Lumigan vs. Travatan vs. Xalatan

March 5, 2009

I read a letter to the editor in the Ocular Surgery News from a doctor who was very frustrated with the studies that each drug rep shows him that proves one glaucoma medication for controlling ocular hypertension is better than the other. He suggested, and I agree, that this essentially “proves” that corporate-sponsored studies are biased, for how could experts studying the same thing consistently come to different conclusions, each one coincidentally proving that the product made by their sponsor is the best?

So, I have come to the point where I tell my reps that when I choose a prostaglandin, I simply toss a coin. This way, the reps don’t harrass me! Or, I choose based on the patient’s insurance coverage. I wonder if anyone out there really sees a significant difference among the three in terms of efficacy ( we all know that Xalatan has the least redness).




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28 Responses to “Lumigan vs. Travatan vs. Xalatan”

  1. ana maria on January 16th, 2010 6:52 pm

    I have read your thought about Travatan/Lumigan and Xalatan and I have one question for u. Can u tell what do you think about controll of fluctuations or Peak/Trough? Whos controlling better this things?

  2. Dr. Ari Weitzner on January 24th, 2010 8:41 pm

    i think lumigan has a very slight edge in controlling fluctuation. but again, i dont think there is much clinical significance among the 3

  3. Joshua Lee on February 2nd, 2010 9:51 pm

    I have a question. I’ve built up a tolerance to Lumigan and my choices are either Xalatan or travatan. I know you pretty much said that you flip a coin, but in your experience which one has better control over the peaks and valleys? Any help would be appreciated.

  4. Deb G on May 30th, 2010 3:39 pm

    I just started on Lumigan and I immediately noticed I have red blotchy circles around my eyes! And my eyes seem a bit dry. My cousin recommend Xalatan stating it has the least side effects. The specialist said I have some thinning and loss of tissue so he decided to put me on Lumigan for precautions as I have had for the past twenty years what is called “Glaucoma suspect”. I just want to be sure this redness under the eyes isn’t permanent! Can anyone else share their experience with me? Thanks!

  5. Ian M on December 21st, 2010 5:39 am

    Lumigan does lead to a lot of red eye, new incidences are still reported months after initiation. Xalatan used to be the best tolerated, but ever since Travatan was available as BAK-free formulation this has the best all round efficacy & tolerability. And according to the data Travatan does have the best peak-trough control.

  6. ari on December 22nd, 2010 9:53 am

    the new lumigan (0.01%) is 1/3 as strong but equally effective as the old lumigan with much less redness.
    redness is not permanent, but the increased pigmentation of iris and skin is.

  7. Al on June 21st, 2011 1:31 pm

    I was on xalatan about two years with success. My doctor Dr. switched me to Lumigan a couple of months ago. My eye lids are red and some bloodshot in my eyes. The Dr. said that Xalatan is now generic and does not contain all of the ingredients in the original Xalatan. Is it true that Xalatan changed the formula ?

  8. Irv Arons on June 21st, 2011 5:32 pm

    Having just written about a sustained release version of latanoprost (Travatan) that is just starting clinical dosing trials — see — that may provide treatment for 3 to 6 months, why aren’t glaucoma docs using SLT as frontline treatment?

    I am biased, as I am a laser guy, and not a drug guy — the latter knowledge coming only when I started writing my online Journal (blog).

  9. ari weitzner on June 21st, 2011 5:43 pm

    here’s why:

    patients are reluctant to expose their eye to a laser treatment- they are scared, having heard of people who lost vision from laser (even though the slt cannot possibly harm the vision). so they prefer drops.

    also, slt too expensive to buy- have to shlep to the hospital or surgery center to perform it there. easier and equally effective to use argon in alt in the office.

  10. Irv Arons on June 21st, 2011 5:53 pm

    Now I understand.

  11. R. Hill on October 12th, 2011 10:53 am

    I tried Lumigan for one week. The one eye with glaucoma became swollen, light sensitive and I had blurred vision. The other eye had similar but less dramatic effects. My doctor switched me to Latanaprost (generic) and I have no side effects other than a slight burning sensation after using drops.

    Do I really need to refrigerate the Latanaprost?

  12. ari on October 15th, 2011 11:43 pm

    not sure how critical it is, to be honest.

