Rhopressa
Rhopressa, also known by its generic name, netarsudil, is an eye drop medication used to lower eye pressure in people with glaucoma or ocular hypertension. It received FDA approval in December 2017 and belongs to a newer class of medications called ROCK (rho kinase) inhibitors. The medication is given as a drop into the affected eye(s) once every night. Common side effects include eye redness and blurry vision.
What is Rhopressa (netarsudil)?
What is Rhopressa (netarsudil) used for?
- Lowering pressure in the eye in people with ocular hypertension (high pressure in the eye) or open-angle glaucoma
How Rhopressa (netarsudil) works
Rhopressa (netarsudil) is a ROCK (rho-kinase) inhibitor, which means it blocks a protein in the eye called rho kinase. By blocking this protein, it helps to drain fluid from the eye, leading to lower eye pressure.
Drug facts
Side effects of Rhopressa (netarsudil)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Eye redness (53%)
- Cornea deposits (20%)
- Eye pain when putting the drop in the eye (20%)
- Red spot on the white of your eye (20%)
Less Common Side Effects
- Cornea staining
- Blurry vision
- Watery eyes
- Red eyelids
- Lowered vision sharpness
The following Rhopressa (netarsudil) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Change in vision
- New or worsening eye pain, redness, irritation, or discharge
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Blurry vision
- Change in eye, eyelash, or eyelid color
- Eye irritation or itching
- Increased tears after use
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Pros and cons of Rhopressa (netarsudil)
Pros
- Can be used with other glaucoma medications to further lower eye pressure
- Doesn't cause the color of your eye to darken like other eye drops
- Only needs to be used once in the evening
Cons
- Eye redness is a very common side effect
- No lower-cost generic available
- Its role in treatment isn't clear yet
Pharmacist tips for Rhopressa (netarsudil)
- You'll need regular eye exams so that your eye specialist can check how well Rhopressa (netarsudil) is working for you and whether there are any side effects related to the eyes.
- If you're using other eye drops besides Rhopressa (netarsudil), wait 5 minutes between each medication to give your eyes time to absorb each one.
- If you wear soft contact lenses, take them out before using Rhopressa (netarsudil). The eye drops contain a preservative called benzalkonium chloride that can damage your contact lenses. You can put your contacts back in 15 minutes after using the eye drops.
- If you wake up in the morning and realize you forgot to use your Rhopressa (netarsudil) drops last night, just skip that dose and wait until evening for your regularly scheduled dose. Using two drops in one day can lead to more side effects and isn't recommended.
How to use Rhopressa (netarsudil):
- Make sure you know how to use the Rhopressa (netarsudil) eye drops to avoid accidentally hurting yourself or wasting any of the medication. Review the steps on how to use eye drops, and ask your eye specialist or pharmacist if you have any questions about using the medication.
- Wash your hands before putting the drops in your eyes. Don't touch the dropper tip with your eye, hands, or any other surface. This will help you avoid eye infections by preventing contamination of the solution.
- After placing a drop in the eye, close your eye and press one finger to the inner corner of your eye by the nose and press lightly for 1 minute. This helps make sure your eye absorbs the drop.
- You can wipe away any extra liquid that might be on your skin with a clean tissue.
Common questions about Rhopressa (netarsudil)
No, Rhopressa (netarsudil) isn't a prostaglandin, it's a ROCK (rho-kinase) inhibitor. Both prostaglandins and ROCK inhibitors work to lower eye pressure, but they do so in different ways. Depending on how serious your glaucoma is, your optometrist or ophthalmologist might recommend taking a prostaglandin eye drop along with Rhopressa (netarsudil).
It takes about 12 to 15 hours for most of Rhopressa (netarsudil) to leave the body after a dose. This time frame is estimated based on the medication's half-life.
New, unopened bottles of Rhopressa (netarsudil) should be stored in the refrigerator. Once you open a bottle, you can either continue storing it in the refrigerator or you can leave it at room temperature. If you leave it at room temperature, the bottle is good for 6 weeks after you open it. If you keep it in the refrigerator (and never let it get to room temperature), then the bottle is good until the expiration date written on the bottle.
Probably not, Rhopressa (netarsudil) doesn't appear to change or affect blood pressure. Since it's applied directly to the eye, it only lowers pressure in the eye.
It depends. In studies, the effect of Rhopressa (netarsudil) to lower eye pressure is strongest 8 hours after taking a dose, and it lasts for 24 hours. Additionally, other studies reveal that people taking Rhopressa (netarsudil) experienced a noticeable reduction in eye pressure within 15 days of starting the daily medication. Talk to your prescriber if you're concerned with how well or how quickly the medication is working for you.
A drop of Rhopressa (netarsudil) contains about 0.05 mL of medication. So a 2.5 mL bottle of Rhopressa (netarsudil) will have about 50 drops in it. Assuming that you need to use the medication in both eyes, this means that a 2.5 mL bottle should last you about 25 days. Keep in mind that some medication might accidentally get wasted, so the bottle might not last as long as expected. Ask for a refill from your pharmacist or eye specialist when you notice your Rhopressa (netarsudil) bottle is starting to get empty.
No, Rhopressa (netarsudil) contains a preservative called benzalkonium chloride. This preservative can damage contact lenses. Because of this risk, you should remove any soft contact lenses each time before you use Rhopressa (netarsudil). Then, wait at least 15 minutes after placing the eye drops to put your contacts back in.
Rhopressa contains the active ingredient netarsudil. On the other hand, Rocklatan is a combination medication of netarsudil and latanoprost (a prostaglandin). Rocklatan is for people who might need more than one medication to help lower the pressure in the eye.
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Risks and warnings for Rhopressa (netarsudil)
Rhopressa (netarsudil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk for bacterial eye infection when using contaminated medication
- Risk factors: Corneal disease | Injury or damage to the surface of the eye
Eye infections can happen if the medication inside your Rhopressa (netarsudil) bottle gets contaminated with germs. Some people who used contaminated eye drops developed bacterial keratitis, an infection of the cornea (the protective covering on the front of the eye). It's important to wash your hands before each time you use Rhopressa (netarsudil). Be careful not to let the dropper tip touch your eye or to any other surface.
Not for use with contact lenses
Rhopressa (netarsudil) contains a preservative called benzalkonium chloride. This preservative can be absorbed by soft contact lenses and cause damage to the lenses. Take out your soft contact lenses each time before you place Rhopressa (netarsudil) drops into your eye(s). Wait at least 15 minutes after your dose before putting your contacts back in.
Rhopressa (netarsudil) dosage
Eye dropper| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2.5ml of 0.02% | 1 eye dropper | $338.30 | $338.30 |
Typical dosage for Rhopressa (netarsudil)
The typical dose is 1 drop in the affected eye(s) once daily in the evening.
How much does Rhopressa (netarsudil) cost?
$338.30
What are alternatives to Rhopressa (netarsudil)?
Rhopressa (netarsudil) images
