Bimatoprost is a drug that is a component of ophthalmic preparations used in the fight against certain types of glaucoma.

However, today the drug has become widespread as a cosmetic product that helps strengthen and grow eyelashes.

Indications for use

The drug is indicated for:

• increased intraocular pressure;
• eyelash hypotrichosis, their loss;
• weak eyelash growth.

Drops with Bimatoprost

The substance is used in some medicines. The most common are Careprost, Latisse and Gunfort drops..

Careprost stimulates blood circulation, activates an increased metabolism and provides blood flow to the eyelashes.. Thanks to this, nutrients penetrate better into the hair follicle, which ensure the growth and health of eyelashes. Also, the drug increases their volume and length. In addition, it can be applied to the eyebrows.

Drops are applied to the upper eyelid along the roots of the eyelashes with a special applicator 1 time per day.. The duration of the course is 3 months. If the product gets into other areas of the eye, it is immediately removed with a cotton pad. The cost of the drug is from 850 rubles.

Latisse is designed to strengthen eyelashes, nourish hair follicles and improve general health.. Thanks to this tool, eyelashes begin to grow faster, while becoming thicker and darker.

Use the product once a day before bed. Before use, it is necessary to thoroughly cleanse the face of impurities and cosmetics and remove contact lenses. The package contains disposable sterile applicators, with which drops are applied to the upper eyelid along the lash line. The product should not flow out of the limits and, if necessary, remove excess moisture.

A new applicator is used for each eye and should be discarded after use.. The average cost of Latisse is 3048 rubles.

The composition of the drops includes not only bimatoprost, but also timolol. Together they reduce intraocular pressure, increase the outflow of intraocular fluid and reduce its formation.. Gunforth is directly used as agents for the treatment of glaucoma. G anfort is applied 1 time per day in the morning. It is necessary to drip 1 drop into the conjunctival sac of the affected eye.

In the case of using several drugs, make a pause of 15 minutes between their use.The cost is 885 rubles.

special instructions

After using the drug, the clarity of vision may be temporarily lost. therefore it is necessary to wait some time before driving or doing work that requires special attention. The product should not be applied if contact lenses are worn.. After using the drug, you need to wait a while for the drops to be absorbed.

Tests studying the interaction of the substance with drugs have not been conducted. In theory, it enhances the effect of drugs that depress the central nervous system.. These include sedatives, anesthetics, alcohol, barbiturates, and opioids.

Interaction with other types of substances is unlikely due to the fact that Bimatoprost enters the blood in low concentrations. The tests also did not reveal interaction with β-blockers

Pregnancy and lactation

The drug is contraindicated during pregnancy and lactation, as it penetrates the body and actively affects it.. In addition, Bimatoprost enters the mammary glands. For these reasons, the medicine should not be used in these cases.

(5Z)-7-((1R,2R,3R,5S)-3,5-dihydroxy-2-[(1E,3S)-3-hydroxy-5-phenyl-1-penten-1-yl]cyclopentyl) -N-ethyl-5-heptenamide

Chemical properties

Bimatoprost is a fatty acid, synthetic prostamid , analogue prostaglandin , used for treatment and increased. The substance is highly soluble in ethanol, methanol, DMSO and DMF. Molecular weight of Bimatoprost on Wikipedia = 415.6 grams per mole. The product is produced in the form of eye drops or a solution for application to the eyelashes.

pharmachologic effect

Lowers intraocular pressure.

Pharmacodynamics and pharmacokinetics

The mechanism of action of Bimatoprost is not fully understood. It is believed that the substance selectively mimics the effect prostamids thus reducing IOP. Under the influence of the drug, the outflow of fluid through the trabecular network increases and stimulates uveoscleral outflow intraocular fluid. The effect of the use of the drug develops within 4 hours after administration and reaches a maximum after 8-12 hours. The duration of action is one day.

The substance penetrates well through the sclera and cornea of ​​the eye. Does not accumulate, does not have any systemic effects. With a single use, the maximum concentration of the substance is observed 10 minutes after the procedure and decreases within 1.5 hours.

