I wondered if others have had any experience yet of what seems to be a relatively new eye drop. Roclanda is a mixture of Latanoprost and Netarsudil (which is a RHO Kinase inhibitor). I heard this mentioned on one of the Glaucoma UK online support group presentations earlier this year and it seemed to be described as a new type of glaucoma eye drop and its application seemed to fit with my situation.
I'm already on a number of eye drops each day (Azarga, Brimononidine, Dorzolamide and Lumigan) and I mentioned Roclanda to my consultant at my next hospital appointment. They agreed that it would be worth trying and for 6 weeks I've replaced my night-time Lumingan drop in one of my eyes with Roclanda. When my pressures were tested yesterday, the eye that I had been using the Roclanda on was 11 mmHg instead of 14 mmHg (which it had been stubbornly stuck at for over a year).
My next review is now 6 months and we'll see if it remains consistent but after a short trial the results were very good. I t struck me when I mentioned this medication to another hospital ophthalmologist and to my pharmacist they had never heard of it, therefore I thought it might be worth sharing to make others aware and also to check the experience of others who have been using it.
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Jazzers
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Plymouth eye hospital were not able, in 2021 to see any new patients with a waiting list of 18 months. So I had to go private because my optician said my left eye fields test was bad. My private consultant recommended Roclanda 6 months ago. At that time it was not a NHS approved drug. Cost £29.50 for 2.5ml. Amazing results. My pressures were 21/24 and and even a SLT hadn’t reduced them much. Now this combi drug at night does wonders!!
I asked my consultant about it on Tuesday and he said they still waiting for NICE to approve it. So private doctors can prescribe but it’s not in the system, can’t be set up to repeat and will have to be done monthly. He says the reason they’re dragging their heels is that there have been a (small) number of cases in the US of (I think) retinal bleeding and the other drug companies have piped up saying it’s not safe. It’s all very frustrating but interesting to hear that it’s not held some consultants back from prescribing.
I was advised to try Roclanda earlier this year. Unfortunately, I didn't read the ingredients (which is unlike me) and experienced a bad reaction - very red, gritty, sore eyes. I'd previously had the same reaction when taking Latanaprost and discovered, too late, its presence in the Roclanda. I can only assume that the prescribing consultant had forgotten its effects on me (we all have out off days). It's my understanding that Roclanda is a relatively new eye-drop for treating Glaucoma and I'm sure it might work very well for others.
I'm sorry to hear you didn't get on with Roclanda. You have my sympathy as it really does seem tp be a game changer in the management of IOPs.
You may see from my answer to the OP that I too suffered similar side effects when I first started Roclanda. However, as I was in rather a desperate position, I persevered with the drops and I found that after 4-6 weeks, the 'side effects' became tolerable. For me it was the new drops or being in real danger of losing my eyesight. With that choice, side efects was definitely preferable.
I have normal tension glaucoma in both eyes and from time to time my pressures go above their permitted maximum of 12.
Late 2023/early 2024, my pressures were all over the place (for me) ranging from the occasional 6 to regular 12, 13 and 14s and with each eye different from the other, more so than ever before. I knew something was wrong. My usual drops of Timolol, Brimonidine and latanaprost plus 1000mg of diamox a day were not sorting me out. The pressures remained unstable and too high for me. With only 5% of my eyesight left, I was very concerned and worried that I had come to the end of the road.
The Consultant I saw privately in March (who was new to me because my previous one had given up glaucoma patients) happened to have been the Chairman of the Committee who recommended to NICE that Roclanda be approved. He had no problem prescribing Roclanda for me and my GP has added it to my repeat medication list and I have no trouble getting it monthly.
My pressures within a few days of starting Roclanda (and keeping my brimonidine and timolol drops but reducing my diamox to 500mg slow release capsules) have stabilised at an average of 7 in each eye. My eyes have been checked and they are tolerating the Roclanda. I consider the Roclanda drops to have been a sight saver for me.
There are 'side effects' to the Roclanda drops. Of all the drops I have used during the 40 years I've had glaucoma, Roclanda is the one that stings the most. It has also caused some redness of the lids, red and sore gritty eyes and, my vision is badly affected for 2 hours or so after taking them. However, if I take the Roclanda at about 11pm and my other drops around 1am, I find I can function pretty well alright. Obviously, the 'side effects' were much worse for the first 4-6 weeks and while they are still there to a lesser extent, they are tolerable. At the end of the day, a few 'side effects' are preferable to ;osing my sight. I feel that Roclanda has saved my remaining eyesight and I am so glad that it became available to me and I hope it helps others too.
I'm really glad that they seem to be so effective for you. I've only been using them for 6 weeks and they appear to have resulted in a few mm drop in IOP which is great. I haven't had any significant side effects - certainly nothing worse than those I get with my other drops so I'm hoping that continues....... Also encouraging to hear you have them on repeat as I'm hoping I can get to that point too.
does anyone know if they do a preservative-free version of Roclanda? I know it has BAC in it, which is a problem for many eye drops that cause irritation. I’d certainly like to give it a go as latanaprost, which worked well for me, seems to have stopped working (pressures higher than ever!) and I’m reluctant to go on beta blocker as I have low blood pressure.
On a more general note, I know IOP is realistically the only variable clinicians have to work with at present, but it’s astonishing how many medications have inflammation as a side effect, as increasingly we know that ultimately, that’s what causes the damage to the optic nerves. 🤔
I think it might be a bit early to expect a preservative free Roclanda just yet but as I.m seeing my Consultant tonight, I'll ask him.
I too have very low BP but I have managed the beta blocker drops over the years eve though they sometimes have caused a further dip (70/40 is not unusual) in the mornings. I found that the presrvative free BBs did the same but holding the tear ducts after putting in the drops for a good 1-2 minutes does help mitigate the effect of of the BB.
that’s good to know Peg. I do hold the puncta closed for a good two minutes, and that seems to limit any systemic effects of the monoprost, though I don’t think there are many.
Saw my Consultant tonight and he advised that NICE is about to approve Roclanda so that all hospitals and GPs will be able to prescribe it soon.
It is hoped that a preservative free version will appear in time but no firm plans at the moment.
As a point of interest, I was told that while Roclanda has been in use in USA for some time we in UK have a different product. Ours is a 2 drug drop whereas the USA version does not have the prostaglandin in (ie no Latanaprost).
Good Luck if you do try Roclanda. It's been a sight saver for me.
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