Netarsudil

Generic name: netarsudil ophthalmic
Brand name: Rhopressa
Dosage form: ophthalmic solution (0.02%)
Drug class: Ophthalmic glaucoma agents

Medically reviewed by A Ras MD.

What is netarsudil?

Netarsudil is a prescription medicine that is used to treat glaucoma. It is used to lower high eye pressure.

Description

Netarsudil is a Rho kinase inhibitor. Its chemical name is (S)-4-(3-amino-1-(isoquinolin-6-yl-amino)-1-oxopropan-2-yl) benzyl 2,4-dimethylbenzoate dimesylate. The molecular formula of the free base is C28H27N3O3 and the molecular formula of the dimesylate is C30H35N3O9S2. The molecular weight of the free base is 453.54 and the molecular weight of the dimesylate is 645.74. The chemical structure is:

Netarsudil dimesylate is a light yellow-to-white powder that is freely soluble in water, soluble in methanol, sparingly soluble in dimethyl formamide, and practically insoluble in dichloromethane and heptane.

RHOPRESSA (netarsudil ophthalmic solution) 0.02% is supplied as a sterile, isotonic, buffered aqueous solution of netarsudil dimesylate with a pH of approximately 5 and an osmolality of approximately 295 mOsmol/kg. It is intended for topical application in the eye. Each mL of RHOPRESSA contains 0.2 mg of netarsudil (equivalent to 0.28 mg of netarsudil dimesylate). Benzalkonium chloride, 0.015%, is added as a preservative. The inactive ingredients are: boric acid, mannitol, sodium hydroxide to adjust pH, and water for injection.

Mechanism of Action

Netarsudil is a rho kinase inhibitor, which is believed to reduce IOP by increasing the outflow of aqueous humor through the trabecular meshwork. The exact mechanism is unknown.

Before taking netarsudil, tell your doctor:

If you are allergic to netarsudil; any part of this medicine; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take netarsudil with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take netarsudil?

Tell all of your health care providers that you take netarsudil. This includes your doctors, nurses, pharmacists, and dentists.
Use care when driving or doing other tasks that call for clear eyesight.
Tell your doctor if you have an eye infection, eye injury, or will be having eye surgery.
Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

How is netarsudil best taken?

Use netarsudil as ordered by your doctor. Read all information given to you. Follow all instructions closely.

For the eye only.
Use in the evening.
Take out contact lenses before using netarsudil. Lenses may be put back in 15 minutes after netarsudil is given. Do not put contacts back in if your eyes are irritated or infected.
Do not touch the container tip to the eye, lid, or other skin.
If more than 1 drug is being used in the same eye, use each drug at least 5 minutes apart.

What do I do if I miss a dose?

Skip the missed dose and go back to your normal time.
Do not use 2 doses at the same time or extra doses.

What are the side effects of netarsudil that I need to call my doctor about immediately?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Change in eyesight, eye pain, or very bad eye irritation.

What are some other side effects of netarsudil?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

Eye irritation.
Blurred eyesight.
More tears.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If overdose is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out netarsudil?

Store unopened containers in a refrigerator. Do not freeze.
After opening, store in a refrigerator or at room temperature. If refrigerated, you may use netarsudil until the expiration date. If stored at room temperature, throw away any part not used after 6 weeks.
Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Label

PACKAGE/LABEL PRINCIPAL DISPLAY PANEL

NDC 70727-497-25
rhopressa®
(netarsudil ophthalmic solution) 0.02%
For topical application in the eye
Sterile
Rx only
2.5 mL