Mechanism of action<unk>  is a prodrug of the active substance,<unk>  acid, a structural and functional analogue of prostaglandin F2α (PGF2α).<unk>  acid is a selective agonist at the prostaglandin F receptor, increasing outflow of aqueous fluid from the eyes and thus lowering intraocular pressure. Other PGF2α analogues with the same mechanism include latanoprost and travoprost. Pharmacokinetics<unk> , as a lipophilic ester, easily penetrates the cornea and is then activated to the carboxylic acid,<unk>  acid. Onset of action is 2 to 4 hours after application, the maximal effect is reached after 12 hours, and ocular pressure remains lowered for at least 24 hours.<unk>  acid is inactivated by beta oxidation to 1,2-dinortafluprost acid, 1,2,3,4-tetranortafluprost acid, and its lactone, which are subsequently glucuronidated or hydroxylated. The cytochrome P450 liver enzymes play no role in the metabolism. An analogous pathway (at least up to the tetranor-metabolites) has been found for latanoprost and travoprost. Metabolism. From left to right:<unk> ,<unk>  acid (the active metabolite), 1,2-dinortafluprost acid, 1,2,3,4-tetranortafluprost acid, 1,2,3,4-tetranortafluprost acid lactone A<unk> /timolol combination ophthalmic solution
Tafluprost
Osilodrostat
Lubiprostone
Travoprost
Carboprost
Latanoprost
Iloprost
Androstanolone valerate