Travoprost Eye Drops Uses, Dosage, Side Effects & Price | DrugsAtlas
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DRUG NAME: Travoprost
Therapeutic Class: Prostaglandin F2α Analogue
Subclass: Antiglaucoma Agent
Speciality: Ophthalmology
Schedule (India): Schedule H (Prescription Drug)
Route(s): Ophthalmic (topical)
Formulations Available in India:
- Eye drops: 0.004% w/v (40 mcg/mL) solution — 2.5 mL bottle
INDICATIONS + DOSING — FOR CLINICIAN USE ONLY
Primary Indications (Approved / Standard in India)
1. Open-Angle Glaucoma
| Parameter | Recommendation |
| Starting dose | 1 drop into affected eye(s) once daily in the evening |
| Titration | Not applicable |
| Usual maintenance dose | 1 drop once daily in the evening |
| Maximum dose | Once daily only — more frequent dosing may paradoxically reduce IOP-lowering efficacy |
2. Ocular Hypertension
| Parameter | Recommendation |
| Starting dose | 1 drop into affected eye(s) once daily in the evening |
| Titration | Not applicable |
| Usual maintenance dose | 1 drop once daily in the evening |
| Maximum dose | Once daily only |
Clinical Notes (Both Indications):
- Remove contact lenses before instillation; wait at least 15 minutes before reinsertion
- If using multiple topical ophthalmic agents, maintain minimum 5-minute interval between drops
- Evening dosing preferred due to superior nocturnal IOP control
Secondary Indications — Adults (Off-label, if any)
Not established in Indian clinical practice. No documented off-label uses.
PAEDIATRIC DOSING (Specialist Only)
Primary Indications
Juvenile Open-Angle Glaucoma / Paediatric Ocular Hypertension
⚠️ Specialist supervision mandatory
| Age Group | Dose | Maximum | Monitoring Notes |
| ≥2 years to <18 years | 1 drop into affected eye(s) once daily in the evening | Once daily only | Regular IOP measurement; observe for iris/eyelash changes |
| <2 years |
NOT RECOMMENDED
|
— | Inadequate safety data; risk of adverse ocular effects |
Safety Monitoring:
- Baseline and periodic IOP measurements
- Conjunctival hyperaemia assessment
- Monitor for iris pigmentation changes
- Eyelash growth and eyelid pigmentation monitoring
- Children <3 years may show smaller therapeutic benefit
Secondary Indications — Paediatric Doses (Off-label, if any)
Not established in India.
RENAL ADJUSTMENT
No dose adjustment required — negligible systemic absorption via ophthalmic route.
HEPATIC ADJUSTMENT
| Severity | Recommendation |
| Mild impairment | No adjustment required |
| Moderate impairment | No adjustment required |
| Severe impairment | Use with caution — limited pharmacokinetic data in humans |
CONTRAINDICATIONS
- Hypersensitivity to travoprost, benzalkonium chloride, or any formulation component
- Active uveitis or intraocular inflammation
- History of recurrent uveitis
CAUTIONS
- Aphakic patients — increased risk of cystoid macular oedema
- Pseudophakic patients with torn posterior lens capsule — macular oedema risk
- History of herpetic keratitis — potential for reactivation
- Active ocular inflammation — may exacerbate condition
- Risk factors for cystoid macular oedema (diabetic retinopathy, retinal vein occlusion)
- Preadolescent patients — higher propensity for iris pigmentation and eyelash changes
- Patients with mixed-colour irides — gradual, irreversible pigmentation change likely
- Contact lens wearers — preservative (benzalkonium chloride) may be absorbed by soft lenses
PREGNANCY
| Parameter | Recommendation |
| Risk category | Avoid unless no safer alternative available |
| Rationale | Prostaglandin analogues may theoretically stimulate uterine contractions |
| Preferred alternative | Timolol (if systemic beta-blockade acceptable) |
| When permissible | Only in sight-threatening IOP elevation; specialist ophthalmology input essential |
| Monitoring | Close IOP monitoring; watch for uterine irritability |
LACTATION
| Parameter | Recommendation |
| Compatibility | Generally compatible — minimal systemic absorption |
| Drug levels in milk | Expected to be negligible |
| Preferred alternative | Timolol (if topical beta-blocker acceptable) |
| Infant monitoring | Observe for irritability, feeding difficulties with prolonged use |
