Topical prostaglandin F2α analogue for ophthalmic use
Brand names: Travatan Z, Izba
Updated · Methodology
First line
Travoprost is used to lower IOP in ocular hypertension with elevated risk of conversion to glaucoma (corneal thickness under 555 µm, IOP above 26 mmHg, age over 60, family history). EGS 2024 and PPP 2020 recommend prostaglandins as first line in this group. The target is 20–30% IOP reduction from baseline.
Sources
ICD-10: H40.0 · ICD-11: 9C61.01
First line
Travoprost is a first-line prostaglandin F2α analogue for primary open-angle glaucoma. EGS 2024 and SEG/SEO 2023 position prostaglandins as starting monotherapy: a single evening instillation lowers IOP by 25–32% with 24-hour effect. The Cochrane 2014 review (Li et al.) found travoprost comparable to latanoprost and bimatoprost. If target IOP is not reached within 4–6 weeks, a second agent (beta blocker, carbonic anhydrase inhibitor or α2-agonist) is added.
Sources
ICD-10: H40.1 · ICD-11: 9C61.0
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Travoprost is a prostaglandin F2α analogue approved by AEMPS only as eyedrops for IOP reduction. Eyelash lengthening, darkening and thickening occurred as a side effect in some glaucoma patients. For cosmetic eyelash growth the approved bimatoprost (Latisse), not travoprost, and no large RCTs support this use of travoprost. Lid-margin application outside the eye carries real risks: periorbitopathy with globe deepening and lid skin darkening (PAP – prostaglandin-associated periorbitopathy), permanent iris hyperpigmentation if it reaches the eye, and lash hypotrichosis after withdrawal. If travoprost was suggested as a lash serum, consider seeking a second opinion.
Selective agonist of the FP prostaglandin F2α receptor. Increases uveoscleral outflow of aqueous humour and, to a lesser extent, trabecular outflow through extracellular matrix remodelling in the ciliary muscle. Lowers IOP by 25–32% from baseline with once-daily evening instillation. Onset within 2 hours, peak at 12 hours. Minimal systemic absorption, plasma half-life around 45 minutes.
AEMPS summary of product characteristics (section 4.6): travoprost has harmful pharmacological effects on pregnancy or on the fetus and newborn. It is not used in pregnancy unless clearly necessary. In women of childbearing potential, it is used only with adequate contraception.
Compatible with caution. Hale L3. Systemic absorption from ophthalmic instillation is minimal. Milk concentrations have not been studied. Nasolacrimal occlusion for 1–2 minutes after instillation reduces systemic exposure. Severe glaucoma is not a contraindication to breastfeeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
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Travoprost is evaluated for the following indications with varying evidence strength: Ocular hypertension (evidence tier A), Open-angle glaucoma (evidence tier A), Eyelash lengthening (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Travoprost (≥ 1 in 100): Conjunctival hyperaemia, Ocular itching and burning, Increased iris pigmentation (irreversible), Eyelash lengthening and darkening, Transient blurred vision after instillation, Dry eyes. See the Safety section for uncommon and serious reactions.
AEMPS summary of product characteristics (section 4.6): travoprost has harmful pharmacological effects on pregnancy or on the fetus and newborn. It is not used in pregnancy unless clearly necessary. In women of childbearing potential, it is used only with adequate contraception.
Compatible with caution. Hale L3. Systemic absorption from ophthalmic instillation is minimal. Milk concentrations have not been studied. Nasolacrimal occlusion for 1–2 minutes after instillation reduces systemic exposure. Severe glaucoma is not a contraindication to breastfeeding.
Travoprost is contraindicated in: Hypersensitivity to travoprost, benzalkonium chloride or other components; Under 18 years of age (safety data lacking). Full list in the Safety section.
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Bimatoprost, Brimonidine, Carbomer, Dorzolamide, Latanoprost, Tetryzoline, Hypromellose, Lutein + zeaxanthin