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Prostaglandin Analogue Pregnancy: Must not be used in women of child-bearing age/potential unless adequate contraceptive measures are in place. Travoprost has harmful pharmacological effects on pregnancy and/or the foetus/new-born child and should not be used during pregnancy unless clearly necessary. It is unknown whether travoprost from the eye drops is excreted in human breast milk (animal studies show excretion) — use by breast-feeding mothers is not recommended.

Travoprost

Brand names: Travatan

Travoprost is a topical prostaglandin analogue eye drop used to lower intraocular pressure in open-angle glaucoma and ocular hypertension.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One drop of travoprost 40 micrograms/mL eye drops in the conjunctival sac of the affected eye(s)
Route: Ophthalmic (topical eye drops)
Frequency: Once daily; optimal effect is obtained if the dose is administered in the evening
Max: The dose should not exceed one drop in the affected eye(s) daily
Applies to adults including the elderly population. Nasolacrimal occlusion or gently closing the eyelid after administration is recommended — this may reduce systemic absorption and systemic adverse reactions. If more than one topical ophthalmic medicinal product is being used, the products must be administered at least 5 minutes apart. If a dose is missed, continue treatment with the next dose as planned. When substituting another ophthalmic antiglaucoma product with travoprost, discontinue the other product and start travoprost the following day. PAEDIATRIC (not per-kg — not structured): the UK SPC states travoprost 'can be used in paediatric patients from 2 months to < 18 years at the same posology as in adults', with limited data in the 2 months to < 3 years age group (9 patients); safety and efficacy below 2 months of age have not been established (no data). DIVERGENCE TO VERIFY: the US label fetched (Mylan travoprost ophthalmic solution 0.004%) states 'Use in pediatric patients below the age of 16 years is not recommended because of potential safety concerns related to increased pigmentation following long-term chronic use' — this conflicts with the UK SPC paediatric statement above. Contact-lens wearers: see SPC §4.4.

Dose adjustments

Renal

No dose adjustment is necessary — travoprost has been studied in patients with mild to severe renal impairment (creatinine clearance as low as 14 mL/min) and in mild to severe hepatic impairment, with no dose adjustment required

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients

Side effects

  • Ocular hyperaemia (very common — approximately 20% of patients in clinical trials)
  • Iris hyperpigmentation (common, approximately 6%), eye pain, ocular discomfort, dry eye, eye pruritus, eye irritation
  • Eyelash changes — increased length, thickness, pigmentation and/or number of lashes; periorbital and eyelid skin darkening, deepening of the eyelid sulcus
  • Corneal erosion, uveitis, iritis, anterior chamber inflammation, keratitis, punctate keratitis, photophobia, blepharitis, blurred vision, conjunctivitis (uncommon)
  • Macular oedema (frequency not known) — caution in aphakic patients, pseudophakic patients with a torn posterior lens capsule or anterior chamber lenses, and those with risk factors for cystoid macular oedema
  • Headache (uncommon); palpitations (uncommon); cough, nasal congestion, throat irritation (uncommon)

Interactions

  • If more than one topical ophthalmic medicinal product is being used, the medicinal products must be administered at least 5 minutes apart (§4.2, referring to §4.5)

Clinical monograph

How it works

It is a selective prostaglandin F2-alpha receptor agonist that reduces intraocular pressure mainly by increasing uveoscleral outflow of aqueous humour.

Prescribing in practice

  • Patients should be counselled that it can cause gradual and often permanent increased brown iris pigmentation, periocular skin darkening and increased eyelash growth, which is most apparent when only one eye is treated.
  • Use with caution in patients at risk of intraocular inflammation or macular oedema, including those with active uveitis or aphakia.
  • Avoid skin contact with the drop, as periocular pigmentation and hair growth can occur where it runs onto the skin.

Monitoring

Monitor intraocular pressure to confirm response and review periodically for iris and periocular pigmentary changes and ocular surface tolerability.

Counselling the patient

  • Instil once daily, usually in the evening, and continue regularly even without symptoms.
  • Iris colour, eyelid skin and eyelashes may darken or change and this can be permanent.
  • Wipe away any excess from the skin and expect brief blurring after instillation.

Evidence & guidelines

Prostaglandin analogues such as travoprost are recommended by NICE as a first-line option for lowering intraocular pressure in open-angle glaucoma and ocular hypertension.

Reference: RCOphth Glaucoma Guidelines; NICE CG85; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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