What Is The Difference Between Xalatan And Vyzulta?
In our latest question and answer, the pharmacist discusses the difference between Xalatan and Vyzulta.
My first eye doctor started me on Xalatan, but now my new doctor wants to try Vyzulta. I picked it up from the pharmacy yesterday and as far as I can tell, it's the same drug (latanoprost). Is there any difference between them?
Nov 11, 2022- Xalatan contains latanoprost while Vyzulta contains latanoprostene bunod, which breaks down into latanoprost plus nitric oxide for a dual-mechanism approach to lowering eye pressure.
- Both medications lower intraocular pressure by essentially the same amount in clinical trials, so there is minimal practical difference in how well they work.
- Xalatan is available as a generic medication costing around $12 per bottle while Vyzulta is brand-only and costs about $360 per bottle, making Xalatan the more affordable first-line option for most people.
Answer
Xalatan and Vyzulta have a similar looking active ingredient, but they are different. Xalatan contains latanoprost while Vyzulta contains latanoprostene bunod.
I discuss in the next sections how these are different, but it is important to note from the outset that there is only a very minimal difference in how well they work to treat glaucoma.
Different Active Ingredients
As mentioned, Xalatan and Vyzulta have different active ingredients.
Xalatan contains latanoprost, a prostaglandin. Vyzulta contains latanoprostene bunod, which, when administered is broken down to two components:
- Latanoprost
- Nitric oxide
So, in a sense, Vyzulta simply adds on an additional component to Xalatan (nitric oxide).
Vyzulta is often described as having a 'dual-mechanism of action' since it works two different ways to lower intra-ocular pressure (IOP).
The manufacturer's website does a good job of explaining how latanoprost and nitric oxide work via different pathways (specifically, they increase the outflow of aqueous humor through both the trabecular meshwork [nitric oxide] and uveoscleral [latanoprost] routes).
There Is Not Much Clinical Difference Between Xalatan and Vyzulta
Clinical trials for Xalatan and Vyzulta show they both lower intra-ocular pressure by essentially the same amount:
- For Xalatan (latanoprost), patients with an average intraocular pressure of 24 – 25 mmHg were treated for 6 months and had a 6 – 8 mmHg reduction in pressure.
- For Vyzulta (latanoprostene bunod), patients with an average intraocular pressure of 26.7 mmHg were treated for 12 months and had a 7 – 9 mmHg reduction in pressure.
Price
The price difference between Vyzulta and Xalatan is a big consideration. Xalatan is available generically while Vyzulta is not.
Vyzulta costs about $360 per 5 mL bottle, versus $12 for a 2.5 mL bottle of latanoprost. This is a significant difference.
In most cases, even if your insurance covers Vyzulta, it will likely have a higher copay than generic Xalatan.
For most individuals, it would make sense to use Xalatan first, and if you don't see the appropriate clinical response, Vyzulta could be an option.
Final Words
Thanks for reaching out to us! Please contact us again anytime.
References & sources
Glossary — Terms in This Answer
- Prostaglandin
- A hormone-like substance in the body that helps regulate various functions, including lowering eye pressure in glaucoma treatment.
- Nitric oxide
- A gas produced naturally in the body that helps relax blood vessels and improve fluid flow.
- Dual-mechanism of action
- When a medication works in two different ways to produce its therapeutic effect.
- Intra-ocular pressure
- The fluid pressure inside the eye, which can be elevated in glaucoma and lead to vision loss.
- Aqueous humor
- The clear fluid that fills the front part of the eye and maintains eye pressure.
- Trabecular meshwork
- A network of tissue in the eye through which fluid drains to help control eye pressure.
- Uveoscleral
- Relating to a drainage pathway in the eye where fluid flows out to lower eye pressure.
- Clinical trials
- Research studies conducted on people to test whether a medication works safely and effectively.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
More answers from Brian →