Travoprost is a prostaglandin F2 alpha (FP) receptor agonist that lowers the intraocular pressure in patients with ocular hypertension and open-angle glaucoma.

Travoprost Uses:

• Elevated intraocular pressure:

  • It is used to reduce intraocular pressure in patients 16 years of age or older with open-angle glaucoma or ocular hypertension

Travoprost Dose in Adults

Travoprost Dose in the treatment of  Elevated intraocular pressure:

• Ophthalmic: Instill one drop into the affected eye(s) once a day in the evening.
• Do not exceed once-daily dosing (as it may decrease the IOP-lowering effect).

Travoprost Dose in Childrens

Travoprost Dose in the treatment of Elevated intraocular pressure: Ophthalmic:

• Children and Adolescents: Limited data available:

  • 1 drop is instilled into the affected eye(s) once a day in the evening.
  • Note: Avoid exceeding once-daily dosing (frequent dosing may decrease the IOP-lowering effect of the drug).

Pregnancy Risk Factor C

• In animal reproduction studies, systemic administration has led to adverse outcomes for fetuses.
• It has been labeled as contraindicated during pregnancy by the Canadian Labeling.
• To minimize systemic absorption, and fetal exposure, it should only be administered in the lowest possible dose. Punctal occlusion is recommended.

Use during breastfeeding:

• It is unknown if the drug is excreted from breastmilk.
• It is recommended that you use it with caution if you are breastfeeding.

Dose in Kidney Disease:

• There are no dosage adjustments provided in the manufacturer's labeling.
• Dosage adjustments are unlikely due to minimal systemic absorption.

Dose in Liver disease:

• There are no dosage adjustments provided in the manufacturer's labeling.
• Dosage adjustments are unlikely due to minimal systemic absorption.

Common Side Effects of Travoprost:

• Ophthalmic:

  • Ocular hyperemia

Less Common Side Effects of Travoprost:

• Cardiovascular:

  • Angina Pectoris
  • Bradycardia
  • Chest Pain
  • Hypertension
  • Hypotension

• Central Nervous System:

  • Foreign Body Sensation Of Eye
  • Anxiety
  • Depression
  • Headache
  • Pain

• Dermatologic:

  • Hyperpigmentation Of Eyelashes
  • Increased Growth In Number Of Eyelashes

• Endocrine & Metabolic:

  • Hypercholesterolemia

• Gastrointestinal:

  • Dyspepsia
  • Gastrointestinal Distress

• Genitourinary:

  • Prostatic Disease
  • Urinary Incontinence
  • Urinary Tract Infection

• Hypersensitivity:

  • Hypersensitivity Reaction

• Infection:

  • Infection

• Neuromuscular & Skeletal:

  • Arthritis
  • Back Pain

• Ophthalmic:

  • Decreased Visual Acuity
  • Eye Discomfort
  • Eye Pain
  • Eye Pruritus
  • Blepharitis
  • Blurred Vision
  • Cataract
  • Conjunctivitis
  • Corneal Staining
  • Crusting Of Eyelid
  • Dry Eye Syndrome
  • Hyperpigmentation Of Eyelids
  • Iris Discoloration
  • Keratitis
  • Lacrimation
  • Ophthalmic Inflammation
  • Photophobia
  • Subconjunctival Hemorrhage
  • Visual Disturbance
  • Increased Eyelash Length
  • Increased Eyelash Thickness

• Respiratory:

  • Bronchitis
  • Flu-Like Symptoms
  • Sinusitis

Contraindications to Travoprost:

The manufacturer's labeling does not contain any contraindications. Canadian labeling: Additional contraindications not in US labeling

• Allergy to travoprost, or any component of its formulation
• Women who want to conceive or pregnant.

Warnings and precautions

• Bacterial Keratitis

  • Bacterial contamination can lead to bacterial keratitis. It is important that patients avoid touching the tip or any surrounding surfaces.

• Ocular effects

  • It can permanently increase or cause brown pigmentation in the eyelid skin, iris, and eyelashes. It can also increase the number and thickness of the eyelashes. The slow process can take several months or years and patients may not notice any changes.
  • The long-term effects of the drug on the eyes are unknown.

• Ocular disease:

  • It should be used with caution for patients with an existing ocular inflammation condition such as uveitis, pseudophakia with torn posterior lenses, and those at high risk of developing macular degeneration.
  • Patients with angle-closure, inflammatory, and neovascular Glaucoma have not been able to determine the drug's safety or efficacy.

Travoprost: Drug Interaction

Monitoring parameters:

None mentioned. Monitor intraocular pressure and visual acuity at regular intervals.

How to administer Travoprost?

• It may be used with other ophthalmic medications and eye drops to lower intraocular pressure.
• However, if used with other medications, the application of the two medicines should be spaced by at least five minutes.
• Patients should be asked to remove contact lenses and wait for at least 15 minutes after the instillation of the drops before reinserting.
• Bacterial contamination should be avoided by not touching the tip of the dropper with the eyes or with the surrounding surfaces. After administering the drops, keep the bottle tightly closed.

Mechanism of action of Travoprost:

It lowers intraocular pressure by increasing trabecular meshwork, outflow of aqueous and other physiological functions.

The beginning of action:

• It takes approximately 2 hours

Peak effect:

• 12 hours

Absorption:

• It gets absorbed through the cornea;
• plasma levels <10 pg/mL within one hour

Metabolism:

• It is hydrolyzed to the active free acid by corneal esterases.
• The free acid is then metabolized into inactive metabolites in the blood.

Half-life elimination:

• 45 minutes (range: 17 to 86 minutes)

International Brand Names of Travoprost:

• Travatan Z
• APO-Travoprost Z
• Izba
• SANDOZ Travoprost
• TEVA-Travoprost Z
• Avatan
• Avost
• Avro
• Fredomat
• Izba
• Tekliva
• Trapost
• Travatan
• Travatanz
• Travotan
• Vizitrav

Travoprost Brand Names in Pakistan: