Once-daily (p.m.) netarsudil ophthalmic solution 0.02% (Rhopressa) is approved 
in the United States for lowering elevated intraocular pressure (IOP) in 
patients with open-angle glaucoma or ocular hypertension. Netarsudil, a Rho 
kinase (ROCK) inhibitor that lowers IOP primarily by increasing trabecular 
outflow, produces statistically and clinically significant reductions in mean 
IOP from baseline, with comparable effects on nocturnal and diurnal IOP. In 
three phase III trials of patients with elevated IOP, the ocular hypotensive 
efficacy of once-daily netarsudil 0.02% met the criteria for noninferiority to 
twice-daily timolol 0.5% at all time points over 3 months in patients with 
baseline IOP less than 25 mmHg. The most frequent adverse event (AE) was 
generally mild conjunctival hyperemia, the severity of which did not increase 
with continued dosing. Netarsudil was associated with minimal treatment-related 
serious or systemic AEs, likely due to the lack of systemic exposure. This 
report summarizes the available preclinical and clinical data on netarsudil.