Rocklatan (Netarsudil/Latanoprost)

Rocklatan is a prescription eye drop combining two glaucoma medications—netarsudil (a rho kinase inhibitor) and latanoprost (a prostaglandin analog)—in a single bottle. It's used to lower intraocular pressure (IOP) in patients with glaucoma or ocular hypertension.

How It Works

Rocklatan combines two mechanisms:

Netarsudil (rho kinase inhibitor):

• Increases fluid drainage through the trabecular meshwork
• Reduces fluid production
• Also may reduce episcleral venous pressure

Latanoprost (prostaglandin analog):

• Increases fluid drainage through the uveoscleral pathway
• One of the most effective IOP-lowering mechanisms

Together, these provide greater pressure reduction than either alone.

Common Uses

• Glaucoma (open-angle)
• Ocular hypertension
• When single medications don't adequately control pressure
• To simplify regimen (one drop vs. two separate drops)

How to Use

• Dosing: One drop in affected eye(s) once daily in the evening
• Timing: Evening dosing is important (how prostaglandins work best)
• Contact lenses: Remove before use; wait 15 minutes before reinserting
• Technique: Wash hands, tilt head back, pull down lower lid, apply drop
• After instillation: Close eyes gently; press on inner corner to reduce drainage
• Multiple drops: Wait at least 5 minutes between different eye drops

What to Expect

Pressure Reduction

• Typically lowers IOP by 30-36%
• More effective than either component alone
• Effect maintained with continued use

Side Effects You May Notice

• Eye redness is common (see below)
• Some discomfort initially
• Gradual changes in eyelash appearance

Side Effects

Common

• Eye redness (conjunctival hyperemia)—most common
• Eye discomfort or pain
• Increased eyelash growth
• Darkening of eyelashes
• Iris color change (permanent, more common with dark eyes)
• Eyelid skin darkening

Less Common

• Blurred vision
• Eye itching
• Corneal changes (verticillata)
• Headache

About Eye Redness

• Occurs in about 50% of patients
• Often most noticeable when starting
• May improve over time
• Usually doesn't require stopping medication

Long-Term Changes

From the latanoprost component:

• Eyelashes may become longer, thicker, darker
• Iris color may darken (more common with hazel/mixed color eyes)
• Eyelid skin may darken
• These changes may be permanent

Precautions

• Active eye inflammation: Use with caution
• Contact lenses: Remove before use
• Pregnancy: May affect fetus; discuss with doctor
• Breastfeeding: Use with caution
• After eye surgery: Follow surgeon's guidance

Cost and Insurance

• Brand-name medication
• Often requires prior authorization
• May be more cost-effective than two separate drops
• Check manufacturer savings programs

Comparing Glaucoma Combinations

Medication	Components	Dosing
Rocklatan	Netarsudil + Latanoprost	Once daily (evening)
Simbrinza	Brinzolamide + Brimonidine	Twice daily
Combigan	Brimonidine + Timolol	Twice daily
Cosopt	Dorzolamide + Timolol	Twice daily

Frequently Asked Questions

Why is Rocklatan used in the evening?

The latanoprost component works best when used in the evening. Studies show better pressure control with evening dosing for prostaglandin analogs.

Will my eye color change?

The latanoprost component can cause iris darkening, especially in eyes with mixed colors (hazel, green-brown). This change is usually gradual, may be permanent, and is more common with long-term use. Solid blue or brown eyes are less affected.

Why are my eyes red after using Rocklatan?

Eye redness is a common side effect of the netarsudil component. It's usually most noticeable when starting treatment and often improves with continued use. It doesn't typically harm the eye.

Can I use Rocklatan if I wear contact lenses?

Yes, but remove contacts before instilling the drop and wait at least 15 minutes before reinserting them.

Is Rocklatan better than using two separate drops?

Rocklatan provides the convenience of one drop instead of two. Pressure-lowering may be similar to using the components separately. The main advantage is simplified dosing and better adherence.

What if I miss a dose?

Apply the missed dose as soon as you remember. If it's almost time for your next dose, skip the missed dose. Don't double up.