compared against
A dummy treatment
Kind of result
A number that stands in for health
What was found
Adjusted hazard ratio 0.44 (95% CI 0.28 to 0.69), P = 0.0003
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The trial was stopped early on the recommendation of its Data and Safety Monitoring Committee, and the primary outcome was changed at that point from a difference in proportions progressing to time to deterioration. Early stopping on an interim analysis tends to overstate effect size.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical ophthalmic solution 0.005%, instilled once daily
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Development of reproducible visual field abnormality or optic disc deterioration attributed to primary open-angle glaucoma
✓ The study showed what it set out to show
Who was studied
OHTS (NCT00000125)
How many people
1636
Study design
Randomised, controlled, class-level rather than drug-specific
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
4.4% against 9.5% cumulative probability at 60 months; hazard ratio 0.40 (95% CI 0.27 to 0.59), P < 0.0001
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The medication arm used any commercially available topical agent, not latanoprost specifically. This trial establishes that pressure lowering works as a class. It does not measure this molecule.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical ophthalmic solution 0.005%, instilled once daily
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Mean intraocular pressure over visits and time of day across travoprost, latanoprost and timolol
✓ The study showed what it set out to show
Who was studied
Travoprost 12-month comparative study (Netland 2001)
How many people
801
Study design
Randomised, active-controlled, four-arm
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Latanoprost 18.5 to 19.2 mmHg against travoprost 0.004% 17.7 to 19.1 and timolol 19.4 to 20.3; travoprost 0.8 mmHg lower than latanoprost at 4 PM pooled, P = 0.0191
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Sponsored by the manufacturer of the comparator that won. Iris pigmentation change occurred in 5.2% of latanoprost patients and 3.1% on travoprost 0.004%, so the safety difference runs the other way from the efficacy one.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical ophthalmic solution 0.005%, instilled once daily
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Latanoprost
What a person takes: Topical ophthalmic solution 0.005%, instilled once daily.
The measurement behind this step
A drop onto the ocular surface, from which a small fraction crosses the cornea while the rest drains through the nasolacrimal duct. The isopropyl ester exists to get the molecule through the cornea, where esterases release the active free acid. Bottles are refrigerated until first opened because the molecule oxidises and isomerises on storage.
Getting in
A drop lands on the eye and most of it is lost
A drop is far bigger than the eye can hold. Most of it runs down the tear duct within minutes. Only a small fraction ever crosses into the eye, and that is what the dose is built around.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Latanoprost is supplied as an isopropyl ester in an aqueous vehicle preserved with benzalkonium chloride in the original formulation. Tear turnover and nasolacrimal drainage remove the great majority of an instilled drop within minutes. The ester’s lipophilicity is what allows the surviving fraction to partition into the corneal epithelium.
The molecule that goes in is not the molecule that works. Enzymes in the cornea snip off a chemical tail as it passes through, releasing the active form on the far side.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Corneal esterases hydrolyse the isopropyl ester to latanoprost free acid during passage through the epithelium and stroma. The free acid is the pharmacologically active species and penetrates the cornea poorly on its own, so the ester functions as a permeation prodrug rather than a formulation convenience. Peak aqueous humour concentration of the free acid is reached roughly two hours after instillation.
It switches on one receptor and deliberately misses the rest
The active form binds a single receptor on the muscle that rings the lens. The prostaglandin family it belongs to also causes pain and inflammation through other receptors, and this molecule was reshaped to avoid them.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Latanoprost free acid is a selective agonist at the FP prostanoid receptor, expressed on ciliary muscle cells and trabecular meshwork. The 13,14-dihydro-17-phenyl-18,19,20-trinor modification of the prostaglandin F2-alpha skeleton is what confers selectivity over EP, DP, IP and TP receptors, whose activation would produce the hyperemia, pain and inflammation that made native prostaglandins unusable as drugs.
Cells dismantle the packing between the muscle bundles
The receptor tells the cells to break down some of the connective tissue filling the spaces around them. Gaps open up where there were none. This takes days to weeks, which is why the effect builds rather than appearing at once.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
FP receptor activation upregulates matrix metalloproteinases in the ciliary muscle, remodelling the extracellular matrix of the uveoscleral outflow pathway and reducing hydraulic resistance. The effect is transcriptional, not mechanical, which accounts for the lag between first dose and full effect. The trabecular route is affected far less, which is why the drug works in eyes where the conventional drain is compromised.
