Travoprost

Pronunciation: (tra-voe-prost)
Class: Prostaglandin agonist

Trade Names

Travatan Z
- Solution, ophthalmic 0.004%

Pharmacology

May reduce IOP by increasing trabecular meshwork and uveoscleral outflow.

Pharmacokinetics

Absorption

C _max range is 0.01 to 0.052 ng/mL and T _max is 30 min.

Metabolism

Hydrolyzed by esterases in the correa to its biologically active free acid. Systemically, travoprost free acid is metabolized to inactive metabolites via beta-oxidation.

Elimination

Plasma half-life is 45 min. Less than 2% is excreted in the urine within 4 h as the free acid.

Special Populations

Renal Function Impairment

No data available.

Hepatic Function Impairment

No data available.

Indications and Usage

Reduction of IOP in patients with open-angle glaucoma or ocular hypertension who are intolerant of other IOP-lowering agents or insufficiently responsive to other IOP-lowering medications.

Contraindications

None well documented.

Dosage and Administration

Adults

Ophthalmic Instill 1 drop in affected eye(s) in evening. May be used with other ophthalmic drug products to lower IOP.

Storage/Stability

Store between 36° and 77°F.

Drug Interactions

None well documented.

Adverse Reactions

Cardiovascular

Angina pectoris, bradycardia, chest pain, hypertension, hypotension (1% to 5%).

CNS

Anxiety, depression, headache (1% to 5%).

EENT

Ocular hyperemia (30% to 50%); decreased visual acuity, eye discomfort, foreign body sensation, pain, pruritus (5% to 10%); abnormal vision, blepharitis, blurred vision, cataract, conjunctivitis, corneal staining, dry eye, eye disorder, flare, iris discoloration, keratitis, lid margin crusting, photophobia, subconjunctival hemorrhage, subconjunctival hyperemia, tearing (1% to 4%).

GI

Dyspepsia; GI disorder.

Genitourinary

Prostate disorder; urinary incontinence; UTI.

Respiratory

Bronchitis, sinusitis (1% to 5%).

Miscellaneous

Accidental injury, allergy, arthritis, back pain, cold/flu syndrome, hypercholesterolemia, infection, pain (1% to 5%).

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Bacterial keratitis

Bacterial keratitis has been reported with multiple-dose containers as a result of patient contamination.

Contact lenses

Remove contact lenses prior to and 15 min following administration.

Intraocular inflammation

Use with caution in patients with iritis/uveitis. Do not use in patients with active intraocular infection.

Macular edema

May occur in aphakic patients, pseudophakic patients with a risk of torn posterior lens capsule, or in patients with risk factors for macular edema; use with caution in these patients.

Pigmentation changes

Permanent changes to pigmented tissue may occur, most frequently involving pigmentation of the iris and eyelid and increased pigmentation and growth of eyelashes. Gradual change in eye color (ie, increased amount of brown pigmentation in the iris) may occur.

Patient Information

• Warn patient to not instill more often than once a day in the evening. More frequent use may decrease effectiveness of the medication.
• Teach patient proper technique for instilling eye drops. Wash hands; do not allow dropper to touch eye. Tilt head back, look up; pull lower eyelid down; instill drop. Close eye for 1 to 2 min and apply gentle pressure to bridge of nose. Do not rub eye.
• Advise patients who wear contact lenses to remove lenses before instilling this medicine and to wait at least 15 min after instilling eye drop before inserting lenses.
• Advise patient that if more than 1 topical ophthalmic drug is being used, administer the drugs at least 5 min apart.
• Inform patient that this medication may cause a gradual increase in brown pigment in the pupil, which may slowly change eye color.
• Inform patient that this medication may also cause eyelid skin darkening and increases in length, thickness, color, and number of eyelashes.
• Advise patient to contact eye doctor if eye or eyelid inflammation is noted, if eye is injured, or if having surgery on the eye.
• Remind patient that eye examinations and measurement of IOP are necessary while using this medication; advise patient to keep appointments.

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