Travoprost

Travoprost is a synthetic prostaglandin F analog, indicated for topical use to relieve high pressure in the eye arising from some medical conditions. We’ve listed more information about travoprost below.

Overview

Travoprost is a generic drug name and the active ingredient in drugs marketed in the U.S. under the brand names Izba, Travatan, and Travatan Z. The medication works by controlling fluid flow within the eye to maintain normal pressure. It relieves high pressure in the eye to help prevent blindness.

Travoprost has a molecular weight of 500.55g/mol and is clear oil - colorless to slightly yellow. It is quite insoluble in water, but highly soluble in methanol, acetonitrile, chloroform, and octanol.

Travoprost belongs to the drug class ophthalmic glaucoma agents. Travatan Z (travoprost), which is the latest formulation of Travatan, is FDA approved and received its first approval on September 21st, 2016.

In Travatan Z, the benzalkonium chloride preservative is replaced with the gentler ionic, buffered Sofzia. The disadvantage of the replaced chemical is that it can react with contact lenses.

Condition(s) treated

  • Open angle glaucoma
  • Ocular hypertension

Type of Medicine

  • Prostaglandin

Side Effects

Some unwanted effects could arise from the use of this medicine.

A healthcare professional should be notified immediately and use of travoprost discontinued if the following signs of allergic reactions are observed.

  • Breathing difficulties
  • Hives
  • Swelling of face, tongue, throat or lips

The following side effects should be considered severe. A doctor should be notified immediately, and use of travoprost discontinued immediately.

  • A discharge or oozing coming from the eye
  • Swelling, redness, itching or pain around the eye - these are a relatively common effect of travoprost
  • More sensitivity to light
  • Chest pain
  • Vision changes - this is not so common
  • Redness, itching or swelling of the eyelid - this is also commonly seen

Others which are less common but also require discontinuation of medication and notifying a medical practitioner, are the following.

  • Eye color changes
  • Burning, itching or dry eyes

Other side effects of travoprost are not critical and do not require immediate medical attention. As the patient's body adjusts to the medication, these effects go away. However, in cases where these symptoms become bothersome or refuse to go away, the advice of a doctor, nurse or pharmacist can be sought. The healthcare professionals can give tips on how to minimize or altogether prevent the unwanted effects.

Here are the more common of these less serious side effects:

  • The patient may feel like there is something in their eye.
  • Eye discomfort.

Less common symptoms of these not so serious side effects include the following:

  • Blood in urine
  • Sour or acid stomach (indigestion or heartburn)
  • Dry eyes or having a discharge from the eye or excessive tearing
  • Lightheadedness or feeling faint when rising from a sitting or lying position
  • Losing bladder control
  • Pain in the lower back
  • Muscles may become stiff or painful
  • Swelling, pain or redness in the joints
  • Pelvic pain
  • Burning or pain when urinating

Others that may be checked out by your doctor include the following:

  • Hypertension
  • Hypotension
  • Bradycardia
  • Palpitations
  • Decreased heart rate and diastolic blood pressure
  • Increased systolic blood pressure
  • Tachycardia
  • Reactivated peptic ulcer
  • Diarrhea
  • Nausea
  • Dry mouth
  • Constipation
  • Urinary tract infection
  • Arthritis
  • Shoulder pain
  • A headache and dizziness
  • Bronchitis
  • Vertigo
  • Tinnitus
  • Cold/flu syndrome
  • Sinusitis
  • Asthma
  • Nasal congestion
  • Throat irritation
  • Malaise
  • Anxiety
  • Depression
  • Hypercholesterolemia

Dosage

The recommended dosage is one drop to the affected eye once a day in the evening.

Travoprost ophthalmic solution should not be administered more than once in a day as increasing the frequency of application of prostaglandin analogs lowers their effect of reducing intraocular pressure.

After administration of travoprost solution, the intraocular pressure lowering effect begins in two hours and reaches a maximum in 12 hours.

A travoprost ophthalmic solution may be used concomitantly with other topical products to reduce intraocular pressure. However, administration of such solutions must be done at least 5 minutes apart and never at the same time.

The safety and efficacy of this drug have been proven for persons 16 years and under. There are no suggested dose adjustments for patients with renal and liver impairment or those undergoing dialysis.

An excess solution of travoprost ophthalmic that may overflow onto the skin should be wiped away to prevent the darkening of the skin that regularly contacts the solution.

The eyelids should be gently closed after administration of the drug. This may help reduce systemic absorption of the topically administered ophthalmic solution.

The medicine should be regularly used, at the same time each day and continued even if there are no symptoms. Most people with high pressure in the eyes show no signs.