With the secondary drain widened, fluid leaves the eye more quickly than before. Pressure falls by around five millimetres of mercury and stays there for as long as the drops continue.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Increased uveoscleral outflow lowers steady-state intraocular pressure. The pooled network meta-analysis puts the reduction at 4.85 mmHg (95% credible interval 4.24 to 5.46) at three months. The registration trial found no long-term drift over six months, in contrast to the tachyphylaxis reported with beta-blockers.
A lower number on the tonometer is not the same as keeping your sight. One trial has tested this drug against a dummy drop for vision, and it measured blind spots on a field test, not blindness.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
UKGTS is the only placebo-controlled randomised trial of a topical agent with a visual function primary outcome: time to visual field deterioration within 24 months, adjusted hazard ratio 0.44 (95% CI 0.28 to 0.69). Perimetric deterioration is a reading-centre judgement on a threshold test, not a measure of useful sight lost, and no trial of any single glaucoma drug has used blindness as an endpoint.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Adults with open-angle glaucoma or with pressure high enough to put them at risk of it. It is a once-daily drop taken for the rest of a person’s life.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of IYUZEH have not been established in pediatric patients.”
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-30
On older people, the label states: “No overall differences in safety or effectiveness have been observed between elderly and younger adult patients.”
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary There are no adequate and well-controlled studies of IYUZEH administration in pregnant women to inform drug-associated risks.”
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary It is not known whether this drug or its metabolites are excreted in human milk.”
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-30
Where the result stopped carrying
Iris pigmentation appeared in the first six-month registration trial, was photographed, and does not reverse when the drug is stopped
Prostaglandin-associated periorbitopathy was not identified in the registration programme at all and was described years later from clinical case series
The benzalkonium chloride preservative in the original formulation damages the ocular surface over years of daily use, which is why two preservative-free reformulations were later developed and approved
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (11)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Prescription only
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Topical ophthalmic solution 0.005%, instilled once daily
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
A drop onto the ocular surface, from which a small fraction crosses the cornea while the rest drains through the nasolacrimal duct. The isopropyl ester exists to get the molecule through the cornea, where esterases release the active free acid. Bottles are refrigerated until first opened because the molecule oxidises and isomerises on storage.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Increased brown iris pigmentation, permanent, documented photographically from the first registration trial. Eyelash lengthening, thickening and darkening. Conjunctival hyperemia, more than with timolol. Eyelid skin darkening and prostaglandin-associated periorbitopathy, the latter described only after approval. Rare reports of macular oedema, mostly in aphakic or pseudophakic eyes with torn posterior lens capsules, and of herpes simplex keratitis reactivation. Systemic effects are minimal compared with the topical beta-blockers, and pulse rate was unchanged in the registration trial where timolol reduced it significantly.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Topical ophthalmic solution 0.005%, instilled once daily
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
The isopropyl ester exists to get the molecule through the cornea, where esterases release the active free acid. Bottles are refrigerated until first opened because the molecule oxidises and isomerises on storage.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
46 products list this as an active ingredient in the United States drug directory. 45 of them contain it and nothing else.
FDA National Drug Code directory · 65035-128 · read 2026-08-29
They are sold as liquid, oil, powder, solution and solution/ drops, taken ophthalmic and topical.
FDA National Drug Code directory · 65035-128 · read 2026-08-29
20 published labels name it as an active ingredient. 19 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-29
IYUZEH is ophthalmic at 3 DOSAGE FORMS AND STRENGTHS Ophthalmic solution: opalescent, white to slightly yellow solution containing latanoprost 0.005% (50 mcg/mL)., recorded as fda label in effect 2024-07-30 in the United States.
