Prostaglandin analogs are first-line for glaucoma, but a meaningful share of patients respond poorly or cannot tolerate them. Omlonti (omidenepag isopropyl) works through a different prostaglandin receptor.
Unlike FP-receptor prostaglandin analogs that act mainly on one route, Omlonti increases aqueous outflow through both the trabecular and uveoscleral pathways as the first selective EP2 receptor agonist approved. The once-daily drop reduces elevated intraocular pressure in open-angle glaucoma or ocular hypertension.
Omlonti is contraindicated in pseudophakic patients with a torn posterior lens capsule because of macular edema risk, and concomitant use with latanoprost is not recommended. Its non-FP mechanism positions it for prostaglandin non-responders, which defines its addressable niche.