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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Comments
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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?
i think lumigan has a very slight edge in controlling fluctuation. but again, i dont think there is much clinical significance among the 3
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.
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!
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.
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.
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 ?
Having just written about a sustained release version of latanoprost (Travatan) that is just starting clinical dosing trials — see http://tinyurl.com/pSivida-implant — 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).
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.
Now I understand.
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?
not sure how critical it is, to be honest.
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…