Pilocarpine and Latanoprost Ophthalmic: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pilocarpine
Latanoprost Ophthalmic
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced latanoprost efficacy
Interaction Deep Dive
Nineteen adults with open-angle glaucoma or ocular hypertension participated in a single-center prospective study to determine the optimal timing of dose administration between pilocarpine and latanoprost. Three different dosing schedules were evaluated. In schedule 1, a fourth dose of pilocarpine was given one hour before the bedtime dose of latanoprost, the fourth dose of pilocarpine was given 10 minutes after the bedtime dose of latanoprost in schedule 2, and in schedule 3, the fourth dose of pilocarpine was given one hour after the bedtime dose of latanoprost. When pilocarpine was given one hour before latanoprost, morning intraocular pressure (IOP) was not significantly different from latanoprost alone. In contrast, the reduction in morning IOP was significantly enhanced compared to baseline when pilocarpine was given either 10 minutes or one hour after latanoprost1.
Why it happens (mechanism)
Decreased access of latanoprost to the receptor; increased resistance to flow through the uveoscleral pathway
Common questions
Can I take Pilocarpine and Latanoprost Ophthalmic together?
Reduced latanoprost efficacy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Pilocarpine and Latanoprost Ophthalmic interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Pilocarpine or Latanoprost Ophthalmic need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Kent AR, Vroman DT, Thomas TJ, et al: Interaction of pilocarpine with latanoprost in patients with glaucoma and ocular hypertension. J Glaucoma 1999; 8:257-262.
Keep reading about Pilocarpine
Keep reading about Latanoprost Ophthalmic
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