Travoprost

Travoprost is a prescription eye (ophthalmic) solution used to reduce elevated intraocular pressure. Intraocular pressure is the pressure exerted on the retina and cornea by the fluid in the eye. This fluid is called aqueous humor and is different than tears. Elevated intraocular pressure is a characteristic of an eye disease called glaucoma. Travoprost belongs to a family of medications called prostaglandin analogs, which mimic the action of prostaglandins. Travoprost is marketed under the name Travatan by Alcon Labs. The Food and Drug Administration approved its use on March 16, 2001.

Prostaglandin analogs, like travoprost, reduce the pressure in the eye by enhancing outflow of fluid through either the meshwork and the sclera. Source: Wikimedia Commons

Uses

Travoprost is used to reduce elevated intraocular pressure for people in whom other medications are either ineffective or produce intolerable side effects. It is used to treat two conditions that are characterized by high intraocular pressure:

• open-angle glaucoma (accumulation of fluid in the eye caused by either a blockage that reduces fluid outflow, or overproduction of aqueous humor)
• ocular hypertension (which occurs when the pressure in the eye exceeds 21 mm Hg)

How Travoprost is Taken

Travoprost is available in a 7.5 ml bottle at a concentration of 0.04 mg/ml. The recommended dose is one drop in the affected eye(s) once daily at night. The effectiveness of travoprost may be reduced if it is taken more than once a day.

How Travoprost Works

Travoprost belongs to a family of drugs called prostaglandin analogs. All drugs in this family increase aqueous humor outflow from the inside of the eye. As the fluid leaves the compartment between the cornea and retina, the pressure in the eye decreases. The diagram below shows the two mechanisms by which these drugs reduce intraocular pressure.

How the Body Affects Travoprost

Travoprost is absorbed through the cornea. In the cornea, it is changed into an active form. Very little travoprost enters the circulation. The drug that does enter the circulation is eliminated very quickly. The concentration of drug in the blood is reduced by half in approximately 45 minutes, and within one hour no drug can be detected.

Side Effects

The most common side effect observed in clinical studies with travoprost was an increase in the amount of blood in the eye (ocular hyperemia). This was reported in 35%–50% of patients. Other side effects that were reported at an incidence of 1% to 10% include the following:

• decreased vision
• eye pain or discomfort
• foreign body sensation
• itching
• blurred or other abnormal vision
• eyelid inflammation/crusting
• cataract
• red and sore eye (“pink eye”)
• dry eye
• flaring
• iris discoloration
• inflammation of the cornea
• sensitivity to light
• burst blood vessels
• excessive tearing

Risks and Precautions

Travoprost can change the color of the iris, eyelid, eyelashes, or other parts of the eye. It may also increase eyelash growth. These changes may be permanent.

Travatan contains a preservative that can be absorbed by contact lenses. Removing contact lenses during drug administration reduces the risk of the drug accumulating in the lenses. After 15 minutes, the lenses are unlikely to absorb Travatan.

Drug Interactions

Because very little travoprost enters the bloodstream, interactions with drugs that are taken by mouth are very unlikely.

Alternatives

Other prostaglandin analogs used to treat elevated intraocular pressure are bimatoprost (Lumigan) and latanoprost (Xalatan). They all have similar mechanisms of action. Other treatment approaches to reducing intraocular pressure include the following:

• beta blocker eye drops (e.g., timolol)
• acetazolamide (Diamox), a diuretic taken by mouth
• surgery (e.g., trabeculectomy)

Development

Prostaglandins are made in the body from molecules called arachidonic acid. They cause the pain associated with inflammation, help prevent stomach ulcers, and regulate blood vessel constriction. In the eye, prostaglandins cause blood vessels to widen and become leakier, as well as facilitate outflow of aqueous humor. Prostaglandin analogs like travoprost were developed based on the structure of the natural prostaglandins.

Clinical Trials

In clinical studies of patients with open-angle glaucoma or ocular hypertension, travoprost reduced intraocular pressure by 7 mm HG to 8 mm Hg.^[1]

References

1. ↑ DailyMed Web site. Travatan travoprost ophthalmic solution 0.004%Sterile

External Links

FDA: Patient Information Sheet

International Glaucoma Association