Latanoprost, a prostaglandin analogue (PGF2α), is a commonly used antiglaucoma medication.1 As plasma concentration is low following topical administration, systemic adverse effects are unlikely to occur.1 Studies carried out in asthmatic volunteers with topical prostaglandin PGF2α did not show any respiratory side effects.2 Systemic administration of PGF2α has significant cardiac effects3,4,5 and it has a role in the mediation of sensory (pain) perception.6 Such side effects have not been reported with topical use. We report five cases of chest tightness following the use of latanoprost eye drops.

Case 1 A 73-year-old lady with primary open-angle glaucoma had therapeutic failure with several antiglaucoma medications. In view of inadequate control of intraocular pressure and undesirable side effects to β-blockers, brimonidine and dorzolamide, she was given latanoprost (Xalatan®Pharmacia) eye drops as monotherapy. She complained of chest tightness following 1 month of Xalatan therapy, which was persistent. Although there was no objective evidence to suggest cardiac ischaemia, the symptoms subsided on discontinuation of the drug.

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