Netarsudil

Netarsudil is a rho kinase (ROCK) inhibitor used in ophthalmology to lower intraocular pressure (IOP) in adults with open-angle glaucoma or ocular hypertension. It is marketed as Rhopressa, a 0.02% ophthalmic solution for once-daily use, and in a fixed-dose combination with latanoprost marketed as Roclatan. The drug was approved by the U.S. FDA for Rhopressa in 2017 and for Roclatan in 2019. It is developed by Aerie Pharmaceuticals.

Mechanism of action

Netarsudil lowers IOP primarily by increasing aqueous humor outflow through the trabecular meshwork and Schlemm’s canal via ROCK inhibition, and by reducing episcleral venous pressure, which helps facilitate drainage. It may also have a modest effect on aqueous humor production, contributing to its overall IOP-lowering effect.

Administration and use

Netarsudil is administered as one drop in the affected eye(s) once daily, preferably at bedtime. Patients should follow the prescribing information and consider potential interactions with other glaucoma medications. It should be stored per label directions and used exactly as directed.

Safety and adverse effects

Common adverse effects include conjunctival hyperemia, mild conjunctival irritation, and corneal verticillata (lens-like corneal deposits). Other reported effects can include eye pain, punctate keratitis, and blurred vision. Serious systemic adverse effects are uncommon due to localized ocular administration. Caution is advised in patients with hypersensitivity to netarsudil or any excipients, and in those with active ocular infections.

See also

Rhopressa; Roclatan; ROCK inhibitors in glaucoma therapy.