Indications for use

Bimatoprost is prescribed:

• for treatment open-angle ;
• at ophthalmic hypertension ;
• for treatment eyelash hypotrichosis .

Contraindications

The drug is not used:

• in the treatment of pregnant women and persons under the age of 18;
• during breastfeeding;
• with the active active components of the product.

• at aphakia , pseudophakia ;
• patients who have damage to the posterior lens capsule;
• if there is a risk of edema macula ;
• after prolonged treatment;
• patients with elevated;
• at nephropathy ;
• with low blood pressure;
• sick uveitis (the disease can progress).

Side effects

Possible side effects of Bimatoprost:

• itching and irritation of the eyes, redness of the eyelids;
• hyperemia conjunctiva ,hyperpigmentation skin on the eyelids;
• dry eye syndrome, low

Instructions for use (Method and dosage)

Eye drops are usually used once a day. The medicine is instilled into conjunctival sac the affected eye once a day, in the morning.

If the next instillation of the drug was missed, then the treatment is resumed the very next day. The duration of treatment depends on the recommendations of the doctor.

Instructions for Bimatoprost for eyelash growth

The substance is used once a day, before going to bed, after cleansing the face of decorative cosmetics and removing contact lenses. The drug is applied along the hairline with a special applicator brush along the edge of the upper eyelid.

Do not apply the product on the lower eyelid. The sterile applicator is used once and then discarded. The dropper of the vial should not come into contact with the skin or other surfaces to avoid infection.

Overdose

With oral administration of Bimatoprost to rats, at a dosage of 100 mg per kg of body weight, no symptoms of toxic effects were observed for 2 weeks.

There is no information about an overdose of the drug. If an accidental overdose of the drug occurs, symptomatic treatment is carried out.

Interaction

When combined with other drugs that affect intraocular pressure, the pressure may decrease more slowly, and the degree of reduction will be less pronounced.

Terms of sale

On prescription.

Storage conditions

The drug is stored in a cool place, closed, away from small children.

Best before date

24 months. After opening the vial, the medicine must be used within 28 days.

special instructions

The effect of the drug, if it is used to enhance eyelash growth, is temporary. The tool must be used for a long period of time and repeated courses. Also, eyelashes may grow unevenly, their color and thickness, and the direction of growth may change.

One of the side effects of using the remedy is hyperpigmentation iris, especially dark pigment. In the iris increases the content melanin and the number increases melanocytes . It is unknown how long this effect will last. The color of the skin of the eyelids may also change. Such changes are temporary and reversible.

Contact lenses must be removed 15 minutes before using the drug and reinstalled 15 minutes after instillation.

If unusual symptoms occur during treatment, visual acuity has decreased, the eye has been injured or infected, it is recommended to contact an ophthalmologist and decide on stopping treatment.

children

The drug should not be administered to children under the age of 18 years.

During pregnancy and lactation

Experiments were conducted on animals in which the substance was given orally, at doses 30-40 times higher than recommended. As a result, the number of miscarriages increased in females, a reduction in the gestation period, a decrease in the body weight of newborns, and an increase in the frequency of fetal death were observed. There is not enough data on the safety of the drug in pregnant women. Therefore, special care should be taken during treatment with the drug during pregnancy.

Bimatoprost passes into breast milk. During treatment, breastfeeding is recommended to stop.

Preparations containing (Analogues)

Coincidence in the ATX code of the 4th level:

Bimatoprost is part of the preparations: Latisse , Bimatoprost I-lashpro , Careprost . Also, the substance is an active component of eye drops. Gunforth (in combination with ).

The active substance of the drug is bimatoprost, which is a prostamide of artificial origin. When using the drug, the outflow of intraocular fluid improves. The action of Bimatoprost begins approximately 4 hours after the instillation of the medication. The agent is able to penetrate the cornea of ​​​​the eye. "Bimatoprost" is used in the treatment of open-angle glaucoma, excessive loss of eyelashes. In addition to the active substance, there are other components in the medication: sodium chloride, a certain amount of citric acid, and specially purified water.

