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| Clinical data | |
|---|---|
| Trade names | Lumigan, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a602030 |
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| Routes of administration | eye drops |
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| Pharmacokinetic data | |
| Bioavailability | Low |
| Protein binding | 88% |
| Onset of action | 4 hrs |
| Eliminationhalf-life | 45 min afterintravenous application |
| Duration of action | ≥ 24 hrs |
| Excretion | 67%Kidney, 25%fecal |
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| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.170.712 |
| Chemical and physical data | |
| Formula | C25H37NO4 |
| Molar mass | 415.574 g·mol−1 |
| 3D model (JSmol) | |
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Bimatoprost, sold under the brand nameLumigan among others, is amedication used to treathigh pressure inside the eye includingglaucoma.[6] Specifically it is used foropen angle glaucoma when other agents are not sufficient.[6][7] It may also be used to increase the size of theeyelashes.[4][5] It is used as an eye drop and effects generally occur within four hours.[6][5]
Common side effects include red eyes, dry eyes, change in color of the eyes, blurry vision, andcataracts.[6][7][5] Use duringpregnancy orbreastfeeding is generally not recommended.[1][7][5] It is aprostaglandin analog and works by increasing the outflow ofaqueous fluid from the eyes.[6]
Bimatoprost was approved for medical use in the United States in 2001.[6] It is available as ageneric medication.[7][4][8] In 2023, it was the 238th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[9][10]
Bimatoprost is used for the treatment ofopen-angle glaucoma and ocular hypertension in adults, either alone or in combination with abeta blocker, typicallytimolol.[6][5][11]
Studies have shown bimatoprost to be more effective than timolol in reduction of intraocular pressure (IOP) and at least as effective as the prostaglandin analogslatanoprost andtravoprost in reducing IOP.[12]
Bimatoprost may be used to treat small or underdeveloped eyelashes.[4][5] The medical term for this is treatment ofhypotrichosis; however, the U.S.Food and Drug Administration (FDA) approval is for purely cosmetic purposes (seeProstaglandin F receptor#Clinical significance).[13][verification needed]
Side effects are similar to other prostaglandin analogs applied to the eye. The most common one isconjunctival hyperemia, which occurs in more than 10% of patients. Other effects include blurred vision, eye and eyelid redness, eye burning or other discomfort, and permanent darkening of theiris to brown.[11][6][4] Occasional adverse effects (in less than 1% of patients) are headache and nausea.[11]
Some side effects are specific to the cosmetic formulation, which is applied to the skin at the base of the eyelash rather than instilled into the eye. These include infection if the one-time applicators are reused, and darkening of the eyelid or of the area beneath the eye.[4][14] Research suggests that wiping the eye with an absorbent pad after the administration of eye drops can result in shorter eyelashes and a lesser chance of hyperpigmentation in the eyelid, compared to not wiping off excess fluid.[15]
No interaction studies with this substance have been performed. Interactions with systemic (for example, oral) drugs are considered unlikely because bimatoprost does not reach relevant concentrations in the bloodstream. Bimatoprost does not negatively interact with timolol eye drops.[11]
Bimatoprost is astructural analog ofprostaglandin F2α (PGF2α). Like other PGF2α analogs such as travoprost, latanoprost andtafluprost, it increases the outflow of aqueous fluid from the eye and lowers intraocular pressure. However, in contrast to these it does not act on theprostaglandin F receptor, nor on any other known prostaglandin receptor. It is thought that bimatoprost mimics the human body's ownprostamides (which are chemically similar), a class of substances related to prostaglandins, but with an unknown mechanism of action.[6][11] No prostamidereceptor has been identified as of 2015[update]; the search is ongoing.[16] As of 2019 it was thought that bimatoprost worked via the trabecular meshwork and uveoscleral pathways.[17][18]
Bimatoprost is well absorbed through thecornea. It starts lowering intraocular pressure after four hours, lasting for at least 24 hours. A low percentage enters the bloodstream. In the blood plasma, peak concentrations are reached after 10 minutes, then drop below the detection limit of 25pg/ml after 1.5 hours. The substance does notaccumulate in the body.[6][11]
Plasma protein binding is 88%. Bimatoprost is metabolized by oxidation,N-deethylation andglucuronidation, forming a variety ofmetabolites. Biological half-life was measured to be 45 minutes afterintravenous infusion. 67% are eliminated via the kidney, and 25% via the feces.[6][11]
Bimatoprost has been used to treat eyebrow hypotrichosis in a 60-year old female.[19] The 0.03% solution was applied topically once a day for eight months and showed "increased hair growth and thickening of the eyebrow hairs".
Bimatoprost and its endogenous analog prostaglandin F2α ethanolamide present the side-effect of being anti-adipogenic, and have been shown to be inducers of preadipocyte proliferation. These findings suggest bimatoprost is a possible therapy for obesity.[20]
Bimatoprost reduces intraocular pressure in man by increasing aqueous humour outflow through the trabecular meshwork and enhancing uveoscleral outflow.
