Bimatoprost

LUMIGAN

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Pronunciation: bi-MA-toe-prost

Bimatoprost ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Bimatoprost ballicule

What it isProstamide agonist that increases aqueous outflow; glaucoma, ocular hypertension, and eyelash hypotrichosis.

Why this oneIt is among the strongest pressure-lowering drops and uniquely doubles as an eyelash-growth treatment.

What limits itIris darkening and periorbital fat loss can be permanent; conjunctival redness commonly limits adherence.

Bimatoprost molecular structure (skeletal formula) — Molecular structure: Bimatoprost

FDA-approved for

glaucoma / ocular hypertension (2001)
eyelash hypotrichosis (2008)

FDA label

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FDA dosing	Population	Start	Target	Max
Elevated intraocular pressure (open-angle glaucoma or ocular hypertension)	Adults	1 drop affected eye(s) QHS	1 drop QD (evening)	1 drop QD

Renal Undefined

Hepatic Undefined

Do not administer more than once daily

Instructions

Instill in the evening; do not administer more than once daily
Separate other topical ophthalmic products by at least 5 minutes
Not recommended in patients <16 years (pigmentation risk)

Available strengths

drops 0.01, 0.03 %
gel 0.01 %
implant 10 mcg

Cautions

Pigmentation of iris (likely permanent), periorbital tissue and eyelashes
Gradual eyelash changes (length, thickness, number)
Intraocular inflammation
Macular edema

Adverse reactions

Conjunctival hyperemia (31%)
Conjunctival edema/hemorrhage
Eye irritation, pain, pruritus
Eyelash growth/hypertrichosis
Punctate keratitis
Skin hyperpigmentation
Blurred vision

Pregnancy No adequate well-controlled studies; animal abortion/early delivery at high systemic exposures; use only if benefit justifies risk

Lactation Unknown whether present in human milk; weigh benefits of breastfeeding against maternal need

Cost

Bimatoprost (LUMIGAN)

Strength		#/mo	generic $/unit	CostPlus
0.01 %	drops	per unit		not offered
0.03 %	drops	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Bimatoprost is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2014

NO BOXED WARNINGS

Principal riskPermanent iris darkening and periorbital fat loss

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger0 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.

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