TM Owner Alcon Laboratories, Inc.
Rocklatan 0.02%/0.005% Eye Drops
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Indications & Clinical Uses
- Rocklatan 0.02%/0.005% ophthalmic solution combines netarsudil, a Rho kinase inhibitor, with latanoprost, a prostaglandin analogue, in one eye drop.
- It is approved in the United States, where it is manufactured by Alcon Laboratories, Inc. (which acquired originator Aerie Pharmaceuticals in 2022), to reduce elevated intraocular pressure in adults with open-angle glaucoma or ocular hypertension, generally when a single agent has not lowered pressure enough.
- Rocklatan is a fixed-dose combination of the same two mechanisms used separately in netarsudil-only and latanoprost-only drops, so it should not be confused with either ingredient alone.
- The identical combination is marketed in the European Union and United Kingdom under the separate brand name Roclanda by Santen, a legitimate regional brand rather than a duplicate product.
- Rocklatan is a self-administered eye drop, not a hospital-only medicine.
Side Effects
- Rocklatan has NO boxed warning.
- The most common reaction, affecting more than half of patients, is conjunctival hyperemia (eye redness); instillation-site pain occurs in about 1 in 5 people, corneal verticillata (fine corneal deposits, usually without visual effect) in about 1 in 7, and small conjunctival haemorrhages in about 1 in 10.
- Rocklatan can gradually and permanently darken the iris and thicken, lengthen or darken the eyelashes; changes to the iris colour are usually permanent even after stopping treatment.
- Rarely, epithelial corneal oedema has been reported, more often in people with pre-existing corneal problems or prior eye surgery - report any new eye pain or blurred vision promptly.
- Tell your eye doctor if redness, discomfort or vision changes do not settle or get worse.
Precautions & Warnings
- Rocklatan is for use in the eye only; it must not be swallowed or injected.
- Remove contact lenses before instilling a drop, because of the benzalkonium chloride preservative, and wait at least 15 minutes before putting them back in.
- Because latanoprost can permanently increase brown pigmentation in the iris, patients should be told this before starting, especially with mixed-coloured or unilateral treatment.
- Use with caution in people with a history of herpetic keratitis, intraocular inflammation (uveitis), or risk factors for macular oedema, including aphakia or torn lens capsules.
- Netarsudil-related corneal changes warrant extra caution in eyes with pre-existing corneal endothelial compromise.
- There is limited human data in pregnancy and breastfeeding; use only if the expected benefit outweighs any risk.
- If more than one drop is prescribed, give other eye medicines at least five minutes apart from Rocklatan.
Avoid Interactions
- Do not use Rocklatan with other prostaglandin analogues, prostaglandin derivatives, or another netarsudil-containing product, since combining agents from the same class does not add benefit and increases side effects; space any other eye drop at least five minutes apart.
- Rocklatan can precipitate when mixed with eye drops that contain thimerosal, so these should not be instilled together.
- There are no known clinically significant systemic drug interactions with oral medicines because ocular absorption is low, but tell your eye doctor and pharmacist about all other eye drops and medicines you use, including any other glaucoma treatment, so duplicate mechanisms are avoided.
- If you use more than one type of eye drop, always apply Rocklatan last if instructed to do so by your prescriber, and never share a bottle with another person.
References
Frequently Asked Questions
Rocklatan (netarsudil and latanoprost) lowers eye pressure in adults with open-angle glaucoma or ocular hypertension, usually when one drop alone has not worked well enough. It combines two pressure-lowering mechanisms in a single daily drop and is approved for use in the United States.
Put one drop of Rocklatan into the affected eye or eyes once daily in the evening. Remove contact lenses first and wait 15 minutes before reinserting them, because of a preservative in the drop. Wash your hands before and after use.
Rocklatan commonly causes eye redness, stinging at the time of use, fine corneal deposits, and small conjunctival haemorrhages. It can also permanently darken the iris and eyelashes. Rarely it causes corneal swelling, so report new eye pain or blurred vision to your eye doctor.
Avoid using Rocklatan with other prostaglandin or netarsudil-containing eye drops, and do not instil it with drops containing thimerosal. Wearing contact lenses during application should be avoided until 15 minutes after the drop. Tell your eye doctor about every other eye medicine you use.
If you miss a dose of Rocklatan, apply it as soon as you remember that day, then go back to your normal evening schedule. Do not use two drops at once to make up for a missed one. Missing occasional doses can let eye pressure rise, so try to keep to the same time each evening.
There is limited human data on Rocklatan (netarsudil and latanoprost) in pregnancy, so it is used only if the benefit clearly outweighs any risk, and only under your eye doctor's guidance. Tell your prescriber if you are pregnant, planning pregnancy, or breastfeeding before starting treatment.
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