Pharmacy and Medications

Are Travatan Z and The WalMart Pescription Plan Medicnes the Same?

12/15/2008 12:55PM

Question:

My doctor prescribed Travatan Z for my Glaucoma, which costs $85 per 2.5 mL bottle. The WalMart prescription plan offers a number of Glaucoma optical solution medications (Atropine Sulfate 1%, Gentamicin 0.3%, Levobunolol 0.5%, Pilocarpine 1% and 2%, Polymyxin Sulfate/TMP, Sulfacet Sodium 10%, Timolol Maleate 0.25%, Timolol Maleate 0.5%, and Tobramycin 0.3%) for $4. What is the difference?

Answer:

First of all, the WalMart $4 medication list categorizes all prescription eye care drugs together. Only some of the medications listed are indicated for the treatment of glaucoma.
From your list, the following medications are eye drops for glaucoma:

atropine sulfate 1%,

levobunolol 0.5%,

pilocarpine 1 and 2 %,

timolol maleate 0.25% and 0.5%.

These agents are older products that have been around for awhile and are available as generic medications.
Timolol maleate and levobunolol are drugs that work by decreasing the eye’s ability to make a fluid called aqueous humor, which can increase eye pressure when it builds up.
Other agents, such as atropine and pilocarpine, work to treat glaucoma by directly binding to receptors in the eye that can help the fluid drain out.
Travatan and Travatan Z were approved in 2001, and work at specific eye receptors to increase fluid drainage. They are available only as a brand medication, which could partly explain the difference in the price.
Currently, timolol maleate is the most common choice of eye drops to treat glaucoma. It works very well to reduce eye pressure, but can also affect other body systems, such as the heart and lungs.
Travatan is FDA-approved to treat glaucoma in patients who do not tolerate the other medications. It can be added in conjunction with other eye drops in patients who do not have adequate pressure control on just one medication.
The other drugs on the list:

gentamicin 0.3%,

polymyxin sulfate/TMP,

sulfacetamide sodium 10%,

and tobramycin 0.3%

are antibiotic eye drops for different infections. These drugs may be used to prevent infections before eye surgery, but are not typically used to treat glaucoma.
Submitted by Tze-chun Vivian Liao
Pharm D. Candidate 2009
Midwestern University College of Pharmacy

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Response by:

Carmen M. Hadley, RPh, CSPI
Clinical Instructor
Central Ohio Poison Center
Nationwide Children’s Hospital
College of Pharmacy
The Ohio State University