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Travatan
Class: Prostaglandin agonist

 Action May reduce intraocular pressure (IOP) by increasing uveoscleral outflow.

 Indications Reduction of IOP in patients with open-angle glaucoma or ocular hypertension who are intolerant of other IOP-lowering agents or insufficiently responsive to other IOP-lowering medications.

 Contraindications Standard considerations; pregnancy.

 Route/Dosage

ADULTS: Ophthalmic Instill 1 drop in affected eye(s) in evening.

 Interactions

None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Angina pectoris; bradycardia; chest pain; hypertension; hypotension. CNS: Anxiety; depression; headache. EENT: Ocular and conjunctival hyperemia; decreased visual acuity; eye discomfort and disorder; foreign body sensation; pain; pruritus; abnormal vision; blepharitis; blurred vision; cataract; conjunctivitis; dry eye; flare; iris discoloration; keratitis; lid margin crusting; photophobia; subconjunctival hemorrhage; tearing; sinusitis. GI: Dyspepsia; GI disorder. GU: Prostate disorder; urinary incontinence; UTI. META: Hypercholesterolemia. RESP: Bronchitis. OTHER: Arthritis; back pain; cold symptoms; infection; pain.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Active intraocular inflammation: Use with caution in patients with iritis/uveitis. Bacterial keratitis: Bacterial keratitis has been reported with multiple-dose containers as a result of patient contamination. Contact lenses: Remove contact lenses prior to and 15 min following administration. Macular edema: Use with caution in aphakic patients, pseudophakic patients with a risk of torn posterior lens capsule, or in patients with risk factors for macular edema. Pigmentation changes: Permanent changes to pigmented tissue may occur, most frequently involving pigmentation of the iris and eyelid and increased pigmentation and growth of eyelashes. Gradual change in eye color (ie, increased amount of brown pigmentation in the iris) may occur.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • If instilling other ophthalmic eye drops, separate each medication by ³ 5 min.
  • Store at controlled room temperature. Keep container tightly closed.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Ensure that IOP has been measured and documented in the patient’s record.
  • Ensure that women of childbearing potential are not pregnant or attempting to become pregnant.

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Warn patient to not instill more often than once a day in the evening. More frequent use may decrease effectiveness of the medication.
  • Teach patient proper technique for instilling eye drops. Wash hands; do not allow dropper to touch eye. Tilt head back, look up; pull lower eyelid down; instill drop. Close eye for 1 to 2 min and apply gentle pressure to bridge of nose. Do not rub eye.
  • Advise patients who wear contact lenses to remove lenses before instilling this medicine and to wait ³ 15 min after instilling eye drop before inserting lenses.
  • Advise patient that if > 1 topical ophthalmic drug is being used, administer the drugs ³ 5 min apart.
  • Inform patient that this medication may cause a gradual increase in brown pigment in the pupil, which may slowly change eye color.
  • Inform patient that this medication may also cause eyelid skin darkening and increases in length, thickness, color, and number of eyelashes.
  • Advise patient to contact eye doctor if eye or eyelid inflammation is noted, if eye is injured, or if having surgery on the eye.
  • Remind patient that eye examinations and measurement of IOP are necessary while using this medication; advise patient to keep appointments.

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