Prostaglandin Analogue Pregnancy: Contraindicated — prostaglandins are uterogenic; risk of miscarriage

Travoprost

Brand names: Travatan

Adult dose

Dose: 1 drop OD in the affected eye(s), in the evening

Route: Topical ophthalmic

Frequency: Once daily (evening)

Max: 1 drop OD per eye

For chronic open-angle glaucoma and ocular hypertension. Administer in the evening (peak IOP lowering effect at night). Similar to latanoprost but may be preferred if conjunctival hyperaemia problematic.

Paediatric dose

Route: Ophthalmic

Frequency: OD

Max: 1 drop OD

Concentration: 40 mcg/mL drop/ml

Off-label in children — specialist paediatric ophthalmology only

Dose adjustments

Renal

N/A (topical)

Hepatic

N/A

Clinical pearls

As with latanoprost: iris pigmentation is permanent — warn patients before starting, especially heterochromic irides
Evening administration: prostaglandins match circadian IOP rhythm — better IOP lowering in the morning if applied evening before
Do NOT combine two prostaglandin analogues — paradoxical IOP increase (prostaglandin receptor downregulation)
Contact lenses: remove before instilling drops; can replace after 15 min (preservative absorption)

Contraindications

Pregnancy (uterotonic effect — potential miscarriage)
Active uveitis

Side effects

Iris pigmentation (permanent darkening)
Eyelash changes (growth, darkening)
Periocular skin pigmentation
Conjunctival hyperaemia
Blurred vision (application)

Interactions

Latanoprost — do not use two prostaglandins together (paradoxical IOP increase)

Monitoring

IOP (at baseline and 4–8 weeks after starting)
Iris colour changes
Visual field

Reference: BNFc; BNF; RCOphth Glaucoma Guidelines; NICE CG85. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Bishop Score · Labour & Delivery

Drugs

Bimatoprost · Prostaglandin analogue

Pathways