Xalatan vs Other Glaucoma Eye Drops: Detailed Comparison Guide
Oct, 16 2025
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When it comes to lowering eye pressure, Xalatan is often the first name that pops up, but there are several other drops that could work just as well-or even better-for certain patients. This guide breaks down how Xalatan stacks up against its most common rivals, so you can see which option fits your lifestyle, budget, and eye health.
What is Xalatan and how does it work?
Xalatan is a prescription eye drop whose active ingredient is latanoprost, a prostaglandin F2α analogue. It works by increasing the outflow of aqueous humor through the uveoscleral pathway, which in turn reduces intraocular pressure (IOP). Lower IOP is the cornerstone of glaucoma management because sustained high pressure damages the optic nerve over time.
Because it targets the natural drainage system, Xalatan usually achieves a 20‑30% drop in IOP after just a few weeks of daily use. Most ophthalmologists prescribe one drop per eye once every evening, which aligns with the body’s natural circadian rhythm and minimizes side‑effects.
Key attributes of Xalatan
- Class: Prostaglandin analogue
- Typical dosage: 0.005% (one drop in each affected eye nightly)
- Onset of action: 3-4 days, full effect in 4-6 weeks
- Common side‑effects: mild eye irritation, changes in iris colour (usually brown), eyelash growth, and occasional darkening of the peri‑ocular skin
- Cost (Australia, 2025): around AUD 35-45 for a 2.5ml bottle (roughly a month’s supply)
Popular alternatives to Xalatan
While Xalatan is a solid first‑line choice, some patients prefer-or need-different agents. Below are the most frequently prescribed alternatives, each with its own mechanism and profile.
Travoprost (brand name Travatan) is another prostaglandin analogue, very similar to latanoprost but marketed in a preservative‑free formulation for sensitive eyes.
Bimatoprost (brand name Lumigan) belongs to the prostaglandin‑frequent class but is technically a prostamide, offering a slightly stronger IOP reduction for some patients.
Timolol (brand name Timoptic) is a non‑selective beta‑blocker that lowers IOP by reducing aqueous humor production rather than enhancing outflow.
Dorzolamide (brand name Trusopt) is a carbonic anhydrase inhibitor that also decreases production of aqueous humor.
Brimonidine (brand name Alphagan) works by both reducing production and increasing uveoscleral outflow, making it a hybrid option.
Side‑by‑side comparison
| Brand (Active Ingredient) | Drug Class | Typical Dosage | Average Cost (AU$) | Most Common Side‑effects |
|---|---|---|---|---|
| Xalatan (Latanoprost) | Prostaglandin analogue | 0.005% - one drop nightly | 35‑45 | Eye redness, iris colour change, eyelash growth |
| Travatan (Travoprost) | Prostaglandin analogue (preservative‑free) | 0.004% - one drop nightly | 40‑50 | Conjunctival hyperemia, dry eye |
| Lumigan (Bimatoprost) | Prostamide analogue | 0.03% - one drop nightly | 45‑55 | Hyperemia, darkening of eyelid skin |
| Timoptic (Timolol) | Beta‑blocker | 0.25% - one drop twice daily | 30‑40 | Bronchospasm, low heart rate |
| Trusopt (Dorzolamide) | Carbonic anhydrase inhibitor | 2% - one drop three times daily | 25‑35 | Metallic taste, bitter eye sensation |
| Alphagan (Brimonidine) | Alpha‑2 agonist | 0.15% - one drop three times daily | 35‑45 | Dry mouth, fatigue, ocular allergic reactions |
Factors to consider when picking the right eye drop
- Mechanism of action: If you need maximum outflow enhancement, prostaglandin analogues (Xalatan, Travoprost, Bimatoprost) are typically first‑line. If you have contraindications like asthma, beta‑blockers like Timolol may be off‑limits.
- Side‑effect tolerance: Some users dislike the brown‑ish iris shift from prostaglandins, while others can’t handle the systemic effects of beta‑blockers. Discuss sensitivities with your ophthalmologist.
- Frequency of dosing: Fewer drops per day improve adherence. Prostaglandins are once‑daily; carbonic anhydrase inhibitors and alpha‑2 agonists often need three‑times daily dosing.
- Cost and insurance coverage: Generic latanoprost (Xalatan’s active ingredient) is often cheaper than brand‑only options. Check your pharmacy benefits for preferred formulary drugs.
- Preservative concerns: Preservative‑free formulations (e.g., Travoprost PF) reduce the risk of ocular surface disease for people who need long‑term therapy.
Tips for using glaucoma eye drops effectively
- Wash your hands thoroughly before each application.
- Tilt your head back, pull down the lower lid to create a small pocket, and squeeze one drop without touching the bottle tip to your eye.
- Close your eye gently for about one minute; press the inner corner (punctal occlusion) to limit systemic absorption.
- If you need multiple medications, wait at least five minutes between drops to prevent wash‑out.
- Store the bottle in a cool, dry place and discard after the expiry date-most drops lose sterility after 30 days of opening.
Frequently Asked Questions
Frequently Asked Questions
Can I switch from Xalatan to another prostaglandin analogue?
Yes, most patients can transition between prostaglandin drugs without a wash‑out period. Your ophthalmologist may monitor IOP for a few weeks after the switch to ensure the new drop is equally effective.
Why does my eye turn brown after using Xalatan?
Latanoprost stimulates melanin production in the iris. The change is permanent but harmless. If colour change is a concern, discuss alternatives like preservative‑free Travoprost with your doctor.
Are there any systemic risks with Xalatan?
Systemic absorption is minimal, but rare cases of low‑grade fever or mild respiratory effects have been reported. If you have a history of asthma, let your ophthalmologist know-some clinicians prefer non‑prostaglandin options in such cases.
How long does a bottle of Xalatan last?
A 2.5ml bottle contains roughly 50 drops. At one drop per eye each night, it lasts about 25 days. Always note the expiration date after opening.
Can I use Xalatan if I’m pregnant?
Animal studies haven’t shown major risks, but human data are limited. Most specialists recommend the safest possible medication, so discuss alternatives like timed‑release timolol if you’re pregnant or planning to conceive.