The use of Bimatoprost for eyelash growth

Positive changes can be seen after 6-8 weeks of active use of Bimatoprost. When the course is stopped, the condition of the eyelashes may worsen again.

Important! "Bimatoprost", which activates the growth of eyelashes, is not recommended for use during pregnancy and lactation, since relevant clinical studies have not been conducted. The tool is effective both with the slow growth of eyelashes, and with their excessive loss.

Contraindications to prescribing medication

From the use of the drug "Bimatoprost" should be abandoned to children under the age of 16 years. The drug is contraindicated in case of hypersensitivity to its components.

Side effects of the drug

Many patients using Bimatoprost complain of conjunctival hyperemia. When using the medication, the following side effects may occur:

• The appearance of a feeling of dryness in the eye;
• Decreased clarity of vision;
• The appearance of a foreign body sensation in the eye;
• The appearance of signs of blepharitis;
• Changing the shade of eyelashes;
• redness of the eyes;
• Photophobia;
• Excessively active growth of eyelashes;
• Increased lacrimation.

Side effects such as asthenia and headache are quite rare when using Bimatoprost. In case of accidental drug overdose, symptomatic treatment is carried out.

Features of the interaction of "Bimatoprost" with other medicines

The drug interacts well with most drugs. But it is not recommended to use it simultaneously with medicines belonging to the group of β-blockers. The interaction of such drugs with Bimatoprost has not yet been studied.

special instructions

• Retinopathy of diabetic nature;
• Afakia.

Bimatoprost should not be used if the patient has angle-closure, narrow-angle or congenital glaucoma. Patients who have been diagnosed with liver failure or severe kidney disease should use the drug with caution.

From the use of "Bimatoprost" should refrain from people with a low heart rate, low blood pressure.

Important! Due to the presence of benzalkonium chloride in Bimatoprost, it is necessary to monitor the condition of the cornea. When using the drug in people with dry eye syndrome, the risk of punctate ulcerative keratopathy increases.

When using the drug "Bimatoprost" there may be a temporary decrease in visual clarity. When undergoing a treatment course, it is recommended to refrain from driving a car or doing mental work.

If the patient has iritis, Bimatoprost should be used with caution. In the presence of this pathology, an inflammatory process is observed in the region of the iris. The likelihood of iritis increases in the presence of the following pathologies:

1. The presence in the body of foci of chronic infection (inflammation of the tonsils, sinusitis);
2. Increased concentration of sugar in the blood;
3. Certain autoimmune diseases;
4. Prolonged stress;
5. Nervous strain;
6. Hypothermia.

Note! Iritis can be a complication of eye surgery.

Features of storage of the drug "Bimatoprost"

Eye drops "Bimatoprost" are recommended to be stored in a place that is not accessible to small children. The shelf life of the drug is 2 years from the date of its manufacture. The drug should be stored in a place protected from direct sunlight.

Reviews about the medicine

Reviews about the drug "Bimatoprost" are generally positive. At the same time, many patients note the high cost of the medicine: about 800 rubles.

Karina, 25 years old, Krasnoyarsk.
I have no particular complaints about Bimatoprost. During the use of the drug, no side effects were observed. After using Bimatoprost, the eyelashes grew noticeably, acquired a darker shade. But, unfortunately, the achieved effect quickly disappeared. In the future, I will not use Bimatoprost, which activates the growth of eyelashes. In my opinion, the medicine does not justify its high cost.

Anna, 30 years old, Omsk.
I have a positive impression of Bimatoprost. After applying the medicine, the eyelashes really began to look more attractive. In the first days of using Bimatoprost, I had increased lacrimation, which quickly passed. Next time I will use a cheaper analogue of the medicine, since the cost of the medicine is quite high.

Other effective drugs for glaucoma

Eye drops "Taurine" are used in the presence of the following indications:

1. Degeneration of the corneal tissue. Pathology can be a congenital anomaly. Corneal tissue dystrophy is often the result of trauma to the trigeminal nerve, keratitis, and age-related changes. In the presence of tissue dystrophy, clouding of the cornea may occur. After the application of "Taurine" there is an improvement in the trophism of the corresponding tissues.
2. Cataract. The disease develops under the influence of factors such as hereditary predisposition, smoking, exposure to radioactive radiation. The drug "Taurine" improves the nutrition of cells in cataracts, activates the process of regeneration of the eye membranes.
3. Glaucoma. The disease develops under the influence of various factors. The risk of glaucoma increases with hereditary predisposition. Glaucoma often occurs in patients who have been diagnosed with various eye diseases (myopia, cataracts, iridocyclitis). Patients with hypertension, obesity, and diabetes mellitus are also at increased risk. Glaucoma can also occur in people suffering from cervical osteochondrosis (when the innervation of the eyeballs deteriorates). In the presence of this pathology, an increase in intraocular pressure occurs due to a slowdown in electrolyte balance. The drug "Taurine" reduces the risk of atrophy of the optic nerves, reduces intraocular pressure.

According to the instructions for the use of Taurine drops, the medicine is not prescribed to patients under the age of eighteen. It is contraindicated in case of hypersensitivity to the components of the drug. From the use of "Taurine" during the period of expectation of the child and breastfeeding should be abandoned.

When using eye drops, the following side effects may occur:

• The appearance of a burning sensation in the eyes;
• Redness;
• Increased lacrimation;

The drug "Ocumol" belongs to the group of beta-blockers of non-selective type. The drug helps to normalize intraocular pressure. In the treatment of open-angle glaucoma, the drug "Pilocarpine" is also actively used.

The active substance of Azopt is brinzolamide. The drug is actively used in the presence of open-angle glaucoma in a patient. Azopt should not be used in case of hypersensitivity to its components. It is contraindicated if the patient has severe kidney pathologies: the main part of brinzolamide is excreted from the body by the kidneys. The drug is not recommended for use in the treatment of patients who have been diagnosed with chronic liver disease.

When using Azopt, the following side effects may occur:

• blurred vision;
• The appearance of a bitter taste in the mouth;
• Feeling of dry eyes;
• Headache;
• Redness of the conjunctiva;
• The appearance of itching;
• Keratopathy;
• Lachrymation.

Important! In some situations, when using the Azopt drug, complications such as nausea, the occurrence of pain in the chest, pain in the lumbar region, and the appearance of an allergic rash are observed.

The use of folk methods in the presence of a patient with glaucoma

At the initial stage of glaucoma, folk methods are actively used. You can pour 30 grams of eyebright pour 400 ml of boiling water. The resulting mixture is infused and cooled to room temperature. A ready-made remedy for cataracts is actively used for washing the eyes. The infusion helps to reduce intraocular pressure, prevents the exacerbation of glaucoma.

Antiglaucoma agent. Bimatoprost is a synthetic prostamide structurally related to prostaglandin F2α that does not act through known prostaglandin receptors. Bimatoprost selectively mimics the effects of a recently discovered biosynthetic substance, the prostamides. However, the structure of prostamide receptors has not yet been identified.

Reduces intraocular pressure by increasing the outflow of aqueous humor through the trabecular meshwork and increasing uveoscleral outflow.

The decrease in intraocular pressure begins approximately 4 hours after the first injection, the maximum effect is reached after about 8-12 hours. The effect lasts for at least 24 hours.

According to clinical studies, there was no significant effect of bimatoprost on heart rate and blood pressure.

Pharmacokinetics

Bimatoprost penetrates well into the human cornea and sclera in vitro. After instillation by adults, the systemic exposure of bimatoprost is very low, no accumulation of the active substance was noted. After the introduction of one drop of the drug in both eyes 1 time / day for 2 weeks, the concentration in the blood reached a maximum 10 minutes after the dose, and within 1.5 hours this indicator was below the detection level (0.025 ng / ml). Mean values ​​of C max and AUC 0-24 h were approximately the same on days 7 and 14 - approximately 0.08 ng / ml and 0.09 ng × h / ml, respectively, indicating that C ss of bimatoprost was achieved within 1 week of instillation. Bimatoprost is moderately distributed in the tissues of the body, and V d in an equilibrium state is 0.67 l / kg. In human blood, bimatoprost is found mainly in plasma. The binding of bimatoprost to plasma proteins is about 88%. Bimatoprost reaches the systemic circulation mainly unchanged. Then there is oxidation, N-deethylation and glucuronization with the formation of a number of metabolites.

