Bimatoprost Ophthalmic Solution 0.03% (BIMAT) is a medication used to treat high intraocular pressure in patients with open-angle glaucoma and ocular hypertension (Conditions in which there is increased pressure in the eyes that can lead to gradual loss of vision) and cosmetically to treat hypotrichosis (A condition where there is little or no hair growth on the head, including eyebrows and eyelashes). It is used for adults 18 years and above. 

What does Bimatoprost (BIMAT) contain?

Bimatoprost contains  a prostaglandin F2a structural analog. It is approved by FDA as a treatment to lower intraocular pressure (IOP in patients with primary open-angle glaucoma and ocular hypertension.

The FDA also approved this medication to treat hypotrichosis, such as for patients post-chemotherapy. It has been studied extensively as an effective method of enhancing eyelash growth with favorable safety profiles and tolerability.

Due to the effects of longer, thicker, and darker eyelashes, Bimatoprost ophthalmic solution is also often purchased as an ophthalmic applicator product over-the-counter (OTC) for cosmetic purposes.

How does Bimatoprost (BIMAT) work?

In the reduction of intraocular pressure, Bimatoprost works by regulating the flow of fluid within the eyes. It improves the aqueous outflow and drainage through the trabecular meshwork and uveoscleral pathway. It exerts such effects by decreasing tonographic resistance to aqueous humor outflow.

Note that it does not affect aqueous humor production. 

Its use in promoting eyelash growth was first noted as a desirable side effect during glaucoma clinical trials. It most likely works by interacting with the prostaglandin receptors in the hair follicle and by stimulating the resting follicles in the telogen phase to growing follicles in the anagen phase of hair growth.

Who cannot take Bimatoprost (BIMAT)?

This medicine is not suitable for everyone. Tell your doctor if you are/have:

• Below 18 years old

• Allergic to Bimatoprost, Eyerida, Zimed, ingredients within the formulation, or silver

• Closed-angle glaucoma

How should you take Bimatoprost (BIMAT)?

It comes in two different strengths:

• 0.1mg/ml, where 1ml of liquid contains 0.1mg of Bimatoprost

• 0.3mg/ml, where 1ml of liquid contains 0.3mg of Bimatoprost

The administration of this medication varies depending on its intended purpose. Use this medicine only as directed or read the instructions that come with your medicine. Do not use more of this medicine than your doctor ordered. 

The preservative used in this eye medicine may be absorbed by contact lenses and cause irritation of your eyes and blur your vision. Remove your contact lenses before applying this product. Wait for 15 minutes before putting your lenses back. 

If you’re using Bimatoprost with another eye product, wait at least 5 minutes before using your other eye product. This will keep it from washing out the first one.

Never use a bottle if the seal is broken before you use it for the first time. Use the eye drops within the expiry date on the bottle and within 4 weeks after opening. This will help prevent risk of contamination and the eye drops not properly working. Do not use the droppers after expiry date.

Applying Bimatoprost for Hypotrichosis

The medication is currently available commercially as a bottled solution along with included applicators. The usual dose is one (1) drop in the upper eyelids every night. 

It is not recommended applying any solution directly to the eye. Do not touch the applicator tip to any surface, including the eye, to avoid contamination.

Be careful to apply as directed and wipe off any excess that comes into contact with other skin areas. There is a potential for hair growth in other areas this medicine comes into contact with.

1. Make sure your face is clean and remove your make-up and contact lenses before using this medicine.

2. Always wash your hands before and after using this medicine.

3. Remove the cap.

4. Place one drop of the solution on the disposable sterile applicator and apply it evenly along the skin of the upper eyelid margin at the base of the eyelashes.

5. Remove any excess solution around the eyes with a tissue or any absorbent cloth.

6. Repeat for the other upper eyelid margin using a new applicator.

7. Do not apply this medicine on the lower eyelashes.

8. Dispose of the applicator after each use.

9. Put the cap back on the bottle.

Applying Bimatoprost for Open-Angle Glaucoma

Follow the instructions given by your doctor and use this medicine regularly to get the most benefit. If you stop using it, pressure in the eye could increase and damage your sight.

The usual dose of Bimatoprost is one drop in the affected eye(s) every evening, although it may vary depending on the physician’s dosing. With Bimatoprost, 0.03%, reduction of IOP should begin after 4 hours, and the effect will peak at 12 hours but will maintain the reduced IOP through 24 hours.

1. Wash your hands first.

2. If you are using a bottle, remove the cap. If it does not come with a separate dropper, practice gently squeezing the bottle away from your eye first to get used to the pressure and the time it takes for 1 drop to fall out.

