Bimatoprost - Brand names: Eyreida, Lumigan, Sturiban

Bimatoprost is a medicine that treats high pressure in the eye (ocular hypertension) and helps with glaucoma.

High pressure can happen when too much fluid builds up inside your eye. Bimatoprost helps to drain the fluid.

If not treated, high pressure can damage your optic nerve and cause vision loss or blindness.

Bimatoprost is available on prescription only.

Bimatoprost eye drops come in bottles or single-dose droppers. Some bottled eye drops contain a preservative (benzalkonium chloride), to keep the eye drops sterile.

Some people will be prescribed bimatoprost eye drops and timolol eye drops (a beta blocker). Combined products of both medicines are known by the brand names Eyzeetan and Ganfort.

• Usually you use bimatoprost eye drops once a day.
• The eye drops should help to reduce the pressure in your eye within 4 hours.
• If it works for you, you will usually use bimatoprost for the rest of your life.
• It’s important to use your eye drops regularly and to go for check-ups, to make sure your vision is not getting worse.
• Side effects can include permanent eye colour change, red and itchy eyelids, and a feeling that something's in your eye.

Bimatoprost eye drops can be used by adults aged 18 years or over.

Bimatoprost is not suitable for everyone. To make sure it’s safe for you, tell your doctor before starting bimatoprost if you:

• have ever had an allergic reaction to bimatoprost or any other medicine
• are about to have or have had eye surgery (including cataract surgery)
• have dry eyes
• have any problems with your cornea (the clear outer layer of your eye)
• wear contact lenses (you can still use bimatoprost, but you will need to remove your contact lenses before using the drops)
• have ever had a viral infection or inflammation in your eye
• have liver or kidney problems
• have low blood pressure, or your heart beats slower than normal (this is known as bradycardia, which is a type of heart arrhythmia)
• have any breathing problems, such as asthma or COPD
• have an allergy to silver, as Eyreida eye drops contain small amounts of silver

It’s important to use bitamoprost as your doctor has advised.

Dosage

Bimatoprost eye drops come in 2 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

Your doctor will decide which strength is right for you.

The usual dose is 1 drop into the affected eye or eyes once a day. It’s best to do this in the evening as bimatoprost works better then.

It comes as a bottle or a box of single-use droppers. Always read the instructions that come with your medicine.

How to use eye drops

If you wear contact lenses, make sure you remove them before using your eye drops. Wait 15 minutes before putting your lenses back in.

The drops may make your vision blurred if you use them with contact lenses.

1. Wash your hands.
2. If you are using a bottle, remove the cap. If it does not come with a separate dropper, practise 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. If you are using the single-use dropper, twist off the tip.
3. Make sure the dropper or tip of the bottle does not touch your eye, eyelashes, eyelid, your skin, or any other surface.
4. Use your finger to gently pull down the lower eyelid and tilt your head back.
5. 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.
6. Close your 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.
7. Wipe away any extra liquid with a clean tissue.
8. Repeat in your other eye if your doctor has told you to do this. There’s enough liquid in 1 single-dose dropper to put a drop in both eyes if needed.
9. Put the cap back on the bottle. If you are using the single-dose dropper, throw it away.

If you use bimatoprost with other eye drops, wait at least 5 minutes before using your other eye drops. The second eye drops can wash out the bimatoprost, so it may not work as well.

Expiry dates

Use the bimatoprost eye drops within the expiry date on the bottle and within 4 weeks of opening. This will help to prevent the risk of eye infections and the eye drops not working so well.

The single-dose droppers come in a silver foil pouch. Once you open the pouch, use the droppers within 30 days. Do not use the droppers after the expiry date.

You could write the date you opened the bottle or packet on the label or the box. This will help you know when you need to start using a new one.

What if I forget to use it?

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.

If you often forget doses, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember your medicines.

What if I use too much?

Using too many drops can irritate your eye and make it water and turn red. If you get too much bimatoprost in your eye, rinse it all out with water. Do not put any more drops in until it is time for your next dose.

Any irritation, watering or redness should get better, but if you are worried about it ask your doctor or pharmacist for advice.

Contact your doctor if you swallow bimatoprost accidentally and feel unwell.

Like all medicines, bimatoprost can cause side effects, but not everyone gets them.

Common side effects

These common side effects can happen in more than 1 in 100 people.

Keep using the medicine, but talk to your doctor or pharmacist if these side effects bother you or do not go away:

• change in eye colour – usually seen within 8 months of using the eye drops. This colour change can be permanent and may be more obvious if you are only using the eye drops in 1 eye
• red and itchy eyelids, irritated eye and eye pain (redness, itching, dryness or feeling that something's in your eye)
• changes to your eyelashes – growing longer and thicker
• darker skin around your eye

Serious side effects

Do not use any more bimatoprost and call a doctor straight away if you:

• become short of breath
• have asthma or COPD and your breathing gets worse
• become dizzy

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to bimatoprost.

These are not all the side effects of bimatoprost. For a full list see the leaflet inside your medicine packet.

What to do about:

• change in eye colour – talk to your doctor before you start using bimatoprost if you are worried about this.
• red and itchy eyelids, irritated eye and eye pain – irritation should go away once your body adjusts to bimatoprost, but talk to your doctor or pharmacist if you're worried about this. A cold water compress on the closed eye may help. If the eye drops are irritating your eyes and making them water so much that you're thinking about stopping using the eye drops, talk to your doctor straight away. They may prescribe something different for you. Do not drive, use tools or operate heavy machinery until your eyes feel comfortable again and your vision is clear.
• changes to your eyelashes – your eyelashes usually return to normal after you stop using bimatoprost. Talk to your pharmacist or doctor if you are worried about this.
• darker skin around your eye – talk to your doctor if this bothers you.

Bimatoprost and pregnancy

You can continue to use bimatoprost during pregnancy. It is applied to the eye and very little gets into your blood. It is not thought to be harmful, although there is little information about it.

Treating high pressure in the eye (glaucoma) is essential and so it's important to keep using this medicine while you're pregnant.

Bimatoprost and breastfeeding

You can use bimatoprost while you’re breastfeeding.

There's not much information on its use in breastfeeding, but only very small amounts are likely to pass into breast milk. This is due to how bimatoprost works and because it's used as eye drops, rather than injected or swallowed.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your midwife, health visitor or doctor as soon as possible.

For more information about how bimatoprost can affect you and your baby during pregnancy, read this leaflet about treating glaucoma in pregnancy on the Best Use of Medicines in Pregnancy (BUMPS) website.

There are some medicines that do not mix well with bimatoprost and can affect how well it works.

Tell your doctor if you are using eye drops that work in a similar way to bimatoprost including:

• latanoprost
• tafluprost
• travoprost

If you use 2 of these medicines (including bimatoprost) together they can increase the pressure in your eye.

Mixing bimatoprost with herbal remedies or supplements

There's very little information about taking herbal medicines and supplements with bimatoprost.