Netarsudil

RHOPRESSA

Open Netarsudil in the interactive console ↗

Pronunciation: ne-TAR-soo-dil

Netarsudil ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Netarsudil ballicule

Netarsudil RHOPRESSA mascot mnemonic cartoon — Visual mnemonic: Netarsudil mascot
**“Netter Sue’s Row pressure”**

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 itWeaker than latanoprost; conjunctival hyperemia and corneal verticillata are common and limit acceptance.

Pearls

Matches timolol when baseline IOP is under 25 mm Hg
Corneal verticillata are mostly reversible
Contains benzalkonium chloride

Netarsudil molecular structure (skeletal formula) — Molecular structure: Netarsudil

Netarsudil prescription history

Animated chart of estimated U.S. prescriptions per year, Glaucoma medicines (1900–2026). Netarsudil enters in 2018 (estimated).

FDA-approved for

open-angle glaucoma / ocular hypertension (2017)

Principal riskConjunctival hyperemia and corneal verticillata

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

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.

FDA label

Read the full label on DailyMed ↗

NO BOXED WARNINGS

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

Available strengths

drops 0.02 %

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

Cost

Netarsudil (RHOPRESSA)

Strength		#/mo	generic $/unit	CostPlus
0.02 %	drops	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Netarsudil is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2034 est.

Open Netarsudil in the interactive console ↗

Self-check

Where does netarsudil increase aqueous outflow?
The trabecular meshwork.
What corneal change can limit netarsudil acceptance?
Corneal verticillata.