travoprost: clinical use

Prescribing considerations

• Counsel before initiation about potentially permanent iris pigmentation and possible unilateral heterochromia.
• Use caution with active intraocular inflammation, predisposition to iritis or uveitis, and known risk factors for cystoid macular oedema.
• Exercise caution in aphakia or pseudophakia with a torn posterior capsule or anterior-chamber lens.
• Evidence is limited below 3 years, and long-term paediatric safety data are unavailable.
• Minimise skin exposure, particularly during pregnancy or when pregnancy is possible.

Contraindications and cautions

• Hypersensitivity to travoprost or any excipient.

Monitoring

• Intraocular pressure and evidence of glaucoma progression at planned ophthalmology reviews.
• Iris, eyelid, periocular and eyelash changes.
• Ocular-surface irritation, dry-eye symptoms and corneal health during prolonged use.
• Inflammation or macular oedema in susceptible patients.
• Administration technique and adherence if response appears inadequate.

Clinical pharmacology

Travoprost is an ester prodrug absorbed through the cornea and hydrolysed to its active free acid. It is a selective FP-receptor agonist that increases aqueous-humour outflow. Systemic exposure after ocular administration is very low and short-lived.

Formulation and product differences

• The selected product is a clear, colourless, benzalkonium chloride-preserved solution.
• Benzalkonium chloride may irritate dry or compromised eyes and can be absorbed by soft contact lenses.
• The bottle is supplied in a moisture-protective sachet and should be discarded 4 weeks after first opening.
• Macrogolglycerol hydroxystearate 40 is included and may cause skin reactions.

Eye drops

Route: Ophthalmic

Strengths: 40 micrograms/mL