What is Bimatoprost?
Bimatoprost is a structural analog of prostaglandin F2⍺ (PGF2⍺). Similar to other PGF2⍺ analogs, it increases the outflow of aqueous fluid from the eye, thereby lowering intra-ocular pressure. Used by ophthalmologists to treat refractory open angle glaucoma, it has been reported that topical ophthalmic treatments also result in eyelashes that are thicker, darker and longer.
Availability
Available by prescription only.
Strength
Bimatoprost 0.01% and 0.03% solution (0.3 mg/ml) in 3,5 & 9 ml.
Brand Names
Latisse 0.03% topical is manufactured by Allergan for the US market.
Lumigan 0.01% and 0.03% ophthalmic is manufactured by Allergan for the UK market.
Generic Lumigan is manufactured by Lupin Pharmaceuticals in Bimatoprost Ophthalmic Solution 0.03% only.
Lumigan is essentially the same solution as Latisse but is meant to be used as eye drops for glaucoma patients.
How to Use?
- 1 drop of Latisse is placed onto a special sterile applicator.
- Then, after closing the eye, it is applied to the upper eyelid margin at the base of the eyelashes.
Application is one-time daily in the evening. Application more often than once per day will not increase eyelash growth more than with recommended use. It is understood that the bimatoprost applied to the upper eyelid margin will give a coating to the lower eyelid when the eyelids close. A new applicator should be used for each eye, and the sterile applicators should not be reused. Excess solution should be blotted with a tissue.
Some patients have used the residual solution off-label on their eyebrows and reported increased growth. In general, use of this product on the scalp has been disappointing. Allergan was in the process of investigating the benefits of scalp application but abandoned their work at the phase 2 stage of research and development.
Also Read: Medications for Hair Loss
Results Timeline
Increased eyelash growth is usually noted at 4 weeks and peaks at 16 weeks. Patients should continue using it even once they notice effects. Discontinuation will result in eyelash length returning to their original appearance within several weeks to months.
Missed Dose
If a dose is missed, continue the regular dosing schedule the next evening. Do not apply extra solution to make up for a missed dose.
Storage Instructions
Bimatoprost should be stored at room temperature and away from excess heat and moisture (not in the bathroom). Refrigeration is not required.
Disposal Instructions
Latisse has a shelf life of 16 months past the shipping date and should not be used past this date. Expired product should not be flushed down the toilet. A medicine take-back program should be identified in your area, or talk to a local pharmacist.
Mode of Action
Topical bimatoprost is used to treat hypotrichosis of the eyelashes. Bimatoprost appears to work by increasing the growth (anagen) phase of the eyelashes, although some think it is by shortening the resting (telogen) phase. It increases the pigmentation of the eyelashes by stimulating melanogenesis.
Also Read: HAIR LOSS AND THE HAIR GROWTH CYCLE
Precautions
Because of safety concerns, the use of bimatoprost to treat open-angle glaucoma or ocular hypertension in children and teenagers younger than 16 years of age is not recommended.
There has not been sufficient research to determine the safety of bimatoprost during pregnancy. However, there has not been sufficient evidence linking bimatoprost to birth defects either.
No information is available on the use of bimatoprost during breastfeeding. In general, because of its short half-life, it is unlikely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. However, that advice should be dispensed from your treating physician.
Interactions
There are no known conflicting medications with bimatoprost. If the patient is taking another medication that is also administered on the eyes, it is recommended to wait at least five minutes between doses.
Side Effects
The treatments are typically well tolerated and associated with very few adverse side effects. Topical bimatoprost may cause darkening of the eyelid skin, which may be reversible. The most common side effect is conjunctival hyperemia, occurring in more than 10% of patients. Other effects can include itching, irritation, redness, dry eyes, watery eyes, and dizziness, occurring in less than 4% of patients. Long-term use (months to years) may cause brown discoloration of the colored portion of the eye (iris), macular edema, and fat atrophy in the peri-orbital tissues.
Increased pigmentation of the eyelashes and sometimes the eyelid skin occurs. Also, patients need to be aware that the color of the iris can darken to a brownish color and that this can be permanent.
Effectiveness
Increases in the density, length, pigmentation, and caliber of eyelashes have been noted from the topical application of PGF2⍺ compounds within weeks.
A study of 278 adults using bimatoprost 0.03% had a 106% increase in eyelash thickness compared to a 12% increase with the control vehicle after 4 months of use.
A 2016 study of 336 patients with eyebrow hypotrichosis had 118 apply 0.03% bimatoprost once daily and another 118 patients twice daily to their eyebrows. 84% at twice daily and 77% at once daily had measurable improvement at 7 months.
Bimatoprost or similar prostaglandin modulators have been used for scalp hair loss, but at this point in time, they would be considered supplementary at best or at least investigational in their efficacy for scalp hair loss.
Alternatives
There have been “natural” eyelash stimulating products that use a variety of ingredients, including different peptides and other growth factors. These treatments usually do not have the adverse side effects of pigmentation on the skin or the eye. However, efficacy may be more variable depending on which product you choose to use and how your body responds to that therapy. Another alternative to medications is an eyelash transplant. You should consult with a qualified hair restoration surgeon to see if you’ll be a good candidate for the transplant.