Bimatoprost belongs to a class of medications called prostamides. It is available in eye-drop form and is used to reduce the pressure inside the eye for people with open-angle glaucoma or intraocular hypertension (increased pressure in the eye).

Fluid is constantly being formed and drained out of the eye. When this fluid does not drain out of the eye properly, pressure inside the eye increases. Bimatoprost works by increasing the flow of fluid out of the eye. It starts to work within 4 hours after being instilled in the eye.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The recommended dose of bimatoprost is one drop in the affected eye(s) in the evening. This medication should not be used more than once a day, since using this medication more often than once a day may cause it to be less effective in lowering the pressure in the eye.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important that this medication be used exactly as prescribed by your doctor.

To use the eye drops:

• Wash your hands before using the eye drops.
• Remove the cap and place it in a clean location. To avoid possible contamination, keep the tip of the container away from contact with any surface.
• Tilt the head back and look towards the ceiling.
• With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
• Apply one drop into the pouch but do not allow the tip of the container to touch the eye or areas around the eye.
• Let go of the lower eyelid and close your eyes for 30 seconds.
• Repeat with the other eye, if prescribed by your physician.
• Wash your hands again to remove any medication.

Do not allow the dropper tip of the bottle to touch the eye or other surrounding structures. This can contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye may result if you use eye drop solutions that have become contaminated.

If you are using other eye drops, apply them at least 5 minutes apart.

If you wear contact lenses, remove them before instilling bimatoprost into your eye. You may put your contact lenses back in 15 minutes after using the medication.

If you miss a dose, instill it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not instill a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children. Safely discard any medication remaining in the dropper bottle 30 days after first opening the bottle.

0.01% Ophthalmic Solution
Each mL of clear, colourless, sterile solution contains 0.1 mg of bimatoprost. Nonmedicinal ingredients: 0.2 mg of benzalkonium chloride as preservative, sodium chloride, sodium phosphate dibasic heptahydrate, citric acid monohydrate, and purified water. Sodium hydroxide and/or hydrochloric acid may be added to adjust pH.

Do not use this medication if you are allergic to bimatoprost or any ingredients of the medication.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• a feeling of something in the eye
• burning eyes
• dry eyes
• excessive hair growth
• eye irritation such as itching, redness, or stinging
• increased tear production
• longer eyelashes
• red, itchy eyelids

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• change of eyelash colour
• darkening of eyelid skin colour
• deepening or drooping eyelid
• discharge from the eye
• eye pain
• feeling tired
• increase in brown colour in coloured part of eye (the iris)
• inflammation of the eyelid
• sensitivity of eye to light
• vision problems (e.g., decreased acuity, blurred vision)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blurred vision: This medication may cause temporarily blurred vision immediately after putting the drops in your eyes. Avoid driving or operating hazardous equipment until your vision clears.

Contact lenses: Contact lenses should be removed before bimatoprost eye drops are applied, and not reinserted for 15 minutes after application of the drops. The preservative in these eye drops can build up on contact lenses and cause the lens to discolour.

Eye changes: Bimatoprost may gradually change the colour of the eye, increasing the amount of brown pigment in the iris (coloured part of the eye). The long-term effects on the eye and the chances of injury to the eye are currently unknown. The change in colour may be permanent. The change in colour occurs slowly, and may not be noticeable for several months or years. Bimatoprost has also been reported to cause darkening, thickening, and lengthening of eyelashes.

Eye conditions: This medication should not be used by people with certain types of eye conditions (e.g., uveitis, certain lens problems). If you have eye conditions other than open-angle glaucoma, discuss with your doctor how bimatoprost may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: The effects of this medication have not been studied for use by people with decreased kidney function. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: The effects of this medication have not been studied for use by people with decreased liver function. If you have liver disease or reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if bimatoprost passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between bimatoprost and any of the following:

• latanoprost
• latanoprostene
• nonsteroidal anti-inflammatory medications (e.g., diclofenac, ibuprofen, ketorolac, naproxen)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.