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Bimatoprost

Bimatoprost is a medication primarily used to reduce elevated intraocular pressure (IOP) in individuals with open-angle glaucoma or ocular hypertension. By lowering IOP, Bimatoprost helps prevent damage to the optic nerve, which can lead to vision loss or blindness if untreated. Additionally, Bimatoprost is used cosmetically to enhance the length, thickness, and darkness of eyelashes under the brand name Latisse. Bimatoprost is a synthetic prostaglandin analog that increases the outflow of aqueous humor (fluid) from the eye, thereby lowering intraocular pressure.

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Frequently Asked Questions

How long does it take for Bimatoprost to work?
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For lowering intraocular pressure, Bimatoprost typically starts working within a few hours, with the full effect seen within a few weeks. For eyelash growth, noticeable results are usually seen after 4 to 8 weeks of consistent use, with full results typically visible after 16 weeks.

Can I use Bimatoprost if I wear contact lenses?
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Yes, but you should remove your contact lenses before applying Bimatoprost and wait at least 15 minutes before reinserting them. This is to prevent the preservative in the drops from being absorbed by the lenses.

What should I do if I miss a dose of Bimatoprost?
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If you miss a dose of Bimatoprost, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not apply extra drops to make up for the missed dose.

Is Bimatoprost safe to use during pregnancy?
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The safety of Bimatoprost during pregnancy has not been fully established. Pregnant women or those planning to become pregnant should consult their healthcare provider to discuss the potential risks and benefits before using this medication.

Can Bimatoprost cause permanent changes to eye color?
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Yes, Bimatoprost can cause increased brown pigmentation of the iris, which may be permanent. This is more likely to occur in patients with mixed-color irises, such as green-brown or blue-brown. Patients should be informed of this potential side effect before starting treatment.

Comprehensive Drug Guide

How Does Bimatoprost Work?

Bimatoprost works by mimicking the effects of naturally occurring prostaglandins, which increase the outflow of aqueous humor through the trabecular meshwork and uveoscleral pathways in the eye. This action reduces intraocular pressure. For its cosmetic use, Bimatoprost is thought to extend the growth phase of hair follicles, leading to longer, thicker, and darker eyelashes.

What is Bimatoprost Used For?

Reduction of Elevated Intraocular Pressure: In patients with open-angle glaucoma or ocular hypertension.

Cosmetic Enhancement of Eyelashes: To increase eyelash growth, including length, thickness, and darkness (marketed under the brand name Latisse).

Common Dosages

Bimatoprost is available by prescription only and is not classified as a controlled substance. It is typically available in ophthalmic solution form, with concentrations such as 0.01% and 0.03% for treating elevated IOP. The cosmetic formulation (Latisse) is also available by prescription and is typically at a concentration of 0.03%.

Ophthalmic Solution for Glaucoma: Apply one drop in the affected eye(s) once daily in the evening. More frequent administration is not recommended, as it may decrease the effectiveness of the medication.

Latisse for Eyelash Growth: Apply one drop to the applicator and brush it along the skin at the base of the upper eyelashes once daily. It is important to avoid getting the medication in the eye or on other areas of the skin, as it can cause unwanted hair growth.

Typical Dosing

FDA Approved Indications

The typical dosage of Bimatoprost depends on its use:

  • For Elevated Intraocular Pressure: One drop in the affected eye(s) once daily, usually in the evening.
  • For Eyelash Enhancement (Latisse): Apply once daily to the base of the upper eyelashes using the provided applicator. It should not be applied to the lower eyelid.

Off-Label Uses


Who Shouldn't Take Bimatoprost?

Bimatoprost is contraindicated in patients with:

  • Known hypersensitivity to Bimatoprost or any component of the formulation.
  • Active eye infections or conditions that may worsen with the use of eye drops (unless specifically advised by a healthcare provider).

Advice From The Pharmacist

Patients using Bimatoprost should be advised to:

  • Apply the medication exactly as prescribed and avoid using more than the recommended amount, as this can reduce its effectiveness.
  • Remove contact lenses before applying the drops and wait at least 15 minutes before reinserting them, as Bimatoprost contains a preservative that can be absorbed by soft lenses.
  • Be aware that Bimatoprost can cause changes in eye color, particularly increasing the brown pigmentation in the iris, which may be permanent.
  • Use the provided applicator for Latisse and avoid touching the applicator tip to prevent contamination and infection.
  • Report any unusual eye symptoms, such as pain, redness, or changes in vision, to their healthcare provider.

Side Effects of Bimatoprost

Common Side Effects

  • Redness or irritation of the eyes
  • Increased pigmentation of the iris, eyelid skin, or eyelashes
  • Eye dryness or discomfort
  • Sensation of something in the eye
  • Changes in eyelash growth

Uncommon/Severe Side Effects

  • Severe eye irritation or allergic reactions
  • Eye infection due to contamination of the dropper or applicator
  • Vision changes or eye pain

Patients should seek medical attention if they experience any serious side effects.

Risks and Warnings of Bimatoprost

Increased Pigmentation: Bimatoprost can cause increased brown pigmentation of the iris, which may be permanent. It can also darken the skin of the eyelids and increase the growth of eyelashes. Patients should be informed of this potential effect, especially if using Bimatoprost in only one eye.

Eyelash Changes: The use of Bimatoprost, particularly for cosmetic purposes, can cause changes in eyelash growth. If treatment is discontinued, these changes are usually reversible but may take several weeks to months.

Eye Infections: Contaminating the dropper or applicator tip can lead to serious eye infections. Patients should be instructed to keep the dropper and applicator clean and avoid contact with any surfaces.

Interactions with Bimatoprost

Common Drug Interactions

Bimatoprost may interact with other eye medications or treatments. Patients should inform their healthcare provider if they are using other eye drops, especially other prostaglandin analogs, to avoid potential interactions that could reduce the effectiveness of treatment.

Alternatives to Bimatoprost

Alternative treatments for elevated intraocular pressure include:

  • Other prostaglandin analogs: Such as latanoprost or travoprost, which work similarly to Bimatoprost.
  • Beta-blockers: Such as timolol, which reduce aqueous humor production.
  • Carbonic anhydrase inhibitors: Such as dorzolamide or brinzolamide, which also reduce fluid production in the eye.
  • Alpha agonists: Such as brimonidine, which both decrease fluid production and increase outflow.

For cosmetic eyelash enhancement, there are no FDA-approved alternatives to Latisse.