What type of drug is Netarsudil (Rhopressa) and what is its effect on aqueous humor?

Netarsudil, marketed as Rhopressa, is a Rho kinase inhibitor that primarily functions to increase the outflow of aqueous humor. This mechanism is particularly significant in managing conditions such as glaucoma and ocular hypertension. By inhibiting Rho kinase, Netarsudil promotes relaxation of the trabecular meshwork, which is the primary drainage pathway for aqueous humor in the eye. This improved outflow reduces intraocular pressure, which is critical in the treatment of glaucoma.

The effectiveness of Netarsudil stands in contrast to other types of medications for glaucoma. For instance, cholinergic agents typically work through a different mechanism, and carbonic anhydrase inhibitors decrease the production of aqueous humor rather than enhancing its outflow. Prostaglandin analogs have a different action that may involve increasing outflow via the uveoscleral pathway but do not relate directly to the Rho kinase inhibition that defines Netarsudil’s pharmacological class. Thus, describing Netarsudil as a Rho kinase inhibitor with increased outflow accurately captures its purpose and function in therapeutic settings.