bimatoprost: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
bimatoprost: clinical details
Prescribing considerations
- Licensed for adults with ocular hypertension or chronic open-angle glaucoma, as monotherapy or adjunctive treatment with topical beta-blockers.
- Counsel about potentially permanent iris pigmentation and prostaglandin-associated periorbitopathy.
- Use caution with risk factors for macular oedema, previous significant ocular viral infection, uveitis or iritis.
- Use caution in asthma, COPD, bradycardia, hypotension, renal impairment or moderate-to-severe hepatic impairment.
- Paediatric safety and efficacy have not been established for the selected products.
Contraindications and cautions
- Hypersensitivity to bimatoprost or an excipient.
- For these preserved products, a previous suspected adverse reaction to benzalkonium chloride that required discontinuation.
Monitoring
- Monitor intraocular pressure and clinical glaucoma control.
- Assess changes in iris pigmentation, eyelids, periorbital tissues and visual field where clinically relevant.
- Review promptly for visual deterioration suggestive of macular oedema.
- Monitor the ocular surface during prolonged use in dry eye, corneal disease or exposure to multiple benzalkonium chloride-containing drops.
- Monitor pressure if another prostaglandin analogue is used concurrently.
Clinical pharmacology
Bimatoprost is a synthetic prostamide related structurally to prostaglandin F2α. It lowers intraocular pressure by increasing trabecular and uveoscleral aqueous-humour outflow; systemic exposure after ocular administration is very low.
Formulation and product differences
- Both selected products are clear, colourless multidose eye-drop solutions containing benzalkonium chloride as preservative.
- The selected generic formulation also specifies phosphate content; phosphate-containing drops have rarely been associated with corneal calcification in people with severely damaged corneas.
- Other UK bimatoprost products may use different strengths, containers or preservative-free formulations, so administration and expiry instructions are not interchangeable.
bimatoprost preparations and strengths
Eye drops
Route: Ophthalmic
Strengths: 0.1 mg/mL, 0.3 mg/mL
bimatoprost interactions
Systemic interactions are unlikely because blood exposure after eye use is very low, but eye treatments can affect one another.
Other prostaglandin or prostamide eye drops, such as latanoprost, tafluprost or travoprost
Using similar agents together may reduce their pressure-lowering effect and requires review and intraocular-pressure monitoring.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.