What is the systemic safety profile of prostaglandin analogs?

• A. They have no systemic side effects
• B. They commonly cause systemic hypotension
• C. They cause hepatic failure
• D. They cause renal toxicity

Answer: (B)

Prostaglandin analogs used for glaucoma are designed to act mainly in the eye. When given as daily eye drops, only a tiny amount enters the bloodstream, so systemic exposure is minimal. Because of this limited systemic absorption, systemic adverse effects are not common. There is no strong link to hepatic failure or renal toxicity with these drugs. The most consistent adverse effects are local to the eye, such as conjunctival redness, eyelash changes, and iris pigmentation. In short, the systemic safety profile is favorable with little risk of systemic hypotension or other major systemic toxicity.