Contact Lenses
Mild
Database
Benzalkonium absorption by lenses
Remove lenses; reinsert after 15 min
Source: Kimi deep-research + Cla
Drug reference
netarsudil
Rho kinase inhibitor (ophthalmic, IOP-lowering) · Antiglaucoma agent
START
1 drop 0.02% in affected eye(s) once daily in evening
TYPICAL MAX
1 drop once daily per eye (do not dose more often)
STOP IF
Vision-affecting corneal deposits or hypersensitivity
WATCH
IOP response, corneal status, conjunctival hyperaemia
CDSCO approvedATC S01EX05
KDIGO 2024 + manufacturer label
- ONSET
- 1h · IOP fall
- PEAK
- 3h · peak effect
- t½
- 30min · local
- DURATION
- 1d · once-daily
EXCRETION
Negligible systemic; local ocular
route + CYP
INTERACTIONS
—
none in our sources
PREGNANCY
Limited data; use only if benefit outweighs risk.
FDA category + note
Mechanism
Inhibits Rho-associated kinase (and norepinephrine transporter), increasing trabecular-meshwork outflow and reducing episcleral venous pressure and aqueous production — lowering intraocular pressure.
Indications
Elevated intraocular pressure in open-angle glaucomaOcular hypertension
Dosing
- Adult
- 1 drop of 0.02% in the affected eye(s) once daily in the evening.
- Pediatric
- Not established.
- Renal adjustment
- No adjustment (negligible systemic absorption).
- Hepatic adjustment
- No adjustment.
- Geriatric
- No specific adjustment.
- Max dose
- 1 drop once daily per eye (more frequent dosing less effective/more hyperaemia)
Pharmacokinetics
Onset
IOP reduction within hours
Peak effect
~2–4 h post-instillation; max effect over weeks
Duration
~24 h (once-daily)
Half-life
Local (negligible systemic exposure)
Bioavailability
Negligible systemic
Protein binding
Not relevant systemically
Metabolism
Ocular esterases (active metabolite)
Excretion
Negligible systemic; local
Contraindications
- Hypersensitivity to netarsudil
Side effects
Common
Conjunctival hyperaemiaCorneal verticillata (whorl deposits)Conjunctival haemorrhageInstillation-site painBlurred vision
Serious
- Corneal deposits affecting vision (rare, usually reversible)
- Severe hypersensitivity
Pregnancy & lactation
Pregnancy
Limited data; use only if benefit outweighs risk.
Lactation
Unknown excretion in milk; caution.
Drug interactions
Other Topical Iop Lowering Agents
Mild
Database
Additive IOP reduction (intended)
Separate instillation by ≥5 min
Source: Kimi deep-research + Cla
Prostaglandin Analogues
Mild
Database
Complementary outflow mechanisms
Common combination; space instillation
Source: Kimi deep-research + Cla
Systemic Drugs
Mild
Database
Negligible systemic absorption
No action required
Source: Kimi deep-research + Cla
Topical Nsaids
Mild
Database
No significant systemic interaction
Routine ophthalmic co-use acceptable
Source: Kimi deep-research + Cla
Related guidelines
Ask House about netarsudil
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20