bimatoprost

Bimatoprost is a synthetic prostaglandin F2 alpha analogue used in ophthalmology to lower intraocular pressure in open-angle glaucoma and ocular hypertension, and in a higher concentration for cosmetic eyelash growth under the brand name Latisse. It is also marketed for glaucoma under the brand Lumigan and in combination forms such as Lumigan RC with netarsudil.

Mechanism of action and effects: Bimatoprost increases the outflow of aqueous humor through the uveoscleral pathway, thereby reducing intraocular pressure. The IOP-lowering effect develops over days to weeks, with continued effect over several weeks of once-daily use. It is a topical medication intended for local ocular action.

Administration and forms: It is supplied as an ophthalmic solution. For glaucoma, the usual regimen is one drop in the affected eye(s) once daily in the evening. For eyelash enhancement, the solution is used at a higher concentration, 0.03%, applied to the upper eyelid margin. Contact lenses should be removed before administration and can be reinserted after about 15 minutes.

Safety and side effects: Common adverse effects include conjunctival hyperemia, eyelid and iris color changes (iris darkening may be permanent with prolonged use), eyelash growth or thickening, periorbital skin darkening, dry eye, and irritation. Less frequent effects include keratitis and itching. Bimatoprost may cause pigmentary changes in the iris and periorbital area and may interact with other ocular medications to increase local side effects. It is contraindicated in the presence of active intraocular inflammation and should be used with caution in patients with a history of uveitis or macular edema.

Availability and notes: Bimatoprost is prescription-only. It is available in multiple concentrations and formulations appropriate to glaucoma management and cosmetic eyelash growth, and is also found in combination products with other glaucoma therapies.