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 Adult

Travoprost Dose in the treatment of  Elevated intraocular pressure:

• You put one drop of the medicine into the affected eye once every evening.
• It's important to stick to this schedule and not use it more than once a day because using it more often might make it less effective at lowering eye pressure.

Travoprost Dose in Children

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

• For kids and teenagers, there isn't a lot of information available, but generally, they can use Travoprost the same way adults do. That means putting one drop into the affected eye once a day in the evening. Just like with adults, it's important not to use it more than once a day because using it more often might make it less effective at lowering eye pressure.

Pregnancy Risk Factor C

• Travoprost is rated as Pregnancy Risk Factor C, meaning there have been adverse effects seen in animal studies when the medication is taken by mouth or injected.
• If pregnant individuals need to use eye drops like travoprost, doctors typically recommend using the lowest effective dose possible.
• They might also suggest using a method called punctual occlusion to reduce the amount of medicine that gets absorbed into the bloodstream, potentially lowering the risk to the developing baby.

Use during breastfeeding:

• It's uncertain whether travoprost passes into breast milk.
• Because of this uncertainty, the manufacturer suggests being cautious when giving travoprost to breastfeeding mothers.
• This caution is important to ensure the safety of both the nursing mother and her baby.

Dose in Kidney Disease:

• The manufacturer's instructions don't include any specific changes in dosage for people with kidney problems.
• This is because travoprost is mainly used as eye drops, so it's not absorbed much into the bloodstream, reducing the likelihood of affecting the kidneys.
• Therefore, dosage adjustments aren't usually needed for individuals with kidney issues.

Dose in Liver disease:

• The manufacturer's instructions don't mention any changes in dosage for people with liver problems.
• This is because travoprost is primarily used as eye drops, so it doesn't get absorbed much into the bloodstream, which means it's unlikely to affect the liver.
• Therefore, adjustments to the dosage are usually unnecessary for individuals with liver impairment.

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:

• In the manufacturer's labeling, there aren't any listed conditions where travoprost should not be used.
• However, in Canada, there are additional contraindications not mentioned in the US labeling.
• These include hypersensitivity (severe allergic reaction) to travoprost or any ingredient in the formulation, as well as pregnancy or women trying to conceive.

Warnings and precautions

Bacterial Keratitis

• Bacterial keratitis, an infection of the cornea caused by bacteria, has been linked to accidental contamination of multi-dose ophthalmic (eye) solutions.
• This contamination can occur when bacteria enter the solution, leading to a risk of infection when the contaminated solution is applied to the eye.

Ocular effects

• Travoprost, like other medications in its class, can lead to permanent changes in the color of the iris (the colored part of the eye), as well as the skin of the eyelids and the eyelashes.
• These changes typically involve an increase in brown pigmentation.
• Additionally, it may cause eyelashes to become longer, thicker, or more numerous, and these changes can vary between eyes.
• It's important to note that these changes happen gradually over time and may not be noticeable for months or even years.

Ocular disease:

• When it comes to certain eye conditions, it's important to be cautious when using travoprost.
• For instance, if a patient has intraocular inflammation like uveitis, or if they've had cataract surgery and don't have a natural lens (aphakic) or have a torn capsule behind their artificial lens (pseudophakic), travoprost should be used carefully.
• Also, for patients with risk factors for macular edema (swelling in the central part of the retina), caution is advised.
• It's worth noting that the safety and effectiveness of travoprost haven't been confirmed for patients with certain types of glaucoma, such as angle-closure, inflammatory, or neovascular glaucoma.

Travoprost: Drug Interaction

Monitoring parameters:

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

How to administer Travoprost?

Using Travoprost with Other Eye Drops:

• Combining with Other Medications: Travoprost can be used along with other eye drops to reduce intraocular pressure.
• Wait Between Applications: If using more than one eye drop, wait at least 5 minutes between applying each medication.
• Remove Contact Lenses: Before using Travoprost, take out contact lenses. Wait for 15 minutes after applying before putting them back in.
• Prevent Contamination: To minimize the risk of contamination, avoid touching your eyelids or the area around your eyes with the tip of the dropper. Keep the bottle tightly closed when not in use.

Mechanism of action of Travoprost:

• Travoprost is a type of medicine that targets a specific receptor in the eye called the FP prostanoid receptor.
• By activating this receptor, it helps to lower the pressure inside the eye by increasing the drainage of fluid through a structure called the trabecular meshwork.
• This improved fluid outflow helps to reduce the pressure within the eye, which is important for managing conditions like glaucoma and ocular hypertension.

The beginning of action:

• It typically starts working around 2 hours after being applied to the eye.

Peak Effect:

• The highest effect is usually seen around 12 hours after application.

Absorption:

• Travoprost is absorbed through the cornea (the clear front part of the eye). Within an hour of applying it, the levels of the medication in the bloodstream are typically less than 10 picograms per milliliter (pg/mL).

Metabolism:

• In the cornea, Travoprost is broken down by enzymes called esterases, turning it into its active form. It's also metabolized in the body. The active form is eventually turned into inactive substances.

Elimination Half-life:

• Travoprost's elimination half-life, which is the time it takes for half of the medication to leave the body, is around 45 minutes on average, but it can range from 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: