How does this medication work? What will it do for me?

This combination product contains two medications: travoprost and timolol. Travoprost belongs to a class of medications called prostaglandin analogues. Timolol belongs to a class of medications called beta-adrenergic receptor blockers (also known as beta-blockers).

Travoprost - timolol is used to reduce the pressure inside the eye for people with open-angle glaucoma or ocular hypertension (increased pressure in the eye) who do not have a complete response to treatment with only one medication. This medication is used when your doctor feels it is appropriate to use both travoprost and timolol. This medication is not to be used as initial treatment.

Fluid is constantly being formed and drained out of the eye. When this fluid does not drain out of the eye properly, pressure inside the eye increases. Travoprost - timolol works by reducing the amount of fluid produced by the eye and by increasing the flow of fluid out of the eye.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

0.004%/ 0.5% eye drops

Each mL of sterile, isotonic, buffered, preserved, aqueous solution contains travoprost 0.04 mg and timolol 5.0 mg. Nonmedicinal ingredients:POLYQUAD (polyquaternium-1), mannitol, polyoxyethylene hydrogenated castor oil 40, propylene glycol, boric acid, sodium chloride, sodium hydroxide and or hydrochloric acid and purified water.

How should I use this medication?

The recommended adult dose of travoprost - timolol is one drop in the affected eye(s) once daily. Do not use it more than once a day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

To use the eye drops:

  1. Wash your hands before using the eye drops.
  2. Remove the cap and place it in a clean location. To avoid possible contamination keep the tip of the container away from contact with any surface.
  3. Tilt your head back and look towards the ceiling.
  4. With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
  5. Apply one drop into the pouch but do not allow the tip of the container to touch the eye or areas around the eye.
  6. Gently apply pressure to the inner corner of the eye (at the bridge of the nose) for about 30 seconds (this is called nasolacrimal occlusion). This prevents the medication from dripping down through the tear duct and entering the bloodstream, which could cause you to experience some side effects.
  7. Repeat with the other eye, if prescribed by your physician.
  8. Wash your hands again to remove any medication.

Do not allow the dropper tip of the bottle to touch the eye or other surrounding structures. This can contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye, possibly leading to loss of vision may result if you use eye drop solutions that have become contaminated.

If you use other eye drops as well, wait at least 5 minutes before using them.

If you wear contact lenses, remove them before instilling travoprost - timolol into your eye. You may put your contact lenses back in 15 minutes after using the medication.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to travoprost, timolol, or any ingredients of the medication
  • have asthma or have had asthma in the past
  • have certain heart diseases or conditions:
    • cardiogenic shock (heart cannot provide enough oxygen to the body)
    • second-degree or third-degree atrioventricular (AV) block (electrical problems)
    • sinus bradycardia (slow heartbeat)
    • uncontrolled heart failure (heart cannot pump effectively)
  • have severe chronic obstructive pulmonary disease (COPD)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • change in colour to the iris or eyelashes
  • cough
  • drowsiness or dizziness
  • dry eyes
  • eye irritation
  • eye itchiness
  • feeling of something in the eye
  • increased tears
  • itchy eyelids
  • lengthening or thickening of eyelashes
  • headache
  • postnasal drip
  • redness of eye
  • temporarily blurred vision
  • thirst
  • throat irritation

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • change in blood pressure or heart rate
  • change in urine colour
  • discomfort inside the nose
  • eye or eyelid infection
  • eye pain
  • injury to your eye
  • sensitivity to light
  • skin infection or skin reaction
  • swelling or inflammation to the eye or eyelid

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a serious allergic reaction, e.g.:
    • difficulty breathing
    • hives
    • itchy skin rash
    • swelling of the mouth and throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: People who have a history of allergies or anaphylactic reactions are more likely to experience these reactions while using travoprost - timolol eye drops. If you have a history of severe allergic reactions, you should discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Asthma and respiratory disease: Although this medication is intended to be used as a topical (surface only) treatment for the eyes, it may be absorbed into the bloodstream and affect breathing if you have a history of breathing problems or difficulty breathing. If you have asthma or other respiratory conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Contact lenses: If you wear contact lenses, remove the lenses before using the eye drops and wait at least 15 minutes before reinserting them.

Diabetes: Although this medication is intended to be used as a topical treatment for the eyes, it may be absorbed into the bloodstream and affect blood sugar control if you have diabetes. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may need to test your blood sugar more often while you are using this medication.

Drowsiness/reduced alertness: This medication may cause drowsiness, dizziness, and temporary blurring of your vision. Do not drive, operate machinery, or engage in any potentially hazardous activities until you determine how this medication affects you.

Eye changes: This medication may gradually change the colour of the eye, increasing the amount of brown pigment in the iris (coloured part of the eye). The long-term effects on the eye and the chances of injury to the eye are currently unknown. As the change in colour may be permanent and occurs slowly, it may not be noticeable for several months or years. This medication can also cause darkening, thickening, and lengthening of eyelashes. Eyelid skin darkening may also occur. Talk to your doctor if you have any concerns.

Eye conditions: If you have certain types of eye conditions (e.g., glaucoma, uveitis, certain lens problems), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience frequent or chronic eye inflammation, discuss the risks and benefits of using this medication with your doctor.

Kidney problems: If you have decreased kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed

Liver problems: If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Myasthenia gravis: The timolol component of this medication may cause increased muscle weakness for people with myasthenia gravis. If you have myasthenia gravis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Severe cardiovascular (heart) disease: Although this medication is intended to be used as a topical treatment for the eyes, it may be absorbed into the bloodstream and have an effect on heart disease. If you have heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Thyroid disease: If you have thyroid disease (e.g., hyperthyroidism), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Timolol passes into breast milk after being used as an eye drop. It is not known if travoprost passes into breast milk. If you are a breast-feeding mother and are using travoprost - timolol eye drops, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between travoprost - timolol eye drops and any of the following:

  • alcohol
  • alpha-adrenergic blockers (e.g., epinephrine, norepinephrine)
  • alpha-1 blockers (e.g., doxazosin, tamsulosin, terazosin)
  • amifostine
  • anaesthetics
  • barbiturates (e.g., butalbital, phenobarbital)
  • benzodiazepines (e.g., diazepam, lorazepam)
  • beta-adrenergic blockers (e.g., atenolol, metoprolol, propranolol)
  • bupropion
  • calcium channel blockers (e.g., nifedipine, verapamil)
  • catecholamine-depleting medications (e.g., guanethidine, reserpine)
  • clonidine
  • cocaine
  • delavirdine
  • digoxin
  • diuretics (water pills; furosemide, hydrochlorothiazide)
  • dronedarone
  • floctafenine
  • fluoxetine
  • methyldopa
  • monoamine oxidase inhibitors (MAOIs; e.g., phenelzine, tranylcypromine)
  • opiate medications (e.g., codeine, hydrocodone, morphine)
  • other high blood pressure medications (e.g., irbesartan, losartan)
  • paroxetine
  • protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • quinidine
  • rituximab
  • tamsulosin
  • terbinafine
  • theophylline
  • thioridazine
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.