Medical treatments and practices. What should be done when a prostaglandin proves ineffective?

Prostaglandin analogs are very frequently used as first-line therapy in the treatment of glaucoma. In some cases, they may be ineffective or insufficient or they may induce side effects. The absence of an ocular pressure-lowering effect of a prostaglandin is in general a class effect. Thus a switch to another prostaglandin will probably not be more effective. In such cases, it may be better to use another therapeutic class. On the other hand, the side effects of prostaglandin are more often directly related to the chemical structure of the drug used and may not occur with another prostaglandin. Consequently, considering the dramatic effect of prostaglandin on ocular pressure compared to other drugs, when one prostaglandin causes side effects, it may be useful to try another one before changing the drug family.