US prescribing information · 192fc081-cc38-4e83-b779-9592e060b915 · read 2026-08-30
Recorded price in US: 1.20918–1.56853 USD per one millilitre, across 10 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Latanoprost studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That this drug has been shown to prevent blindness — no randomised trial of any single glaucoma agent has used blindness as an endpoint
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the sub-millimetre gap to bimatoprost in the pooled ranking is a clinical difference; the authors of that analysis say directly that it may not be
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That elevated pressure alone justifies treatment — OHTS found nine in ten untreated participants free of glaucoma at five years
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the UKGTS hazard ratio is an unbiased estimate; the trial was stopped early at an interim analysis, which tends to inflate effect size
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Latanoprost are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
UKGTS: the only glaucoma drop tested against placebo for vision itself
In plain words
Five hundred and sixteen people with newly diagnosed glaucoma were given either latanoprost or an identical dummy drop, and neither they nor their doctors knew which. Vision was tracked for two years. Deterioration of the visual field came significantly later in the latanoprost group.
What was measured
Time to visual field deterioration within 24 months, latanoprost against identical placebo drops
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The United Kingdom Glaucoma Treatment Study was a randomised, triple-masked, placebo-controlled trial in 516 patients with newly diagnosed open-angle glaucoma at ten UK centres. Baseline mean intraocular pressure was 19.6 mmHg (SD 4.6) in 258 latanoprost patients and 20.1 (4.8) in 258 controls. At 24 months, mean reduction was 3.8 mmHg (4.0) in 231 assessed latanoprost patients against 0.9 mmHg (3.8) in 230 controls. The primary outcome was time to visual field deterioration within 24 months: adjusted hazard ratio 0.44 (95% CI 0.28 to 0.69, p=0.0003). Eighteen serious adverse events occurred, none attributed to the study drug. The Data and Safety Monitoring Committee stopped the trial early in January 2011 after an interim analysis and recommended changing the primary outcome from a difference in proportions progressing to time to deterioration.
Written into the record, not signed off as a reviewed claim
Second of fourteen first-line drops on pressure lowering, by under a millimetre
In plain words
A pooled analysis of 114 trials ranked every first-line eye drop. Bimatoprost was top, latanoprost second, travoprost third. The gaps between the top three are smaller than the measurement error on a single pressure reading.
What was measured
Mean intraocular pressure reduction at 3 months, pooled across 114 randomised trials
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Li and colleagues performed a Bayesian network meta-analysis of 114 randomised controlled trials with data from 20,275 participants, comparing single topical agents against placebo or against each other. Mean reductions in intraocular pressure at 3 months, in mmHg with 95% credible intervals, ranked: bimatoprost 5.61 (4.94 to 6.29), latanoprost 4.85 (4.24 to 5.46), travoprost 4.83 (4.12 to 5.54), levobunolol 4.51 (3.85 to 5.24), tafluprost 4.37 (2.94 to 5.83), timolol 3.70 (3.16 to 4.24), brimonidine 3.59 (2.89 to 4.29), carteolol 3.44 (2.42 to 4.46), levobetaxolol 2.56 (1.52 to 3.62), apraclonidine 2.52 (0.94 to 4.11), dorzolamide 2.49 (1.85 to 3.13), brinzolamide 2.42 (1.62 to 3.23), betaxolol 2.24 (1.59 to 2.88), unoprostone 1.91 (1.15 to 2.67). The authors describe the overall risk of bias in the included trials as mixed and state that within-class differences were small and may not be clinically meaningful.
Written into the record, not signed off as a reviewed claim
Beat timolol by 1.8 mmHg in the registration trial, once daily against twice
In plain words
In the American trial that supported approval, 268 patients took either latanoprost once a day or timolol twice a day for six months. Latanoprost lowered pressure more, and unlike timolol it did not slow the pulse.
What was measured
Diurnal intraocular pressure reduction at 6 months, latanoprost against timolol
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The United States Latanoprost Study Group ran a multicentre, randomised, double-masked, parallel-group study in 268 patients with ocular hypertension or early primary open-angle glaucoma. Comparing six-month with baseline diurnal values, reduction with latanoprost 0.005% once daily was 6.7 mmHg (SD 3.4) against 4.9 mmHg (SD 2.9) with timolol 0.5% twice daily (p<0.001). Neither drug showed long-term drift over six months. Four timolol patients and no latanoprost patients were withdrawn for inadequate pressure control. Pulse rate fell significantly with timolol but not with latanoprost. Latanoprost eyes had slightly more conjunctival hyperemia and fewer subjective side effects.