Bimatoprost is excreted mainly by the kidneys. Up to 67% of the dose administered intravenously to healthy adult volunteers was excreted in the urine, 25% in the feces. T 1/2 after intravenous administration was approximately 45 minutes, the total clearance from the blood was 1.5 l / h / kg.

When using more than one topical ophthalmic preparation, an interval of 5 minutes must be observed between the administration of each of them.

Side effect

Determination of categories of frequency of adverse reactions: very often (≥1 / 10); often (≥1/100 to<1/10); нечасто (≥1/1000 до <1/100); редко (≥1/10 000 до <1/1000); очень редко (<1/10 000), частота неизвестна (невозможно оценить частоту на основе имеющихся данных).

From the nervous system: often - headache; infrequently - dizziness.

From the side of the organ of vision: very often - conjunctival injection, itchy eyes, eyelash growth; often - superficial punctate keratitis, corneal erosion, burning in the eyes, eye irritation, allergic conjunctivitis, blepharitis, decreased visual acuity, asthenopia, conjunctival edema, sensation of a foreign body in the eye, dry eye, eye pain, photophobia, lacrimation, discharge from the eyes , blurred vision, increased pigmentation of the iris, darkening of the eyelashes; infrequently - hemorrhagic disorders of the retina, uveitis, cystoid macular edema, iritis, blepharospasm, eyelid retraction, periorbital erythema; frequency unknown - enophthalmos. In very rare cases, corneal calcification has been reported with the use of phosphate-containing eye drops in patients with concomitant significant corneal damage.

From the side of the cardiovascular system: often - arterial hypertension.

From the hepatobiliary system: often - a deviation from the norm of biochemical indicators of liver function.

From the skin and subcutaneous tissues: infrequently - hirsutism.

General reactions: infrequently - asthenia.

Use during pregnancy and lactation

There are no data from clinical studies on the use of bimatoprost during pregnancy. The use of bimatoprost during pregnancy is not recommended unless clearly indicated.

According to preclinical animal studies, reproductive toxicity has been shown when bimaptoprost is used at high doses that are toxic to the mother's body.

It is not known whether bimatoprost is excreted in human breast milk. Animal studies have shown that bimatoprost is excreted in breast milk. The decision to continue/stop breastfeeding or continue/stop treatment with bimatoprost should be made taking into account the benefits of breastfeeding for the baby and the benefits of therapy for the mother.

special instructions

Caution is required when using bimatoprost preparations for the treatment of patients with known risk factors for macular edema (for example, in patients with aphakia, in patients with pseudophakia and rupture of the posterior lens capsule); in patients with a history of severe eye infections (for example, those caused by the herpes simplex virus) or iritis / uveitis.

There is no experience with the use of bimatoprost in patients with concomitant respiratory dysfunction, which requires caution in such patients. When conducting clinical studies in patients with impaired respiratory function, no significant adverse effects on the respiratory system were noted.

Bimatoprost has not been studied in patients with II or III degree AV block and in patients with uncontrolled congestive heart failure.

Before starting treatment, patients should be informed about the possibility of eyelash growth, darkening of the skin of the eyelids and increased pigmentation of the iris. Some of these changes may be permanent and may result in differences in appearance between the eyes when only one eye is treated. The change in iris pigmentation occurs slowly and may not be noticeable for months or years. Most often, the change in the color of the iris is permanent. The change in the color of the iris is more associated with an increase in the content of melanin in melanocytes than with an increase in the number of melanocytes. The long-term effects of increased iris pigmentation are unknown. In typical cases, the brown pigment spreads from the area around the pupil to the root of the iris, as a result, the entire iris or parts of it become more brown. The use of bimatoprost does not affect the nevi and lentigo of the iris. Pigmentation of the periorbital tissue is reversible in some patients.

