(TRA voe prost)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Travatan Z: 0.004% (2.5 mL, 5 mL) [benzalkonium free; contains cremophor el, propylene glycol]
Generic: 0.004% (2.5 mL, 5 mL)
Brand Names: U.S.
- Travatan Z
- Ophthalmic Agent, Antiglaucoma
- Prostaglandin, Ophthalmic
A selective FP prostanoid receptor agonist which lowers intraocular pressure by increasing trabecular meshwork and outflow
Absorbed via cornea; plasma levels <10 pg/mL within 1 hour
Hydrolyzed by esterases in the cornea to active free acid; systemically; the free acid is metabolized to inactive metabolites
Onset of Action
~2 hours; Peak effect: 12 hours
45 minutes (range:17-86 minutes)
Special Populations: Race
The IOP-lowering effect was shown to be 7-8 mm Hg in clinical studies. The mean IOP reduction in African-American patients was up to 1.8 mm Hg greater than in non-African-American patients. The reason for this effect is unknown.
Use: Labeled Indications
Elevated intraocular pressure: Reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension
There are no contraindications listed in the manufacturer’s U.S. product labeling.
Canadian labeling: Hypersensitivity to travoprost or any component of the formulation; pregnancy or women attempting to become pregnant
Elevated intraocular pressure:
U.S. labeling: Adolescents ≥16 years and Adults: Ophthalmic: Instill 1 drop into affected eye(s) once daily in the evening; do not exceed once-daily dosing (may decrease IOP-lowering effect).
Canadian labeling: Adults: Ophthalmic: Instill 1 drop into affected eye(s) once daily in the evening; do not exceed once-daily dosing (may decrease IOP-lowering effect).
Dosage adjustment in renal impairment: There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustments are unlikely due to low systemic absorption.
Dosage adjustment in hepatic impairment: There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustments are unlikely due to low systemic absorption.
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.
Store between 2°C and 25°C (36°F and 77°F).
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). Monitor therapy
>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%)
Postmarketing and/or case reports: Asthma, bacterial keratitis (due to solution contamination), corneal edema, cystoid macular edema, iritis, macular edema, tachycardia, uveitis
Concerns related to adverse effects:
• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.
• Ocular effects: May permanently change/increase brown pigmentation of the iris, the eyelid skin, and eyelashes. In addition, may increase the length, thickness, and/or number of eyelashes (may vary between eyes); changes occur slowly and may not be noticeable for months or years. Long-term consequences and potential injury to eye are not known.
• Ocular disease: Use with caution in patients with intraocular inflammation (eg, uveitis), aphakic patients, pseudophakic patients with a torn posterior lens capsule, or patients with risk factors for macular edema. Safety and efficacy have not been determined for use in patients with angle-closure-, inflammatory-, or neovascular glaucoma.
• 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 due to possible safety issues of increased pigmentation following long-term chronic use.
Pregnancy Risk Factor
Teratogenic effects were observed in animal studies following systemic administration. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctual occlusion to decrease potential exposure to the fetus (Samples, 1988).
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience foreign body sensation of eye or eyelash changes. Have patient report immediately to prescriber vision changes, ophthalmalgia, severe eye irritation, eye discharge, or eye discoloration (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.