Page 31 - 21st Century Perspective - Glaucoma Supplement

Figure 19.​ Latanoprostene bunod (Vyzulta).

This totally new, single-entity, dual-action upgrade to the first-generation prostaglandins raises the
efficacy to a higher level. The latanoprostene bunod molecule is cleaved into two distinct entities by
resident esterases in the anterior eye tissues. Two compounds result from this cleaving: latanoprost
acid (the metabolically active form of latanoprost) and butanediol mononitrate, which is subsequently
metabolized into nitric oxide, which is thought to relax the smooth muscles of the trabecular

meshwork, thereby enhancing conventional (trabecular) outflow. In phase 2 studies, latanoprostene
bunod reduced IOP an additional 1.23 mm Hg beyond that of first-generation latanoprost.

Supplementing Glaucoma Treatment

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