  13. Walt on December 16th, 2011 11:03 am

    Random thoughts/observations/experiences:

    I’ve been on Lumigan since 2006. My eyes have pretty much been constantly red since then…

    A couple of years ago, my first doctor left the practice and moved to another state. The doctor who replaced him recommended SLT, so I had it done in both eyes. It was completely INEFFECTIVE on me. Quite a disappointment.

    About a year ago, the same doctor gave me some free Xalatan samples to try, in order to see if that would reduce my hyperemia (red eyes). Xalatan did seem to reduce the redness somewhat. It also stings a bit upon instilling the drop (unlike Lumigan, which just felt like water or saline). The stinging wasn’t fun, but it wasn’t a deal-breaker for me, either. However, Xalatan wasn’t covered by my insurance at the time, so I went back to Lumigan.

    Recently my second doctor left the practice, so I now I have a third doctor… Coincidentally, my employer is also switching insurance plans. The new plan doesn’t cover Lumigan. Now that Xalatan is available in generic form (Latanaprost), that’s what the new plan is pushing. So my new doctor is switching me to it. I just picked up two 3 mL bottles (a total of 60 days supply, I think) at Costco for around $22 straight cash (no insurance involvement at all). The manufacturer is Falcon Pharmaceuticals, which is apparently affiliated with Alcon Laboratories.

    I was indeed surprised to see that Falcon recommends refrigerating the Latanaprost vials until opening them. (This was not required for Lumigan.) Well, they’re in my refrigerator now. As soon as my current bottle of Lumigan runs out in a few days, it’s on to the Latanaprost…

  14. Abigai Toner on March 12th, 2012 1:56 pm

    Hi I had a cornea transplant this past January. I already had glaucoma for many years but due to the post surgical steroid drops (anti-rejection) the pressure is out of controlled and my doctors keep trying different combinations. I’m on combigan which is a combo of two meds but its not sufficient so in conjunction to that the doctor put me on Lumigan I have used it for a week in a half. The first drop really burned but after that it was fine. In my second week the pain from the Lumigan was too much. Burning,light sensitivity,and blurriness. Over the phone my doctor was concern that I was rejecting the cornea. It was the lumigan. So he switched me to travatan. I was told it has less side effects. Well we will see. It is hard enough going through my surgery and to suffer with all the meds I have to use should be the least of it. Good luck all

  15. Eileen Previll on April 2nd, 2012 3:24 pm

    Lumigan .03% keep my pressure down to about 17 ea eye. When lumigan changed to .01%, my pressure went up to 25 in ea eye (in 4 mos.). I was recently switched to latanoprost .005% Isn’t that a much smaller solution? .005% vs .01%?

  16. ari on April 3rd, 2012 9:19 am

    the concentrations of medicines cannot be compared to one another- they are different molecules.
    hard to believe the lumigan .01 was so less effective than .03. very atypical.

  17. B. Cota on April 17th, 2012 10:49 pm

    I appreciate all this info. I have been using Lumigan .01% since Nov. 2011. I got so used to it and recently because of insurance had to use Latanoprost .005% generic for lumigan ….Latanoprost stings when drops are inserted. I hate the red eyes…it’s worse w/ Latanoprost…does the redness subside after regular use. After all is said and done only thing i like is the side-effect of the long eyelashes!!

  18. Lynda Fowlie on June 11th, 2012 9:51 am

    because of the cost I just ordered my Travatan (generic)out of Canada, today I discovered they are actually sending Latanoprosr, the generic Xalatan, then I see it listed on line as generic for either eye drop????????? What gives??? Lynda

  19. Pat Zorne on September 24th, 2012 4:11 pm

    I am currently on Lumigan .03 (two yrs.) have two bottles left then will have to go to .01. Just found out my insurance doesn’t cover the .01 (how stupid), so will have to change. However, pressure just went from 14 and 15 to 17 in both, so maybe I don’t care. I’ve been on Xalatan and Travatan Z also, over the past 6 yrs, but was told by my Doc that Lumigan was the best for contact lens wearers. I have worn gas-perms for 40+ years and continue to do so due to very bad astigmatism. Any info on pressure ups/downs for anyone on the generic yet? Hate to risk my eyesight just for cost, but – – – .

    FYI for the dryness – Restasis helps – also costly, BUT you don’t have to throw the vial away after one use like they say to. Snap the top back on, keep in a sealed container in fridge and use for 4 applications – two days. Stretches each script quite a bit. Doc recommended this.

