Page 32 - 21st Century Perspective - Glaucoma Supplement

We know about half of all patients with glaucoma will require a second medication along the care
continuum. This is yet another reason to reduce the IOP as low as is practical to delay this additional
burden as long as possible. It is well known that, as additional drops are added to the regimen,
compliance and adherence decline. When prescribing transitions from a single, once-daily drop to the
addition of a completely new medication, similar compromise often occurs.

The FDA-approved package insert states that Vyzulta is indicated for “the reduction of intraocular
pressure in patients with open-angle glaucoma or ocular hypertension.” Note that it does not say for
“elevated” intraocular pressure but simply for “reduction of intraocular pressure,” thus acknowledging
(planned or unplanned) that many patients have normal-pressure glaucoma or are glaucoma
suspects. The package insert further shares that, “the IOP-lowering effect of Vyzulta is up to 7 to 9
mm Hg.”

Like latanoprost, Vyzulta is stored under refrigeration long-term at the pharmacy; however, once
dispensed to the patient, it can be kept at room temperature for several weeks. Vyzulta is approved
for once-daily use (preferably instilled in the evening). This medication is approved for persons ages
16 and older. Mild conjunctival hyperemia was observed in about 6% of study patients. Vyzulta is
preserved with 0.02% BAK (just like latanoprost).

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