Update on current anti‐glaucomatous drugs

Abstract This update summarizes current and recently launched intraocular pressure (IOP)‐lowering medications. Reducing IOP remains the mainstay of glaucoma treatment. Different classes of IOP‐lowering eye drops have different mechanism of action, efficacy and side effects. The eye drops available in Europe include prostaglandin analogues, β‐blockers, carbonic anhydrase inhibitors, α‐2 adrenergic agonists, and parasympathomimetic drugs. In addition, systemic carbonic‐anhydrase inhibitor drugs are available and can be considered for short time use when eye drops are not effective. Prostaglandin analogues are recommended as first choice treatment for POAG, because of their efficacy, limited systemic side effects and once daily dosing. Combining agents of different classes with different mechanism of action is associated with superior IOP‐lowering efficacy compared to each of the components used alone. Fixed combinations are preferable than concomitant treatment. Novel IOP‐lowering medications have been approved by the Food and Drug Administration and are not yet available in most of the European countries. These include nitric‐oxide donating prostaglandin analogue latanoprostene bunod, rho‐kinase inhibitor netarsudil and fixed combination netarsudil/latanoprost.