3. Tilt your head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Make sure the dropper or tip of the bottle does not touch your eye, eyelashes, eyelid, your skin, or any other surface. 

4. Hold the dropper or tip of the bottle over your eye, look up, squeeze gently and allow 1 drop to fall into your lower eyelid.

5. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed for 1 to 2 minutes to allow the medicine to be absorbed by the eye. Gently press your finger over the inside corner of your eye (over the eyelid) for about a minute. This helps to keep the drops in the eye.

6. Remove any excess solution around the eye with a clean tissue, being careful not to touch the eye.

7. If you think you did not get the drop of the solution into your eye properly, repeat the directions with another drop.

8. Repeat in the other eye as directed by your doctor.

9. Put the cap back on the bottle. If you are using the single-dose dropper, throw it away.

10. Immediately after using the eye drops, wash your hands to remove any medicine that may be on them. 

What if you miss a dose?

If you forget a dose by less than 2 hours, use a single drop as soon as you remember, then return to your normal routine for your next dose. If you forget a dose by more than 2 hours, skip the missed dose and use your next dose at the normal time. 

Never use 2 doses at the same time. Never use an extra dose to make up for a forgotten dose.

What if you take too much?

Taking too much of the eye drops can irritate your eye and make it watery and red. If this happens, rinse it all out with water. Do not put any more drops until it is time for your next dose. It should get better, but if you are worried or if symptoms persist, consult your doctor.

However, if with accidental ingestion, call your doctor or visit the nearest hospital immediately.

Who are the side effects of Bimatoprost (BIMAT)?

Numerous trials have demonstrated the high level of safety and tolerance of Bimatoprost when applied to the ocular surface or eyelids. Like all medicines, Bimatoprost has side effects, but not all get them.  Consult your doctor if they persist or bother you. Common side effects include:

• Red, itchy, dry eyes

• Burning irritation, foreign body sensation

• Eyelid pigmentation

• Change in eye color – may be permanent especially if you take this medication for a long time

Discontinue use and call your doctor immediately if you experience these rare but serious side effects:

• Serious allergic reaction

• Shortness of breath

• Difficulty breathing if you have asthma or COPD

• Dizziness

What other precautions should be taken?

Children

Safety and efficacy of this medication have not been established in this population.

Elderly

It is safe to use in the geriatric population.

Pregnancy

It is safe to use during pregnancy.

Breastfeeding

You can use this medication while you’re breastfeeding. There is insufficient information on its use on breastfeeding, but very small amounts pass into the breastmilk.

If your baby is not feeding well, or you have concerns with your baby, talk to a healthcare professional.

Drug-Disease Interactions

To make sure it’s safe for you, inform your doctor if you:

• • Have had an eye surgery, including eye lens replacement surgery

  • Retinal detachment

  • Loss or torn lens of the eye

  • Have any problems in your cornea (outer layer of the eye)

  • History of inflammation (uveitis/irits) or viral infection (herpes simplex) in the eyes

  • Dry eyes

  • Kidney disease

  • Moderate to severe liver disease

  • Asthma, chronic obstructive pulmonary disease (COPD)

Drug-Drug Interactions

There are medicines that interact with Bimatoprost and affect how it works. Tell your doctor if you are taking any of these. If you are taking 2 of these medicines together, they can increase pressure in your eye. 

• • Latanoprost

  • Tafluprost

  • Travoprost

Alcohol

You can drink alcohol while on this medication.

Driving

You might have blurred vision after you’ve put your drops on. If this happens, do not drive or operate machinery until your vision goes back to normal.

Diet and Lifestyle

You can eat and drink normally while on this medication.

How should you store Bimatoprost (BIMAT)?

• Keep out of the reach of children. 

• Keep away from direct sunlight, heat, or moisture

• Do not keep outdated medicine or medicine no longer needed.

• Ask your healthcare professional how you should dispose of any medicine you do not use.

• You may store the medicine in the refrigerator or at room temperature.

Quick Tips

• Depending on its effects on you, you may have to use it for the rest of your life. However, if it’s not working for you or is troubling you with its side effects, consult your doctor.

• If you’re using this medication for open-angle glaucoma, regular visits to your doctor are necessary for monitoring of IOP.

• If you’re using this dermally for eyelash growth, monitoring for potential side effects is advised.

• When Bimatoprost is discontinued, eyelashes may return to their original pre-treatment length and thickness.

What company produces Bimatoprost (BIMAT)?