Travoprost

About Travoprost

Travoprost is a prostaglandin analog that lowers the pressure inside the eye. The Travatan Z label approves it for reducing elevated intraocular pressure in adults with open-angle glaucoma or ocular hypertension. The dose is one drop in the affected eye or eyes once daily in the evening, and the label says it should not be used more than once a day. Pressure starts to fall about 2 hours after the first dose, with the largest effect at about 12 hours.

There is no boxed warning and the label lists no contraindications. The main warning is pigmentation: travoprost can increase brown pigment in the iris (the colored part of the eye), the eyelid and the eyelashes. The label says iris pigmentation is expected to increase as long as the drops are used, may take months to years to show, and is likely to be permanent after stopping, while darkening of the eyelid skin has been reported to reverse in some people. The drops can also gradually change the eyelashes and fine hair of the treated eye, making lashes longer, thicker, darker or more numerous, or changing the direction they grow, so the two eyes can look different; the label says lash changes usually reverse after stopping. Other warnings cover active eye inflammation such as uveitis, macular edema (swelling at the back of the eye), and infection from a contaminated bottle. The most common side effect is eye redness; others include eye discomfort, pain, itching and decreased vision.

Travatan Z is preserved with sofZia, an ionic buffered system. The original Travatan formulation is discontinued; the FDA listed it as a discontinued product and determined in 2011 that it was not withdrawn for reasons of safety or effectiveness. The label does not recommend use in children under 16 because of the pigmentation concerns with long term use. In pregnancy, the label advises use only if the potential benefit justifies the potential risk to the fetus. Travoprost is also sold as iDose TR, an implant a doctor places in the eye, which is a separate product.

Taking Travoprost

How to take it

Use one drop in the affected eye once a day in the evening, at the same time each day. Wash your hands, keep the dropper tip from touching the eye or anything else, then close the eye and press gently on the inner corner for a few minutes. Remove contact lenses first and wait 15 minutes before putting them back in.

If you miss a dose

Use the missed dose as soon as you remember, unless it is almost time for the next one; then skip it and continue your usual schedule. Do not use extra drops to make up for a missed dose.

Storage

Keep the bottle tightly closed, between 2 and 25 degrees C (36 to 77 degrees F), and out of reach of children. Do not flush unused medicine; use a take-back program.

Interactions to know about

If you use other eye drops, use them at least 5 minutes before or after travoprost. Tell the prescriber about eye inflammation, a past eye surgery or torn lens capsule, an eye injury or infection, and pregnancy or breastfeeding, and tell the pharmacist about every medicine and supplement you take.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Travoprost differs from pharmacy to pharmacy

Most quotes are for generic travoprost drops, which several makers supply, so quotes differ with the maker the pharmacy buys from, whether it keeps the drops on the shelf or orders them in, and its own cash pricing. A prescription written for Travatan Z with substitution blocked is filled with the brand and priced as a brand.

The drops come in 2.5 mL and 5 mL bottles, so compare quotes for the same bottle size and number of bottles. On a single small bottle the dispensing fee is a noticeable part of the quote.

Ways to pay less for Travoprost without insurance

• Ask the prescriber to write the generic name, travoprost 0.004 percent ophthalmic solution, and allow substitution, since rated generics can be dispensed in place of Travatan Z.
• Once the eye pressure is controlled, ask the prescriber whether a larger bottle or a ninety-day supply is appropriate.
• Compare quotes from more than one pharmacy for the same bottle size.
• If the brand is required, ask the maker whether its savings or patient assistance program applies to someone paying cash; many require commercial insurance.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Travoprost

1. 1.Is my travoprost a generic rated as equivalent to Travatan Z, and does it use a different preservative?
2. 2.How long should one bottle last if I use it in one eye or in both eyes?
3. 3.How far apart should I space my travoprost and my other eye drops?
4. 4.What changes in my eye color or eyelashes should I watch for, and when should I call my eye doctor?

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