  20. ari on September 27th, 2012 2:42 pm

    agree with stretching out restasis.
    never heard of lumigan being better for contacts?

    generic may give you 1-2 points higher pressure.

  21. ROB LEE on December 4th, 2012 2:29 pm

    I have been using LUMIGAN .03% for 5 years- one drop in each eye at night. I have been ordering it from Canada. The exact same name[brand[ LUMIGAN. I get it much cheaper paying out of pocket than my medicare plan pays for here in the states. From Canada the bottles are always 3mg in size instead of the 2.5mg that you can only get here in the states. One drop in each eye once a day requires a 3mg size bottle to last a full month. A 2.5mg size bottle only last about 23 days, and I am quite careful how I use it and I always keep it in the frig. It feels nice and cool when you drop it in. My question is, WHY doesn’t the manufacturer[Allergan] sell the Lumigan in a 3mg size bottle here in the states like they do in Canada??? Like I said ,it is cheaper in Canada plus you get more [enough to last 30 days].

  22. Jack Cates on December 24th, 2012 11:42 pm

    I am having problems finding the right combination of drops to control my pressure.
    I used lumigan for about 2 yrs with alphagan. Recently, I have been getting very dizzy while walking. It’s not so bad if I am sitting or running, only walking. It’s getting worse and I have been to 8 specialists this year to eliminate all other possibilities. I have had a cardiologist(2 different ones), Otolarnygologist (ENT), Hematologist, Vascular(2 different ones), Neurologist and internist. I have also had an SLT procedure for both eyes with no appreciable improvement in pressure lowering.
    I have DVR( Deep Vein Reflux) and I am beginning to think my problem is that all the drugs either have beta impact on the hear(outflow control) or the adrenergic agonist(restricts blood vessels) for inflow control. I am thinking these medicines along with my DVR in my arteries are causing me my unsteadiness/dizziness problem. I am not sure what to do and my doctors don”t seem to be able to help either. Are there any drops for controlling pressure that do not restrict the arteries or blood vessels? I need help badly! My last resort is to have a hole lasered into the back of my eye which I would rather not do. Then, I would not have to take any of the medicines to keep my pressure low.

  23. Enrique Castaneda on May 9th, 2013 10:14 pm

    I was on LUMIGAN first and after two months my eye lids were looking as a
    racoon’s .Black eyes!!!! .Not good! Then,I went for TRAVATAN, same thing!!!
    The Doctor changed me to XALATAN,Perfect,but my eyes pressure went up.
    So I changed to XALACOM ,Great but I just red on Internet that you should not
    go for it if you have: Low heart beat,low blood pressure or hyperthyroid issues.
    HELP DR., What do you suggest ????
    Anyway,how low is Low heart beat.? Mine is most of the time : 48 and my blood
    pressure is 115 over 65. Should I stay away from the only drug that is helping me???
    By the way I am 71 yrs old.
    Thank You.

  24. ari on May 20th, 2013 2:53 pm

    the beta blocker in the drop can lower your already low heart rate and cause you to faint/fall or even get a heart attack/stroke in rare cases. discuss with your internist.

  25. Enrique Castaneda on May 23rd, 2013 1:14 pm

    Hi again,well after being on Xalacom for a while and after the other eye drops experience I mentioned on May 19th2013;(Lumigan,Travatan,Xalatan)I am back on Travatan since my eye pressure went up again.I am very concern of getting black eyes again,so I learned about Canaloplasty procedure !Can any one tell me about
    results?Does it work in getting the pressure down?No side effects? There is not
    too many Doctors who practice this procedure,so any comments Dr Ari I would
    appreciate .Thanks.

  26. ari on May 26th, 2013 10:19 pm

    canaloplasty is a nice procedure, but not easy, time-consuming, and not performed by too many surgeons. if you can find an experienced surgeon, then its worth considering.

  27. Jenny Kirby on September 19th, 2013 9:37 pm

    I have pigmentary dispersion syndrome and have been on combigan with pressures around 16. Lumigan added and pressures now at 9. Lumigan is not on my insurance formulary and dr doesn’t want me to try anything else. I can’t afford the $300 for a 5ml bottle. What would be the benefits or risks of trying the other drugs mentioned?

  28. ari on October 9th, 2013 12:08 am

    no risk. they are all very similar. cant hurt to try

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