Written into the record, not signed off as a reviewed claim
The iris colour change is permanent, and it was found in the first trial
In plain words
Latanoprost puts more brown pigment into the iris. It happened in the original six-month trial, it was photographed, and it does not go away when the drug is stopped. One treated eye can end up a different colour from the other.
What was measured
Photographically documented iris pigmentation change, by treatment arm
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
In the 268-patient United States registration trial, both eyes of a patient with baseline concentric iris heterochromia showed a definite, photographically documented increase in pigmentation during latanoprost treatment, making the irides uniformly darker, with three further latanoprost patients recorded as suspects. Longer comparative work quantified the incidence: in the 12-month travoprost comparison, iris pigmentation change was seen in 10 of 194 latanoprost patients (5.2%), 10 of 201 on travoprost 0.0015% (5.0%), 6 of 196 on travoprost 0.004% (3.1%) and 0 of 196 on timolol. The mechanism is increased melanin content in iris stromal melanocytes rather than an increase in melanocyte number, and the change has not been shown to reverse.
Written into the record, not signed off as a reviewed claim
Periorbitopathy was described a decade after approval, not in the trials
In plain words
Long-term users of this class can develop a hollow, sunken look around the treated eye. It was not identified in the registration programme. It was reported by clinicians afterwards, and it partly recovers when the drug is switched.
What was measured
Upper eyelid sulcus depth on switching agents, and FP-receptor-mediated inhibition of adipogenesis in vitro
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Prostaglandin-associated periorbitopathy — deepening of the upper eyelid sulcus, orbital fat atrophy, ptosis, periocular skin darkening — was characterised in case series and comparative reports after these drugs were in wide use. A Japanese series documented recovery from deepening of the upper eyelid sulcus after switching from bimatoprost to latanoprost, establishing both that the effect is real and that it differs in degree between agents in the class. Experimental work then traced the mechanism: activation of the prostanoid FP receptor inhibits adipogenesis, and the loss of orbital fat follows from the same receptor the drug is prescribed to activate. Unilateral treatment produces visible asymmetry, which is how it is usually noticed.
Written into the record, not signed off as a reviewed claim
Millimetres of mercury are not sight, and no drop has been shown to prevent blindness
In plain words
Every trial on this page measures either pressure or blind spots on a field test. None of them counted how many people went blind. The step from a lower pressure reading to keeping your sight is an inference, well supported but not directly measured.
What was measured
That lowering intraocular pressure with this drug prevents blindness — supported by three trials measuring conversion, progression and field deterioration, and never tested against blindness as an endpoint
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Three randomised trials connect pressure lowering to a functional outcome, and all of them stop short of blindness. The Ocular Hypertension Treatment Study randomised 1,636 participants with intraocular pressure between 24 and 32 mmHg to medication or observation. Mean pressure reduction was 22.5% (SD 9.9) against 4.0% (11.6) in observation, and at 60 months the cumulative probability of developing primary open-angle glaucoma was 4.4% against 9.5% (hazard ratio 0.40, 95% CI 0.27 to 0.59, p<0.0001). The Early Manifest Glaucoma Trial randomised 255 patients with early glaucoma to laser plus betaxolol or no initial treatment. Treatment reduced pressure by 5.1 mmHg or 25%, and after a median six years progression occurred in 58 of 129 treated (45%) against 78 of 126 controls (62%, p=0.007). UKGTS measured time to visual field deterioration. Every one of these endpoints is a reading committee’s judgement on perimetry and disc photographs. None is a count of people who lost useful vision.
Written into the record, not signed off as a reviewed claim
OHTS moved the field from treating pressure to treating risk
In plain words
Before 2002 raised pressure was widely treated on sight. The Ocular Hypertension Treatment Study showed that most people with raised pressure never develop glaucoma at all: nine in ten untreated participants were still free of it five years later.
