Travoprost Explained

Travoprost, sold under the brand name Travatan among others, is a medication used to treat high pressure inside the eye including glaucoma. Specifically it is used for open angle glaucoma when other agents are not sufficient. It is used as an eye drop. Effects generally occur within two hours.[1]

Common side effects include red eyes, blurry vision, eye pain, dry eyes, and change in color of the eyes.[1] Other significant side effects may include cataracts. Use during pregnancy or breastfeeding is generally not recommended. It is a prostaglandin analog and works by increasing the outflow of aqueous fluid from the eyes.[1]

Travoprost was approved for medical use in the United States and in the European Union in 2001.[1] [2] It is available as a generic medication in the United Kingdom.[3] In 2020, it was the 304th most commonly prescribed medication in the United States, with more than 1million prescriptions.[4] [5]

Medical uses

Travoprost is used to treat high pressure inside the eye including glaucoma.[1] Specifically it is used for open angle glaucoma when other agents are not sufficient.[3] [1]

Side effects

Possible side effects are:[6]

Research suggests that wiping the eye with an absorbent pad after the administration of eye drops can result in shorter eyelashes and a lesser chance of hyperpigmentation in the eyelid, compared to not wiping off excess fluid.[7]

Pharmacology

Mechanism of action

It is a synthetic prostaglandin analog (or more specifically, an analog of prostaglandin F)[8] [9] that works by increasing the outflow of aqueous fluid from the eyes.[10]

Like other analogs of prostaglandin F such as tafluprost and latanoprost, travoprost is an ester prodrug of the free acid, which acts as an agonist at the prostaglandin F receptor, increasing outflow of aqueous fluid from the eye and thus lowering intraocular pressure.

Pharmacokinetics

Travoprost is absorbed through the cornea, where it is hydrolysed to the free travoprost acid. Highest concentrations of the acid in the eye are reached one to two hours after application, and its half-life in the aqueous fluid is 1.5 hours. Once it reaches the bloodstream, it is quickly metabolised, so that concentrations in the system do not exceed 25 pg/ml (compared to 20 ng/ml in the eye, which is higher by nearly a factor of 1000).

Metabolites are formed by beta oxidation of the acidic chain (compare Tafluprost#Pharmacokinetics), oxidation of the OH-group in the other side chain, and reduction of the double bond next to this OH-group. Travoprost acid and its metabolites are mainly excreted via the kidney with a terminal half-life of 45 minutes.[11]

Notes and References

  1. Web site: Travoprost Monograph for Professionals . Drugs.com . American Society of Health-System Pharmacists . 26 March 2019 . en.
  2. Web site: Travatan EPAR . European Medicines Agency (EMA) . 3 January 2021.
  3. Book: British national formulary : BNF 76. 2018. Pharmaceutical Press. 9780857113382. 1152. 76.
  4. Web site: The Top 300 of 2020 . ClinCalc . 7 October 2022.
  5. Web site: Travoprost - Drug Usage Statistics . ClinCalc . 7 October 2022.
  6. Book: Austria-Codex. Travatan 40 Mikrogramm/ml Augentropfen. Haberfeld, H. Österreichischer Apothekerverlag. Vienna. 2015. German.
  7. Xu L, Wang X, Wu M . Topical medication instillation techniques for glaucoma . The Cochrane Database of Systematic Reviews . 2017 . CD010520 . February 2017 . 2 . 28218404 . 5419432 . 10.1002/14651858.CD010520.pub2 .
  8. Web site: Travatan - travoprost solution. Alcon Laboratories, Inc.. DailyMed. U.S. National Library of Medicine. Bethesda, MD. September 2011. 30 September 2011.
  9. Web site: Travatan Z (travoprost) solution. Alcon Laboratories, Inc.. DailyMed. U.S. National Library of Medicine. Bethesda, MD. September 2011. 30 September 2011.
  10. Web site: Travoprost Ophthalmic. AHFS Consumer Medication Information. MedlinePlus. U.S. National Library of Medicine. Bethesda, MD. 1 January 2011. 30 September 2011.
  11. [Drugs.com]