Netarsudil ophthalmic solution is a novel topical intraocular pressure 
(IOP)-lowering agent that has recently been approved by the US Food and Drug 
Administration (FDA) for the treatment of ocular hypertension and open-angle 
glaucoma. Its unique pharmacology allows for IOP lowering as a result of direct 
reduction in trabecular outflow resistance in addition to a decrease in 
episcleral venous pressure and aqueous humor production. The efficacy of 
netarsudil has been shown in animal studies and human clinical trials. It has 
been shown to be noninferior to the therapy with topical timolol in individuals 
with baseline IOP <25 mmHg. Importantly, netarsudil has been shown to reduce IOP 
to the same degree, regardless of baseline levels. There are no known systemic 
safety issues associated with netarsudil. The most common local adverse effects 
relate to conjunctival hyperemia. The once-daily dosing schedule is advantageous 
for individuals who have difficulties with medication adherence. Further studies 
of a combination of netarsudil and latanoprost agents are currently underway.