Bimatoprost is a synthetic prostaglandin analogue (PGA) used primarily as a topical ophthalmic solution for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. It is also widely used for the treatment of hypotrichosis of the eyelashes. In the Indian context, it is a first-line prostaglandin therapy due to its potent IOP-lowering efficacy and once-daily dosing, improving patient compliance.
Adult: One drop (approximately 0.03 mg) in the affected eye(s) once daily in the evening. Do not exceed once-daily dosing.
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid down to form a pouch. 4. Instill one drop. 5. Close eyes gently and apply pressure to the nasolacrimal duct (inner corner of eye) for 1-2 minutes to reduce systemic absorption. 6. Wait at least 5 minutes before administering any other topical ophthalmic medication. If using contact lenses, remove before application and reinsert after 15 minutes.
Bimatoprost is a synthetic prostamide analogue with ocular hypotensive activity. It is believed to mimic the activity of prostamides (endogenous substances) rather than acting on classic prostaglandin receptors. Its primary mechanism for reducing IOP is by increasing the outflow of aqueous humor through both the trabecular meshwork and, predominantly, the uveoscleral pathways.
Pregnancy: Category C: Animal studies have shown adverse fetal effects. There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Minimal systemic absorption reduces risk.
Driving: May cause transient blurred vision or other visual disturbances after instillation. Patients should not drive or use machinery until vision clears.
| Other Topical Ophthalmic PGAs (Latanoprost, Travoprost, Tafluprost) | Additive IOP-lowering effect, but concurrent use is not recommended due to increased risk of side effects without proven additional benefit. | Major |
| Topical Beta-blockers (Timolol, Betaxolol) | Additive IOP-lowering effect; commonly used in fixed-dose combinations. Monitor for excessive IOP reduction. | Moderate |
| Topical Cholinergic Agonists (Pilocarpine) | The miotic effect of pilocarpine may theoretically reduce uveoscleral outflow, potentially antagonizing bimatoprost's effect. Administer at least 5 minutes apart. | Moderate |
| Thimerosal-preserved eye drops | Physical incompatibility leading to precipitation. Do not administer simultaneously. | Major |