Missed Dose

If a dose is missed, it should be used as soon as possible. However, if the missed treatment can only be taken close to the time of the next dose, it should not be considered. A double dose should never be taken to make up for a missed one.

Administration

Here is how to administer travoprost solution:

  • Hands should be washed thoroughly before using this solution.
  • The head should be tilted back such that the face looks upwards.
  • A finger should be used to pull down the lower eyelid to make a pouch.
  • The dropper with travoprost solution should be held directly over the eye, and a drop of medicine placed in the pouch.
  • The face should be averted downwards and the eyes gently closed for a minute or so.
  • A finger can then be placed near the nose at the corner of the eye, and gentle pressure applied. This will prevent the medicine from flowing out of the eye.
  • The patient should try not to blink or rub their eye.
  • Any overflowing solution should be blotted out from the eyelid.
  • The process should be repeated for the other eye if it is also to be administered with medicine.
  • The dropper should not be rinsed, but the cap should be replaced.
  • The tip of the dropper should not contact the eye, fingers, surrounding structures or any other surface to avoid contaminating the eye solution.
  • The travoprost solution should be used as advised by a physician.

Interactions

Travoprost has very few interactions that are clinically significant. It interacts with one drug (2 generic and brand names) and three diseases.

Travoprost has moderate interactions with the following medications:

  • Bimatoprost topical
  • Latisse (Bimatoprost topical)

It is implied that the interactions are moderately clinically significant and combinations are to be avoided or used only under exceptional circumstances.

Travoprost has the following disease interactions:

  • Macular Edema
  • Uveitis
  • Liver and renal disease

Warnings

Travoprost Pregnancy Warnings

Studies done on animals have shown teratogenic results. Well-controlled adequate studies on women are unavailable.

The AU TGA has listed it in pregnancy Category B3. These are drugs that can only be consumed by a partial number of women who can bear children as well as those already pregnant without an increase in the incidence of malformations and other indirect and direct deleterious effects on the fetus. Other animal studies reveal an increase in the frequency of fetal damage which would not necessarily be the case in humans.

U.S. FDA pregnancy category C: Studies on animals show an adverse effect on the fetus, but there are no well-controlled and adequate studies on pregnant women. Potential benefits of this drug to pregnant women may warrant use of the drug despite the likely risks.

Travoprost is contraindicated for use during pregnancy in Australia. In the U.S. and UK, use of the drug is allowed during pregnancy if the benefits to the woman outweigh the risks to the fetus.

Women who are trying to get pregnant or are already pregnant should avoid direct exposure to travoprost solution.

Breastfeeding Warnings

There is no information on if this drug is passed into human milk, but it is passed into animal milk. Use of this medication during breastfeeding should be avoided unless there are no other alternatives. The effects it would have on a nursing infant are unknown.

Other warnings

  1. A doctor should be informed if a patient using this medication has an eye injury or infection or plans to have eye surgery.
  2. The drug may cause iris, eyelid, and eyelashes in a patient to turn brown. Eyelashes may also become thicker, longer and darker. The eyelid skin may also darken. Some of these changes observed may be irreversible, even after discontinuation of travoprost. Other changes may be reversible, and a doctor should inform the patient of what to expect.

Storage

  1. Travoprost should be stored in a refrigerator or at room temperature. Ideal temperatures are 36-77 degrees F (2-25 degrees C).
  2. It should not be stored in a moist place like in the bathroom.
  3. It should be kept away from children and pets.
  4. A pharmacist should advise on how to discard unwanted and expired drugs.
  5. Medications should never be flushed down the toilet or drain unless instructed to do so by a pharmacist.

Summary

Travoprost should be useful for indicated conditions. If a patient experiences worsening symptoms or no improvement after using this medicine, a doctor should be notified immediately. The patient should never attempt to increase the dose or decide on a course of action on their own.

Taking another person’s drugs should also not be done. Even if the drugs are indicated for the same conditions, a patient should never decide to use what they think works. Only a physician and other healthcare professionals have the expertise to consider all available information and prescribe medicine.

The doctor should similarly be informed of everything the patient is using such as other drugs including OTC medications, natural products, vitamins, and minerals. This is important to help the doctor determine any possible interactions. It should never be assumed that vitamins and natural products are safe to mix with any drug.

A patient can find out anything they need to know about a drug from the product information leaflet that comes with any drug package. The patient should also discuss issues and concerns about their medication with their pharmacist and healthcare provider.

The information contained here is not in any way meant to replace the advice of a healthcare provider. This information is a summary on travoprost and does not in any way endorse the drug as approved, effective or safe for any condition or patient. It should be used for general purposes only, as not all information about the drug is included here.

Resources
Last Reviewed:
December 22, 2017
Last Updated:
December 22, 2017
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