Bimatoprost
Bimatoprost is a topical prostamide analogue used in adults for ocular hypertension and open-angle glaucoma. It reduces intraocular pressure once daily and is also approved for hypotrichosis of the eyelashes in some markets.
- Chemical formula
- C25H37NO4
- CAS number
- 155206-00-1
- ATC code
- S01EE03
- Molecular weight
- 415.57 g/mol
- Drug class
- Prostaglandin analogue
- Also known as
- AGN 192024, Bimatoprost
What is it?
Bimatoprost is a synthetic structural analogue of prostamide F2-alpha, approved for clinical use in 2001. It is supplied as a 0.01% or 0.03% ophthalmic solution and as an eyelash solution for cosmetic indications. Bimatoprost is dispensed only on prescription in most jurisdictions, although the eyelash formulation has wider availability in some markets. It is one of the most commonly prescribed first-line agents for chronic open-angle glaucoma.
Mechanism of action
Bimatoprost is a prostamide analogue that increases aqueous humour outflow through both the trabecular meshwork and the uveoscleral pathway, lowering intraocular pressure. Unlike pure prostaglandin F2-alpha analogues such as latanoprost, bimatoprost may act on prostamide receptors in addition to FP receptors, although the clinical implications of this distinction are debated. The hypotrichosis indication results from prolongation of the anagen phase and increased follicle activity.
Pharmacokinetics
Topical bimatoprost is rapidly absorbed through the cornea, with peak aqueous humour concentrations within 10 minutes. Systemic absorption is minimal. Bimatoprost undergoes oxidation, N-deethylation and glucuronidation to multiple metabolites, with elimination predominantly via urine and faeces. The terminal plasma half-life is approximately 45 minutes after topical administration. The intraocular pressure-lowering effect persists for at least 24 hours, supporting once-daily dosing.
Indications
Bimatoprost is approved in adults for the treatment of ocular hypertension and chronic open-angle glaucoma. It is also approved in some markets for the treatment of hypotrichosis of the eyelashes (insufficient or inadequate eyelashes). According to international guidelines, prostaglandin analogues such as bimatoprost are typically first-line therapy for newly diagnosed glaucoma because of their efficacy, once-daily dosing and favourable systemic safety profile.
Safety profile
Common adverse effects include conjunctival hyperaemia, ocular irritation, eyelash growth and darkening, and progressive iris pigmentation, which is permanent. Periorbital skin pigmentation is also reported and may be reversible. Less common adverse effects include macular oedema, particularly in aphakic or pseudophakic patients, and uveitis. According to the prescribing information, contact lens wearers should remove lenses before instillation, and patients should be informed of potential cosmetic changes.
Products containing this ingredient
Frequently asked questions
How is bimatoprost different from latanoprost? ▾
Both are prostaglandin-class agents used for glaucoma. Latanoprost is a true prostaglandin F2-alpha analogue (an isopropyl ester prodrug), while bimatoprost is a prostamide analogue with somewhat different receptor activity. Clinical efficacy is broadly comparable, with bimatoprost producing slightly greater pressure reduction in some studies but more pronounced conjunctival hyperaemia. According to international guidelines, the choice depends on individual response and tolerability.
Why does bimatoprost cause iris colour changes? ▾
Prostaglandin analogues stimulate melanogenesis in iris melanocytes, leading to gradual increases in brown pigmentation. The change is most noticeable in patients with mixed-colour irises (blue-brown, green-brown, hazel) and is permanent. According to the prescribing information, patients should be informed of this possibility before initiating therapy. The cosmetic change does not affect ocular function or glaucoma control.
When is bimatoprost applied? ▾
Bimatoprost is applied as one drop in the affected eye(s) once daily, ideally in the evening. According to the prescribing information, more frequent dosing reduces rather than enhances the pressure-lowering effect. Multiple ophthalmic medications should be separated by at least 5 minutes. Contact lenses should be removed before administration and may be reinserted 15 minutes later.
Can bimatoprost be used to enhance eyelashes? ▾
A separate ophthalmic solution containing bimatoprost is approved in some countries for the treatment of hypotrichosis of the eyelashes (insufficient or inadequate eyelashes). According to the prescribing information, it is applied once daily to the upper lash line with a single-use applicator. Adverse effects include eyelid hyperaemia, pruritus, periorbital pigmentation and, rarely, iris pigmentation when the product reaches the eye.
What are the main contraindications for bimatoprost? ▾
Bimatoprost is contraindicated in known hypersensitivity to bimatoprost or its excipients. Caution is required in active intraocular inflammation, in aphakic or pseudophakic patients with disrupted posterior lens capsule (risk of macular oedema), and in pregnancy and breastfeeding. According to the prescribing information, the medical history must be reviewed by a clinician before any prescription, particularly in patients with a history of uveitis.
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.