What was measured
That elevated intraocular pressure by itself warrants treatment — an inference the trial designed to support it substantially narrowed instead
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
OHTS found that among 1,636 participants with intraocular pressure of 24 to 32 mmHg and no glaucomatous damage, the five-year cumulative probability of developing primary open-angle glaucoma without treatment was 9.5%. Treatment more than halved it, to 4.4%. Both numbers are small. The authors wrote explicitly that the result does not imply that all patients with borderline or elevated pressure should receive medication, and directed that treatment be considered for those at moderate or high risk. The practical consequence was the arrival of risk calculators built on the trial’s own predictors — age, central corneal thickness, cup-to-disc ratio, pattern standard deviation — and a shift away from treating a pressure number in isolation. Central corneal thickness in particular emerged from this trial as a major predictor and is now measured routinely, which it was not before.
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What is not here
7 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What was measured, goal by goal — found nothing in the sources checked.
How close this is to real life — found nothing in the sources checked.
Felt, measured, or meaningful — found nothing in the sources checked.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A prostaglandin F2-alpha analogue that switches on the FP receptor in the ciliary muscle and opens the eye’s secondary drainage route, lowering pressure by 4.85 mmHg at three months across 114 pooled randomised trials, and the only glaucoma drop tested against placebo for vision itself — in the 516-patient UKGTS it delayed visual field deterioration with a hazard ratio of 0.44 while permanently darkening some patients’ irises.
Recorded evidence blocks (8)
Q1
On the Latanoprost label: indicated for what?
"XELPROS (latanoprost ophthalmic emulsion) 0.005% is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. XELPROS is a prostaglandin F 2α analog indicated for reduction of elevated intraocular pressure in patients with open-angle glaucoma, or…": indications and usage on Latanoprost's label. DailyMed label · 34ad5cf6-4df0-4104-bddd-4c7631133ded · 2025-12-18
Q2
146 registered trials of Latanoprost — at which phases?
Registered studies posting no result
99 of 146
146 registered studies of Latanoprost: 44 phase4, 37 phase2, 37 phase3, 15 na, 10 phase1, 6 na or unstated, 3 early phase1. CLINICALTRIALS_SNAPSHOT · 2026-09-01
562 with a PubMed record
Show the evidence
phase4
44
phase2
37
phase3
37
na
15
phase1
10
na or unstated
6
7 more recorded rows
early phase1
3
completed
107
unknown
21
terminated
7
recruiting
5
withdrawn
5
active not recruiting
1
recorded 2026-09-01 · last checked 2026-09-04
Q3
10 of Latanoprost's trials stopped: accrual/recruitment, funding/business, other?
NCT00751049, NCT00751062, NCT00751127, NCT00856622, NCT00847483 and NCT01379144, and 50 more
Completion dates
oldest 1993-12; newest 2024-08-30
Show the evidence
Trial
NCT00751049
1993-12
NCT00751062
1993-12
NCT00751127
1994-02
NCT00856622
1999-06
NCT00847483
2002-08
NCT01379144
2003-04
14 further recorded trials
NCT00051181
2003-06
NCT01655758
2004-02
NCT00051142
2004-06
NCT00647101
2005-02
NCT00293787
2005-08
NCT00293800
2005-12
NCT00287521
2006-02
NCT00187577
2006-03
NCT00440141
2007-03
NCT00159653
2007-06
NCT00277498
2007-06
NCT00468988
2007-07
NCT00620256
2008-07
NCT00906594
2008-07
Q6
At the median, Latanoprost's trials enrolled 90 people — anything larger?
Median enrolment
90
Largest enrolment
1289
Registered trials counted
144
Q7
What do 4495 spontaneous reports say about Latanoprost — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Latanoprost appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 4495 reaction mentions were counted: treatment failure 1637; eye irritation 649; intraocular pressure increased 481; ocular hyperaemia 394. FAERS via Open Targets · CHEMBL1051 · 2026-06-24
Show the evidence
treatment failure
1637
eye irritation
649
intraocular pressure increased
481
ocular hyperaemia
394
eye pain
363
hypersensitivity
245
4 more recorded rows
vision blurred
228
glaucoma
176
visual acuity reduced
176
cataract
146
recorded 2026-06-24 · last checked 2026-09-04
Q8
Which 10 reactions does Latanoprost's label not list?
ChEMBL 37 — CC BY-SA 3.0 Unported · ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
✗ required summary fields resolved: 4 required field(s) not terminal: Why people use it, Best-supported result, Biggest unanswered question, Human evidence
✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 6 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
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