Rhopressa (Netarsudil) - Ophthalmic

What Is Rhopressa?

Rhopressa (netarsudil) is a prescription eye drop used to reduce high pressure inside the eye in adults with ocular hypertension (high pressure in the eye) and open-angle glaucoma (partially blocked eye drainage that causes increased eye pressure over time).

The exact way netarsudil works (its mechanism of action) is unknown. However, because it's a rho kinase inhibitor, it's thought to work by increasing the flow of fluid out of your eye through its normal path through a particular tissue network called the trabecular meshwork route. This increase in the flow of fluid out of your eye decreases the pressure inside of your eye.

Drug Facts

Generic Name: Netarsudil

Brand Name(s): Rhopressa

Drug Availability: Prescription

Therapeutic Classification: Rho kinase inhibitor

Available Generically: No

Controlled Substance: N/A

Administration Route: Ophthalmic

Active Ingredient: Netarsudil dimesylate 0.285 mg

Dosage Form(s): Ophthalmic Solution 0.02 %

What Is Rhopressa Used For?

Rhopressa is used to reduce high intraocular pressure (pressure inside the eye) in adults with ocular hypertension and open-angle glaucoma.

An illustration with rhopressa netarsudil drug information

Verywell / Dennis Madamba

How to Take Rhopressa

Rhopressa eye drops are meant for application in the eye. Your healthcare provider will let you know how many drops to use, but the usual dosage is one drop into the affected eye(s) every evening. A few things to keep in mind:

  • Do not use more than directed.
  • Wash your hands with soap and water before and after using this medicine.
  • You may lie down or tilt your head back to apply the eye solution to your affected eye(s).
  • With your index finger, pull down the lower lid of your eye to form a pocket.
  • Hold the dropper close to (but just above) your eye with your other hand.
  • Do not allow the tip of the dispensing bottle to come into direct contact with your eye, eyelids, fingers, or any other surfaces to prevent contamination of the solution.
  • Drop the prescribed number of eye drops into your affected eye(s) and gently close your eyes.
  • Do not rinse or wipe the dropper.
  • Put the cap on your bottle right away, and keep your bottle upright when you are not using it.
  • If you are applying other eye medications simultaneously, allow five minutes between each eye drop application to ensure that the medication has fully absorbed into your eyes.
  • If you wear contact lenses, please remove them before applying these drops to your eyes.
  • Wait 15 minutes after application of your eye drops to reinsert your contact lenses.
  • It is important to develop safe practices for administering eye drops because you do not want to develop bacterial keratitis.

Storage

An unopened bottle of Rhopressa should be stored in the refrigerator. Once your bottle has been opened, it can be stored at room temperature or in your refrigerator for up to six weeks.

How Long Does Rhopressa Take to Work?

Data regarding the onset of action of Rhopressa is currently lacking.

What Are the Side Effects of Rhopressa?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects of Rhopressa can include:

  • Pain where you applied the medicine (application site pain)
  • Eye redness (conjunctival hyperemia)
  • Faint golden-brown whorl pattern in the cornea (cornea verticillata)

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Breaking of a tiny blood vessel underneath the clear surface of the eye (conjunctival hemorrhage)
  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness or trouble breathing
  • Blurred vision or other changes in vision, severe eye irritation, or inflammation

Long-Term Side Effects

Long-term effects of Rhopressa are lacking.

Report Side Effects

Rhopressa may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Rhopressa Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For ophthalmic solution dosage form (eye drops):
    • For glaucoma or ocular hypertension:
      • Adults—One drop in the affected eye(s) once a day in the evening.
      • Children—Use and dose must be determined by your doctor.

Modifications

There's not enough scientific evidence to tell whether there would be a risk to your fetus when used during pregnancy or to your child during breastfeeding. If you're pregnant or breastfeeding, please talk with your healthcare provider before starting Rhopressa. It's also unknown whether Rhopressa is safe or effective for people younger than 18.

Missed Dose

If you miss your dose of Rhopressa, skip your missed dose and go back to your regular dosing schedule.

If you miss too many doses, Rhopressa may be less effective at treating your condition. Try to find ways that work for you to help yourself remember to routinely keep your appointments and take your medication.

Overdose: What Happens If I Take Too Much Rhopressa?

Overdose information on Rhopressa is not available. The likelihood of overdose is low with this medicine.

What Happens If I Overdose on Rhopressa?

If you think you or someone else may have overdosed on Rhopressa, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Rhopressa, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your eye doctor (ophthalmologist) check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, check with your doctor right away.

What Are Reasons I Shouldn't Take Rhopressa?

There are no specific reasons why you shouldn't take Rhopressa (contraindications). However, if you've had a severe allergic reaction to Rhopressa or any of its ingredients in the past, then it's normally suggested that you not use Rhopressa.

What Other Medications Interact With Rhopressa?

While taking this medication, you should ask your healthcare provider or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products. If you are using any other eye medications together with Rhopressa, use them at least five minutes before or five minutes after using Rhopressa.

What Medications Are Similar?

Timoptic (timolol maleate) is a beta1 and beta2 (non-selective) adrenergic receptor blocking agent that can be used as an alternative to Rhopressa. Although Timoptic belongs to a different drug class than Rhopressa, clinical data supports that it is another prescription eye drop that can be used to reduce high pressure inside the eye in adults with ocular hypertension and open-angle glaucoma.


Frequently Asked Questions

  • What is Rhopressa used for?

    Reduces pressure in the eye in adults with ocular hypertension (high pressure in the eye) and open-angle glaucoma (partially blocked eye drainage that causes increased eye pressure over time).

  • How does Rhopressa work?

    The exact way that netarsudil works is unknown, but it's believed to work by increasing the outflow of fluid through a network of special tissue in your eye (the trabecular meshwork route).

  • How long should I wait to apply any other eye medications after Rhopressa?

    Wait five minutes.

  • Where should I store Rhopressa?

    An unopened bottle of Rhopressa should be stored in the refrigerator. Once the bottle is opened, it may be stored at room temperature or in the refrigerator for up to six weeks.

How Can I Stay Healthy While Taking Rhopressa?

If you hurt your eye, develop an eye infection, or have an upcoming eye surgery, you should immediately talk to your healthcare provider about whether you should continue to use Rhopressa. You may need to change your medication or stop it all together. Continue to follow up with your healthcare provider to ensure your success with the treatment of your disease.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Rhopressa label.

  2. Khouri AS, Serle JB, Bacharach J, et al. Once-daily netarsudil versus twice-daily timolol in patients with elevated intraocular pressure: the randomized phase 3 ROCKET-4 Study. Am J Ophthalmol. 2019;204:97-104. doi:10.1016/j.ajo.2019.03.002.