Travatan Z (travoprost)

The recommended adult dosage of travoprost for the treatment of open-angle glaucoma or ocular hypertension is 1 drop of a 0.004% ophthalmic solution in the affected eye(s) once daily in the evening. Travoprost 0.004% ophthalmic solution should not be administered more frequently than once daily since more frequent dosing may paradoxically diminish the intraocular pressure (IOP)-lowering effect of the drug.

If the target IOP is not achieved, alternative or additional ocular hypotensive agents may be required. (See Uses: Ocular Hypertension and Glaucoma.)

No dosing information is available for this tab.

No interactions with travoprost are currently known.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

Moderate Interaction: Assess the risk to the patient and take action as needed.

Iop-Lowering Prostaglandin Analogs/Bimatoprost Topical

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: When used ophthalmically to lower intraocular pressure, prostaglandin analogs may be at the top of the dose-response curve. Use of an additional prostaglandin may result in decreased effectiveness.(1)

CLINICAL EFFECTS: Concurrent use of topical bimatoprost may result in decreased effectiveness of ophthalmic prostaglandin analogs and an increase in intraocular pressure.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: Patients using ophthalmic prostaglandin analogs to lower intraocular pressure should be monitored for changes in their intraocular pressure.(1) Use of topical bimatoprost may need to be discontinued in patients who stop responding to their ophthalmic prostaglandin analogue.

DISCUSSION: Studies have shown that the ophthalmic administration of bimatoprost twice daily is less effective at lowering intraocular pressure than ophthalmic bimatoprost administered once daily. Concurrent use of topical bimatoprost may decrease the effectiveness of ophthalmic prostaglandin analogs.(1)

The manufacturer states there are no known contraindications to the use of travoprost.

There are no contraindication contraindications for this drug.

• Cystoid macular edema
• Iritis
• Uveitis

There are no moderate contraindications for this drug.

Ocular hyperemia occurred in approximately 30-50% of patients who received travoprost ophthalmic solution in clinical trials. Up to 3% of patients discontinued therapy because of conjunctival hyperemia. Decreased visual acuity, ocular discomfort, foreign body sensation, pain, and pruritus have been reported in approximately 5-10% of patients who received travoprost ophthalmic solution in clinical trials. Adverse ocular effects reported in approximately 1-4% of patients include abnormal vision, blepharitis, blurred vision, cataract, conjunctivitis, corneal staining, dry eye, iris discoloration, keratitis, lid margin crusting, ocular inflammation, photophobia, subconjunctival hemorrhage, and tearing.

Adverse nonocular events reported in approximately 1-5% of patients include allergy, angina pectoris, anxiety, arthritis, back pain, bradycardia, bronchitis, chest pain, cold/flu syndrome, depression, dyspepsia, GI disorder, headache, hypercholesterolemia, hypertension, hypotension, infection, pain, prostate disorder, sinusitis, urinary incontinence, and urinary tract infection.

Less Frequent

• Angina
• Bradycardia
• Cataracts
• Hypercholesterolemia
• Hypertension
• Hypotension
• Infection
• Keratitis
• Subconjunctival hemorrhage
• Urinary incontinence

Rare or Very Rare

• Cardiac arrhythmia
• Cystoid macular edema

More Frequent

• Conjunctival hyperemia
• Foreign body sensation of eye
• Ocular discomfort
• Ocular irritation
• Ocular itching
• Ocular pain
• Reduced visual acuity

Less Frequent

• Arthritis
• Back pain
• Blepharitis
• Blurred vision
• Bronchitis
• Conjunctivitis
• Depression
• Dry eye
• Dyspepsia
• Eye tearing
• Eyelid crusting
• Headache disorder
• Photophobia
• Sinusitis
• Symptoms of anxiety
• Visual changes

Rare or Very Rare

• Deepening of upper eyelid sulcus
• Epistaxis
• Hyperpigmentation of eyelid
• Hypertrichosis of eyelid eyelashes
• Hypertrichosis of eyelid vellus hair
• Insomnia
• Iris hyperpigmentation
• Tachycardia
• Vomiting

No enhanced messaging available.

Use of travoprost ophthalmic solution in pediatric patients younger than 16 years of age is not recommended because of potential safety concerns related to increased pigmentation following long-term use. (See Pigmentation under Cautions: Warnings/Precautions.)

Category C. (See Users Guide.)

Teratogenic effects, including skeletal, external, and visceral malformations, were observed in rats receiving IV travoprost at dosages up to 250 times the maximum recommended human ocular dosage but not following IV administration in rats or following subcutaneous administration in mice at dosages up to 75 or 25 times, respectively, the maximum recommended human ocular dosage. Increased postimplantation losses and decreased fetal viability were observed in rats and mice at dosages exceeding 75 and 7.5 times, respectively, the maximum recommended human ocular dosage. Increased postnatal mortality, decreased neonatal body weight gain, and adverse effects on neonatal development also have been observed in animal studies.

There are no adequate and well-controlled studies using travoprost ophthalmic solution in pregnant women. Travoprost ophthalmic solution should be used during pregnancy only if the potential benefits justify the potential risk to the fetus.

Travoprost and/or its metabolites are distributed into milk in rats; it is not known whether travoprost and/or its metabolites are distributed into human milk. Caution is advised when travoprost ophthalmic solution is used in nursing women.

No overall differences in safety and efficacy of travoprost ophthalmic solution have been observed between geriatric patients and younger adults.