What is Unoprostone: Uses, Dosage, Side Effects and More

Unoprostone is a prescription eye drop medication that helps lower pressure inside your eyes. It belongs to a class of medicines called prostaglandin analogs, which work by improving the natural drainage of fluid from your eyes. This medication is primarily used to treat glaucoma and ocular hypertension, two conditions that can lead to vision loss if left untreated.

What is Unoprostone?

Unoprostone is a synthetic prostaglandin F2α analog that comes as eye drops. Think of it as a medication that mimics natural substances in your body to help your eyes drain fluid more effectively. The drug was developed specifically to reduce intraocular pressure, which is the medical term for pressure inside your eyeball.

This medication is considered a first-line treatment for certain eye conditions. It's designed to be used long-term under medical supervision. Unlike some other glaucoma medications, unoprostone typically causes fewer systemic side effects because it's applied directly to the eye rather than taken by mouth.

What is Unoprostone Used For?

Unoprostone is primarily prescribed to treat open-angle glaucoma and ocular hypertension. These conditions occur when fluid doesn't drain properly from your eyes, causing pressure to build up inside the eyeball. If this pressure stays high for too long, it can damage the optic nerve and lead to permanent vision loss.

Open-angle glaucoma is the most common form of glaucoma, where the drainage system in your eye becomes less efficient over time. Ocular hypertension means you have higher-than-normal eye pressure but haven't yet developed optic nerve damage. Your doctor might prescribe unoprostone to prevent glaucoma from developing or to slow its progression.

In some cases, doctors may use unoprostone off-label for other conditions that involve elevated eye pressure. However, this should only be done under careful medical supervision with regular monitoring of your eye health.

How Does Unoprostone Work?

Unoprostone works by increasing the outflow of aqueous humor, which is the clear fluid that fills the front part of your eye. Your eyes naturally produce this fluid continuously, and it normally drains out through tiny channels. When these drainage channels become less efficient, pressure builds up inside your eye.

The medication acts like a key that unlocks better drainage pathways in your eye. It binds to specific receptors in the eye tissues and triggers changes that improve fluid outflow. This process typically takes a few hours to begin working and reaches its peak effect within 8 to 12 hours after application.

Unoprostone is considered a moderately strong glaucoma medication. It's not the most potent option available, but it's effective for many people and generally well-tolerated. Some patients may need additional medications alongside unoprostone to achieve their target eye pressure.

How Should I Take Unoprostone?

Unoprostone is typically prescribed as one drop in the affected eye(s) twice daily, usually in the morning and evening. The most common schedule is every 12 hours, but your doctor will give you specific instructions based on your condition. It's important to space the doses evenly throughout the day for the best results.

You can use unoprostone with or without food since it's applied directly to your eye. However, if you wear contact lenses, you should remove them before applying the drops and wait at least 15 minutes before putting them back in. The preservatives in the eye drops can be absorbed by contact lenses and may cause irritation.

When applying the drops, tilt your head back slightly and pull down your lower eyelid to create a small pocket. Look up and squeeze one drop into this pocket, then close your eye gently for 1-2 minutes. Try not to blink excessively or squeeze your eyelids tightly, as this can push the medication out of your eye.

If you're using other eye medications, wait at least 5 minutes between different drops. This gives each medication time to be absorbed properly. Always wash your hands before and after applying eye drops to prevent contamination.

How Long Should I Take Unoprostone For?

Unoprostone is typically a long-term medication that you'll need to use continuously to maintain lower eye pressure. Glaucoma and ocular hypertension are chronic conditions that require ongoing management. Most people need to use their eye drops for months or years, and some may need them for life.

Your doctor will monitor your eye pressure regularly, usually every 3-6 months initially, then less frequently once your pressure is stable. These check-ups help determine if the medication is working effectively and whether any adjustments are needed. Never stop using unoprostone suddenly without talking to your doctor first.

If you stop the medication abruptly, your eye pressure may return to previous levels within days or weeks. This could put your vision at risk, especially if you have advanced glaucoma. Your doctor might adjust your treatment plan over time, but any changes should be made gradually and under medical supervision.

What Are the Side Effects of Unoprostone?

Most people tolerate unoprostone well, but like all medications, it can cause side effects. The good news is that serious side effects are relatively uncommon because the medication is applied directly to the eye rather than taken systemically.

Here are the most common side effects you might experience:

• Burning or stinging sensation when you first apply the drops
• Temporary blurred vision for a few minutes after application
• Redness or irritation of the eye
• Feeling like something is in your eye
• Increased tearing or watery eyes
• Mild headache

These common side effects usually improve as your eyes adjust to the medication over the first few weeks of treatment.

Less common but more concerning side effects include changes in iris color, particularly in people with mixed-colored eyes. The medication can cause the colored part of your eye to gradually become more brown. This change is usually permanent, even if you stop using the medication. Some people also experience increased growth or darkening of eyelashes.

Rare but serious side effects that require immediate medical attention include:

• Severe eye pain or sudden vision changes
• Signs of eye infection (increased redness, discharge, swelling)
• Severe allergic reactions (difficulty breathing, swelling of face or throat)
• Sudden onset of flashing lights or new floaters

If you experience any of these serious symptoms, contact your doctor immediately or seek emergency medical care.

Who Should Not Take Unoprostone?

Unoprostone isn't suitable for everyone. You should not use this medication if you're allergic to unoprostone or any of its inactive ingredients. People with certain types of glaucoma, particularly angle-closure glaucoma, should not use prostaglandin analogs like unoprostone without special precautions.

Pregnant women should discuss the risks and benefits with their doctor before using unoprostone. While the medication is applied topically, small amounts can be absorbed into the bloodstream. The safety of unoprostone during pregnancy hasn't been fully established, so it's typically used only when the benefits outweigh potential risks.

Breastfeeding mothers should also consult their healthcare provider. It's not known whether unoprostone passes into breast milk, but caution is advised. People with a history of eye inflammation, eye infections, or recent eye surgery may need special monitoring or alternative treatments.

Children and adolescents should use unoprostone only under close medical supervision. The safety and effectiveness in pediatric patients haven't been fully established, and dosing may need to be adjusted based on the child's size and condition.

Unoprostone Brand Names

Unoprostone is available under several brand names, with Rescula being the most commonly recognized in the United States. The medication may be sold under different brand names in other countries, but the active ingredient remains the same.

Generic versions of unoprostone may also be available, which can be more affordable than brand-name options. Your pharmacist can help you determine if a generic version is available and appropriate for your needs. Always make sure you're getting the correct strength and formulation as prescribed by your doctor.

When switching between brand names or from brand to generic (or vice versa), it's important to monitor your eye pressure closely. While the active ingredient is the same, inactive ingredients may differ slightly, which could affect how well you tolerate the medication.

Unoprostone Alternatives

If unoprostone doesn't work well for you or causes bothersome side effects, several alternative medications are available. Other prostaglandin analogs include latanoprost, travoprost, and bimatoprost. These medications work similarly to unoprostone but may have different side effect profiles or dosing schedules.

Beta-blockers like timolol or betaxolol are another class of glaucoma medications that work by reducing the production of fluid in your eye. Alpha-agonists such as brimonidine can also lower eye pressure through a different mechanism. Carbonic anhydrase inhibitors, available as eye drops or pills, offer yet another treatment approach.

Some people need combination medications that contain two different types of glaucoma drugs in one bottle. This can simplify your treatment regimen and potentially improve effectiveness. Your doctor will consider factors like your specific type of glaucoma, other health conditions, and how well you respond to different medications.

Non-medication treatments are also available for some people. Laser procedures can improve drainage in your eye, while surgical options may be considered for advanced cases that don't respond well to medications.

Is Unoprostone Better Than Latanoprost?

Unoprostone and latanoprost are both prostaglandin analogs, but they have some important differences. Latanoprost is generally considered more potent and is often prescribed as a first-line treatment for glaucoma and ocular hypertension. It's typically used once daily in the evening, while unoprostone is usually prescribed twice daily.

Studies suggest that latanoprost may be slightly more effective at lowering eye pressure for most people. However, unoprostone may be better tolerated by some individuals, particularly those who experience side effects with latanoprost. The choice between these medications often depends on your individual response and tolerance.

Both medications can cause similar side effects, including changes in iris color and eyelash growth. However, some people find one medication causes less irritation than the other. Your doctor will consider your specific situation, including the severity of your condition, other medications you're taking, and your personal preferences when choosing between these options.

Cost can also be a factor in the decision. Latanoprost is available in generic form and may be less expensive than unoprostone. However, insurance coverage and pharmacy benefits can vary, so it's worth checking with your insurance provider and pharmacist about costs.