Use with caution in patients with risk factors for macular edema (patients with aphakia, pseudo-aphakia and rupture of the posterior lens capsule).

drug interaction

There was a decrease in the hypotensive effect of bimatoprost when it was used together with other prostaglandin analogues in the treatment of ophthalmohypertension or glaucoma.

Tradename
Monopreparation: Latisse (Allergan). Combined preparation: Hanforth (Allergan).

chemical name: (5Z)-7-((1R,2R,3R,5S)-3,5-dihydroxy-2-[(1E,3S)-3-hydroxy-5-phenyl-1-penten-1-yl]cyclopentyl )-N-ethyl-5-heptenamide
Molecular formula: C 25 H 37 NO 4
Molar mass: 415.57
CAS number: 155206-00-1
Solubility: Soluble in ethanol (50 mg/ml), methanol, DMSO (25 mg/ml), DMF (25 mg/ml).

Release form, composition
Latisse - eye drops, 0.3 mg / ml bimatoprost in a 3.0 ml dropper bottle. Clear, colorless liquid, insoluble in water.

Ganfort - eye drops, 0.3 mg / ml bimatoprost + 6.8 mg / ml timolol maleate in a 3.0 ml dropper bottle. Clear colorless or slightly yellowish liquid.

Auxiliary substances in (1 ml.)
Latisse - benzalkonium chloride (0.05 mg), sodium chloride, dibasic sodium phosphate, citric acid, sodium hydroxide or hydrochloric acid, purified water.

Ganfort - benzalkonium chloride (0.05 mg), sodium chloride, sodium phosphate dibasic heptahydrate, citric acid monohydrate, sodium hydroxide or hydrochloric acid, purified water.

pharmachologic effect
Bimatoprost is a synthetic prostamide, structurally related to prostaglandins F2ά. However, the IOP-lowering effect of this drug is not in binding to prostaglandin receptors, but in selective imitation of the effect of prostamides. The exact mechanism of action of bimatoprost is not known, since no receptors for it have been found in the human body at present.

The effect of lowering IOP is to increase the outflow through the trabecular meshwork and uveoscleral outflow of intraocular fluid. The effect of the drug begins to appear approximately 4 hours after ingestion and reaches a maximum after 8-12 hours. Its duration is at least 24 hours.

Bimatoprost - pharmacokinetics
Bimatoprost penetrates well through the human cornea and sclera. It has a very low systemic effect after instillation, and is not capable of cumulation. So, with a single injection per day, its maximum concentration in the blood occurs after 10 minutes, and decreases to the lower limit of sensitivity of laboratory methods (about 0.025 ng / ml) in 1.5 hours. The elimination half-life for intravenous administration is about 45 minutes.

Plasma proteins bind approximately 88% of bimatoprost. The rest is in free form. The excretion of the drug is carried out mainly by the kidneys: up to 67% of it is excreted in the urine, 25% - in the feces.

Dosing regimen
The recommended dose is 1 drop in the evening in the affected eye. An increase in the frequency of instillations may reduce the therapeutic effect of the drug. If the next dose has been missed, the drug should be continued without changing the regimen, that is, no more than 1 drop per day in the affected eye. While taking bimatoprost with other prostaglandin analogues, it is necessary to carefully monitor the level of IOP.

Indications for use
Ophthalmohypertension and open-angle glaucoma.

Clinical researches
According to the results of the study in patients with an initial average IOP level of 26 mm Hg. Art. (P 0) in the treatment of a 0.03% solution of bimatoprost, there was a decrease of 7-8 mm Hg. Art. When comparing the effect of 0.01% and 0.03% solution of the drug in patients with an average IOP of 23.5 mm Hg. Art. the hypotensive effect in the first case was 7.5 mm Hg. st, which is 0.5 mm Hg. Art. less than the drug with a higher concentration.

Contraindications
Hypersensitivity to bimatoprost.