ELDERLY
- No specific dose adjustment required
- Monitor for ocular surface disease (dry eye syndrome common in elderly)
- Assess adherence — may need assistance with drop instillation
- Caution with concurrent ocular comorbidities (cataract, macular degeneration)
- Watch for periorbital changes with long-term use
MAJOR DRUG INTERACTIONS
| Interacting Drug | Effect | Recommendation |
| Other prostaglandin analogues (latanoprost, bimatoprost, tafluprost) | Reduced IOP-lowering effect; unpredictable ocular response | Avoid concurrent use |
MODERATE DRUG INTERACTIONS
| Interacting Drug | Effect | Recommendation |
| Topical corticosteroids (ophthalmic) | May counteract IOP-lowering effect; increased inflammation risk | Monitor IOP closely; use shortest duration possible |
| Topical NSAIDs (ophthalmic) | May attenuate prostaglandin-mediated effect | Monitor for reduced efficacy |
COMMON ADVERSE EFFECTS
- Conjunctival hyperaemia (most common)
- Ocular irritation / foreign body sensation
- Increased eyelash length, thickness, and pigmentation
- Eyelid skin darkening
- Dry eye / excessive tearing
- Transient blurred vision post-instillation
- Ocular pruritus
SERIOUS ADVERSE EFFECTS
- Iris pigmentation — usually permanent; more common in mixed-colour irides
- Cystoid macular oedema — especially in aphakic/pseudophakic patients or post-cataract surgery
- Anterior uveitis — discontinue if occurs
- Periorbital fat atrophy — ”sunken eye“ appearance with prolonged use
- Herpetic keratitis reactivation — rare; discontinue and refer
- Prostaglandin-associated periorbitopathy (PAP) — deepening of upper lid sulcus
MONITORING REQUIREMENTS
| Timing | Parameters |
| Baseline | IOP measurement, iris colour documentation, ocular history, fundus examination |
| 2–4 weeks post-initiation | IOP assessment, tolerability evaluation |
| Every 3–6 months | IOP, ocular surface health, visual acuity, iris colour comparison |
| Long-term | Fundus examination for macular oedema, eyelash/eyelid changes, periorbital changes |
BRANDS AVAILABLE IN INDIA
Single-agent formulations:
- Travatan®
- Travo-Z®
- Travopar®
- Trovax®
- Eyeprost®
- Travocam®
Fixed-dose combinations (with Timolol 0.5%):
- Duotrav®
- Travo-L®
- Travocom-T®
PRICE RANGE (INR)
| Formulation | Price Range (per 2.5 mL bottle) |
| Travoprost 0.004% single-agent | ₹200–₹600 |
| FDC with Timolol 0.5% | ₹350–₹750 |
Note: Not included in NLEM; not under NPPA price control.
CLINICAL PEARLS
- Once-daily evening dosing is essential — twice-daily use paradoxically reduces efficacy due to prostaglandin receptor downregulation
- Counsel all patients about iris colour change — gradual, usually irreversible; more noticeable in heterochromic or mixed-colour irides
- Soft contact lenses absorb benzalkonium chloride — remove before instillation, wait 15 minutes before reinsertion
- Periorbital changes are cumulative — warn patients about potential deepening of lid sulcus and periorbital hollowing with long-term use
- Do not combine with other prostaglandin analogues — no additive benefit, possible reduced efficacy
- Consider preservative-free alternatives if significant ocular surface toxicity develops
TAGS
travoprost; glaucoma; prostaglandin-analogue; ocular-hypertension; ophthalmic-drop; elderly-safe; pregnancy-avoid; NLEM-absent; preservative-warning; ophthalmology
VERSION
RxIndia v1.0 — 03 Feb 2026
REFERENCES
- CDSCO-approved product inserts (Travatan®, Duotrav®)
- Indian Pharmacopoeia 2018
- AIIMS Ophthalmology Department Treatment Protocols
- National Health Portal — Ministry of Health and Family Welfare (MoHFW)
- API Textbook of Medicine
- Indian specialist ophthalmology clinical practice
- WHO Essential Medicines List 2021 (supportive reference only)
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Clinical Responsibility
This platform is designed strictly for healthcare professionals. Data provided is synthesized from authoritative pharmacological sources and clinical registries. Do not use for consumer medical decisions. Always verify critical dosing and contraindications with official institutional protocols and peer-reviewed journals.
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