ripasudil

Ripasudil is a topical ophthalmic medication used to lower intraocular pressure in open-angle glaucoma and ocular hypertension. It is a selective inhibitor of rho-associated kinases (ROCK), enzymes that regulate the actin cytoskeleton in the trabecular meshwork. By inhibiting ROCK, ripasudil increases outflow through the conventional aqueous humor pathway (trabecular meshwork and Schlemm's canal), producing a reduction in intraocular pressure.

Regulatory status: Ripasudil was developed in Japan and approved there in 2014 for lowering intraocular pressure in glaucoma and ocular hypertension. It has since been approved in several other Asian markets; in the United States it has not been approved by the FDA and availability outside Japan varies by country.

Administration and dosing: It is administered as an ophthalmic solution by eye drops, typically two times daily as prescribed. Onset of IOP lowering is relatively rapid, with effects observed within hours and lasting through the day when dosed as directed. It may be used as monotherapy or in combination with other IOP-lowering agents.

Adverse effects and safety: The most common adverse effect is conjunctival hyperemia (red eye), due to vasodilation. Other local effects may include transient irritation or itching after instillation. Systemic adverse events are uncommon.

Research and indications: Ongoing research explores combining ripasudil with other glaucoma therapies and its longer-term safety and efficacy in diverse patient populations.