Elevated intraocular pressure (IOP): Ophthalmic: Infants ≥2 months, Children, and Adolescents: Limited data available: 1 drop into affected eye(s) once daily in the evening (Dixon 2017; Yanovitch 2008). Note: Do not exceed once-daily dosing (may decrease IOP-lowering effect).
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustments are unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustments are unlikely due to low systemic absorption.
(For additional information see "Travoprost: Drug information")
Ocular hypertension/glaucoma (open-angle): Ophthalmic: Instill 1 drop into affected eye(s) once daily in the evening; do not exceed once-daily dosing (may decrease intraocular pressure-lowering effect).
There are no dosage adjustments provided in the manufacturer's labeling; dosage adjustments are unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; dosage adjustments are unlikely due to low systemic absorption.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Ophthalmic:
Travatan Z: 0.004% (2.5 mL, 5 mL) [contains propylene glycol]
Travatan Z: 0.004% (2.5 mL [DSC], 5 mL [DSC]) [benzalkonium free; contains cremophor el, propylene glycol]
Generic: 0.004% (2.5 mL, 5 mL)
Yes
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Izba: 0.003% (2.5 mL, 5 mL) [contains propylene glycol]
Travatan Z: 0.004% (2.5 mL, 5 mL) [contains propylene glycol]
Generic: 0.004% (2.5 mL, 5 mL)
For ophthalmic use only. Travoprost may be used with other eye drops to lower intraocular pressure. If using more than one ophthalmic product, wait at least 5 minutes in between application of each medication. Apply gentle pressure to lacrimal sac immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration to decrease systemic absorption of ophthalmic drops (Urtti 1993; Zimmerman 1984). Remove contact lenses prior to administration and wait 15 minutes (after administration) before reinserting. Avoid contact of bottle tip with skin or eye; ocular solutions can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may occur from using contaminated solutions
Ophthalmic: May be used with other eye drops to lower intraocular pressure. If using more than one ophthalmic product, wait at least 5 minutes in between application of each medication. Remove contact lenses prior to administration and wait 15 minutes (after administration) before reinserting. Minimize contamination by not touching the eyelids or surrounding areas with the dropper tip; keep bottle tightly closed when not in use. Use eyelid closure or nasolacrimal occlusion when applying topical medications to reduce systemic absorption.
Store between 2°C and 25°C (36°F and 77°F).
Reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension (FDA approved in ages ≥16 years and adults).
Travatan may be confused with Xalatan
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%: Ophthalmic: Ocular hyperemia (30% to 50%)
1% to 10%:
Cardiovascular: Angina pectoris (1% to 5%), bradycardia (1% to 5%), chest pain (1% to 5%), hypertension (1% to 5%), hypotension (1% to 5%)
Central nervous system: Foreign body sensation of eye (5% to 10%), anxiety (1% to 5%), depression (1% to 5%), headache (1% to 5%), pain (1% to 5%)
Dermatologic: Hyperpigmentation of eyelashes, increased growth in number of eyelashes
Endocrine & metabolic: Hypercholesterolemia (1% to 5%)
Gastrointestinal: Dyspepsia (1% to 5%), gastrointestinal distress (1% to 5%)
Genitourinary: Prostatic disease (1% to 5%), urinary incontinence (1% to 5%), urinary tract infection (1% to 5%)
Hypersensitivity: Hypersensitivity reaction (1% to 5%)
Infection: Infection (1% to 5%)
Neuromuscular & skeletal: Arthritis (1% to 5%), back pain (1% to 5%)
Ophthalmic: Decreased visual acuity (5% to 10%), eye discomfort (5% to 10%), eye pain (5% to 10%), eye pruritus (5% to 10%), blepharitis (1% to 4%), blurred vision (1% to 4%), cataract (1% to 4%), conjunctivitis (1% to 4%), corneal staining (1% to 4%), crusting of eyelid (1% to 4%), dry eye syndrome (1% to 4%), hyperpigmentation of eyelids (periorbital; 1% to 4%), iris discoloration (1% to 4%), keratitis (1% to 4%), lacrimation (1% to 4%), ophthalmic inflammation (1% to 4%), photophobia (1% to 4%), subconjunctival hemorrhage (1% to 4%), visual disturbance (1% to 4%), increased eyelash length, increased eyelash thickness
Respiratory: Bronchitis (1% to 5%), flu-like symptoms (1% to 5%), sinusitis (1% to 5%)
<1%, postmarketing, and/or case reports: Abdominal pain, arthralgia, asthma, bacterial keratitis (due to solution contamination), cardiac arrhythmia, chest discomfort, corneal edema, cystoid macular edema, diarrhea, dyspnea, dysuria, enophthalmos, epistaxis, erythema of skin, insomnia, iritis, macular edema, musculoskeletal pain, nausea, prostate specific antigen increase, pruritus, tachycardia, tinnitus, uveitis, vomiting
There are no contraindications listed in the US manufacturer’s labeling.
Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to travoprost or any component of the formulation; pregnancy or women attempting to become pregnant.
Concerns related to adverse effects:
• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.
• Eye color changes: May change/increase brown pigmentation of the iris, the eyelid skin, and eyelashes; length and/or number of eyelashes may also be increased. Pigmentation of the iris is likely to be permanent although iris color change may not be noticeable for months to years; pigmentation of the periorbital tissue and eyelash changes may be reversible following discontinuation of therapy. Long-term consequences and potential injury to eye are not known.
• Ocular inflammation: Intraocular inflammation and exacerbation of inflammation may occur; use with caution in patients with a history of intraocular inflammation (eg, iritis/uveitis) and generally avoid use in patients with active intraocular inflammation.
Disease-related concerns:
• Aphakia or pseudoaphakia: Topical prostaglandin analogues have been associated with the occurrence/exacerbation of macular edema. Carefully examine the macula in these patients especially those with an open posterior capsule.
• Herpetic keratitis: Use with caution in patients with a history of herpes simplex keratitis; reactivation may occur. Avoid use in patients with active herpes simplex keratitis.
• Uveitis: Use cautiously in patients with intraocular inflammation as topical prostaglandins may worsen inflammation.
Special populations:
• Contact lens wearers: Remove contact lens prior to instillation; may reinsert 15 minutes following administration.
• Pediatric: Use in pediatric patients (<16 years of age) is not recommended by the manufacturer due to possible safety issues of increased pigmentation following long-term chronic use.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program
Nonsteroidal Anti-Inflammatory Agents: May diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents may also enhance the therapeutic effects of Prostaglandins (Ophthalmic). Risk C: Monitor therapy
Nonsteroidal Anti-Inflammatory Agents (Ophthalmic): May diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents (Ophthalmic) may enhance the therapeutic effect of Prostaglandins (Ophthalmic). Risk C: Monitor therapy
Ophthalmic prostaglandins, such as travoprost, have a theoretical risk of miscarriage. To decrease this risk, agents other than travoprost may be preferred for the treatment of glaucoma in patients planning to become pregnant (Strelow 2020).
Ophthalmic prostaglandins, such as travoprost, are generally avoided during pregnancy due to a theoretical risk of miscarriage and premature labor. Agents other than travoprost may be preferred for the treatment of glaucoma during pregnancy, especially during the first trimester. In general, if ophthalmic agents are needed in pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease exposure to the fetus (Belkin 2020; Prum 2016; Strelow 2020).
A selective FP prostanoid receptor agonist which lowers intraocular pressure by increasing trabecular meshwork and outflow
Onset of action: ~2 hours.
Peak effect: 12 hours.
Absorption: Absorbed via cornea; plasma levels <10 pg/mL within 1 hour.
Metabolism: Hydrolyzed by esterases in the cornea to active free acid; systemically; the free acid is metabolized to inactive metabolites.
Half-life elimination: 45 minutes (range: 17 to 86 minutes).
Excretion: Urine (<2% as metabolites).
Race/ethnicity: The intraocular pressure (IOP)-lowering effect of travoprost was shown to be 7 to 8 mm Hg among patients with a baseline pressure of 25 to 27 mm Hg in clinical studies. The mean IOP reduction was up to 1.8 mm Hg greater in Black patients, although it is not known if this increase can be attributed to race or to heavily pigmented irides.
Solution (Travatan Z Ophthalmic)
0.004% (per mL): $97.77
Solution (Travoprost (BAK Free) Ophthalmic)
0.004% (per mL): $79.34 - $83.84
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