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Netarsudil is a small molecule pharmaceutical drug classified as a rho kinase inhibitor, primarily used to lower intraocular pressure in patients with open-angle glaucoma or ocular hypertension. Its mechanism of action involves inhibiting Rho-associated protein kinase 1 (ROCK1) and Rho-associated protein kinase 2 (ROCK2), which leads to relaxation of the trabecular meshwork, increased aqueous humor outflow through the conventional pathway, and reduced episcleral venous pressure. Netarsudil also inhibits the sodium-dependent noradrenaline transporter (NET), potentially reducing aqueous humor production by prolonging norepinephrine signaling. The drug was developed for topical ophthalmic use and is available as a 0.02% solution.
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