Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Travatan (Alcon)
0.004% solution in 2.5 mL dispenser
Approved indication: raised intraocular pressure
Australian Medicines Handbook Section 11.2.5
Travoprost adds to the choice of prostaglandin analogues available to treat conditions such as glaucoma. Latanoprost is already widely used for this indication(see 'New drugs for glaucoma' Aust Prescr. In press 2002).
As travoprost is an analogue of prostaglandin F2a,it reduces intraocular pressure by increasing the outflow of aqueous humour. Only a single daily dose is required as the effect lasts for at least 24 hours.
A clinical trial compared 801 patients treated with travoprost, latanoprost or timolol for a year.1 Intraocular pressure was reduced by 30% or to below 17 mmHg in 54.7% of the patients using travoprost, 50% of those using latanoprost and 39% of those using timolol. The mean intraocular pressure with travoprost was 0.8 mmHg less than with latanoprost. Another study confirmed that travoprost has a significantly greater effect than timolol on intraocular pressure.2
More than 37% of patients may experience ocular hyperaemia while taking travoprost. This occurs more frequently than in patients using latanoprost or timolol. Other ocular adverse effects include itching, discomfort and changes in the eyelashes. Travoprost can also cause a slow discolouration of the iris which may be permanent.
In addition to monotherapy, travoprost can also be used as adjunctive therapy with timolol. If the patient is using two drugs they should be instilled at least five minutes apart.
While the efficacy of travoprost is similar to that of latanoprost, its local adverse effects may reduce its acceptability to patients.