Precautions and Warnings
Bimatoprost often causes increased pigmentation of the iris, eyelids and eyelashes. These effects are manifested due to an increase in the amount of pigment in melanocytes, but this is not accompanied by an increase in the number of the latter. The severity of manifestations depends on the duration of the reception. After discontinuation of bimatoprost, the pigmentation of the iris often does not return to the original, while the pigmentation of the eyelids and eyelashes may decrease. The long-term consequences of this effect have not been studied.

In some cases, there is a reversible increase in the growth, thickness and number of eyelashes in case of bimatoprost cancellation.

The drug is prescribed with caution in patients with an active intraocular inflammatory process (for example, uveitis, iritis) due to its possible increase. There is also evidence of recurrence of corneal infiltrates or ocular infections with bimatoprost. In this regard, more careful monitoring of patients using this drug is necessary if there is a history of viral eye damage (for example, herpes simplex virus).

Taking bimatoprost in rare cases can contribute to the development of macular edema. For this reason, it is not recommended to use the drug in patients at risk of developing this pathology (aphakia, damage to the posterior capsule as a result of cataract extraction, diabetic retinopathy).

The effect of bimatoprost in the treatment of angle-closure and narrow-angle, uveal, neovascular and congenital glaucoma has not been studied.

Bimatoprost should be used with caution in patients with renal and hepatic insufficiency.

The effect of bimatoprost has not been studied in patients with impaired respiratory function. However, there is evidence of a possible worsening of the course of bronchial asthma, dyspnea and chronic obstructive pulmonary disease.

It is necessary to use the drug with caution in this group of patients.

The safety of using bimatoprost in the presence of intracardiac blockades or progressive heart failure has not been evaluated, but in the literature there are isolated reports of the development of bradycardia or hypotension while taking it. It is recommended to prescribe the drug with caution in patients with low heart rate and low blood pressure.

Due to the presence of chloride in the composition of benzalkonium, it is necessary to monitor the condition of the cornea during long-term use due to the risk of developing pinpoint and / or toxic ulcerative keratopathy, especially in patients with dry eye syndrome and wearing contact lenses.

The risk category for the use of the drug during pregnancy according to the FDA is C. Animal studies have shown that bimatoprost has a teratogenic effect at doses significantly higher than the maximum for humans. Adequate studies on women have not been conducted. The possibility of excretion of the drug and its metabolites into mother's milk has not been studied, but this fact has been established in experiments on animals. For this reason, the appointment of the drug is possible in cases where the effect for the mother outweighs the potential risk of side effects for the fetus or child.

There are currently no data on the effect of bimatoprost on human fertility. The drug also did not have a carcinogenic and mutagenic effect in experiments on animals.

The safety of the drug in children under 18 years of age has not been evaluated.

There may be short-term blurred vision or other visual disturbances. When they occur, you must refrain from driving.

Side effects of Bimatoprost
The most common side effect is conjunctival hyperemia (15-45% of cases). It progressively decreases to almost complete disappearance by the third year of bimatoprost use. In 0.5-3%, this is the reason for discontinuation of the drug. Other common side effects are eyelash growth, itching (15-45%).

In 1-10% of cases, dryness, burning, pain, irritation in the eye, blurred vision, foreign body sensation, pigmentation of the periocular region, blepharitis, cataract, superficial punctate keratitis, periorbital erythema, darkening of the eyelashes, discharge from the eye, lacrimation, photophobia , allergic conjunctivitis, asthenopia, increased pigmentation of the iris, conjunctival edema, hyposphagma, abnormal hair growth.

In less than 1% of cases, intraocular inflammation (iritis) occurs.

Of the systemic side effects, the most common (about 10%) are colds and upper respiratory tract infections. About 1-5% of patients may complain of headache, elevated liver enzymes in laboratory tests, and asthenic condition.

drug interaction
The interaction of bimatoprost with other medicinal substances is unlikely due to its extremely low concentration in the blood after instillation into the eye. As shown by preclinical studies, the drug is biotransformed in various ways, does not affect the liver enzymes involved in the metabolism of other drugs.