Netarsudil
RHOPRESSA
What it isRho kinase inhibitor increasing trabecular outflow; open-angle glaucoma and ocular hypertension.
Why this oneIt acts at the trabecular meshwork, the actual site of outflow resistance, and can add to any other glaucoma-drop class.
What limits itConjunctival hyperemia, corneal verticillata, and small conjunctival hemorrhages commonly limit acceptance.
FDA-approved for
- open-angle glaucoma / ocular hypertension (2017)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Elevated IOP in open-angle glaucoma or ocular hypertension | adult | 1 drop affected eye(s) QHS | 1 drop affected eye(s) QHS | 1 drop QD (evening) |
Renal Undefined
Hepatic Undefined
If a dose is missed, resume with the next evening dose
Instructions
- Instill one drop in the affected eye(s) once daily in the evening; twice-daily dosing not recommended
- If using other topical IOP drugs, separate administration by at least 5 minutes
- Remove contact lenses before instillation; may reinsert 15 minutes after
Cautions
- Epithelial corneal edema in pre-existing corneal stromal edema or after procedures affecting the endothelium
- Bacterial keratitis with contaminated multi-dose containers
- Remove contact lenses before use
Adverse reactions
- Conjunctival hyperemia (53%)
- Corneal verticillata (~20%)
- Instillation site pain
- Conjunctival hemorrhage
Pregnancy No human data; systemic exposure low; IV animal studies showed embryofetal harm at high exposures
Lactation No data; low systemic exposure after topical ocular use
NO BOXED WARNINGS
Principal riskConjunctival hyperemia and corneal verticillata
Cost, est. cash$200–$1,000/month
Generic entry2034 est.
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Mechanism of action: Netarsudil ballicule
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