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Bimatoprost

    DEA Class; Rx

    Common Brand Names; Latisse, Lumigan, Durysta

    • Antiglaucoma, Prostaglandin Agonists

    Synthetic analog of prostaglandin; available as an ophthalmic solution and intracameral implant
    Used to lower IOP in patients with open-angle glaucoma or ocular hypertension; also approved for hypotrichosis
    Associated with increased pigmentation of eyelashes, iris, and periorbital tissue; changes in iridal pigmentation may be permanent

    Indicated for reduction of elevated intraocular pressure in patients with open angle glaucoma or ocular hypertension

    Indicated to treat hypotrichosis of the eyelashes by increasing their growth including length, thickness, and darkness

    Indicated to reduce intraocular pressure in patients with open-angle glaucoma or ocular hypertension

    Hypersensitivity

    • Conjunctival hyperemia (25-45%)
    • Growth of eyelashes (15-45%)
    • Ocular pruritus (15-45%)
    • Ocular dryness (3-10%)
    • Visual disturbance (3-10%)
    • Ocular burning (3-10%)
    • Foreign body sensation (3-10%)
    • Ocular pain (3-10%)
    • Pigmentation of the periocular skin (3-10%)
    • Blepharitis (3-10%)
    • Cataract (3-10%)
    • Superficial punctate keratitis (3-10%)
    • Eyelid erythema (3-10%)
    • Ocular irritation (3-10%)
    • Eyelash darkening (3-10%)
    • Ocular discharge (1-3%)
    • Tearing (1-3%)
    • Photophobia (1-3%)
    • Allergic conjunctivitis (1-3%)
    • Asthenopia (1-3%)
    • Increases in iris pigmentation (1-3%)
    • Conjunctival edema (1-3%)

    Macular edema, including cystoid macular edema, reported; the 0.01% strength should be used with caution in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema

    Prostaglandin analogs, including bimatoprost, reported to cause intraocular inflammation; because these products may exacerbate inflammation, use caution in patients with active intraocular inflammation

    The 0.01% strength contains benzalkonium chloride, which may be absorbed by and cause discoloration of soft contact lenses; contact lenses should be removed prior to instillation and may be reinserted 15 minutes following administration

    Bacterial keratitis reported; associated with use of multiple-dose containers of topical ophthalmic products; containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of ocular epithelial surface

    May gradually change eyelashes and vellus hair in treated eye; these changes include increased length, thickness, and number of lashes; eyelash changes are usually reversible upon discontinuation of treatment

    Potential for hair growth to occur in areas where solution comes in repeated contact with skin surface; carefully blot any excess from the eyelid margin to avoid it running onto cheek or other skin areas

    Not recommended for patients <16 years

    There are no adequate and well-controlled studies in pregnant women; there is no increase in risk of major birth defects or miscarriages based on bimatoprost postmarketing experience; administered during pregnancy only if potential benefit justifies potential risk to fetus

    Not known whether topical ocular treatment with this product could result in sufficient systemic absorption to produce detectable quantities in human milk

    Adults

    1 drop/day of the ophthalmic solution instilled in each affected eye or applied to each upper eyelid; a single 10 mcg implant inserted via intracameral injection.

    Geriatric

    1 drop/day of the ophthalmic solution instilled in each affected eye or applied to each upper eyelid; a single 10 mcg implant inserted via intracameral injection.

    Adolescents

    1 drop/day of the ophthalmic solution applied to each upper eyelid; safety and efficacy of the intracameral implant have not been established.

    Children

    5 years and older: 1 drop/day of the ophthalmic solution applied to each upper eyelid; safety and efficacy of the intracameral implant have not been established.
    younger than 5 years: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Bimatoprost 

    Ophthalmic solution

    • 0.01% (Lumigan)
    • 0.03% (Latisse, generic)

    intracameral biodegradable implant

    • 10mcg