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Special populations: • Contact lens wearers: Contains benzalkonium chloride which may be adsorbed by contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting. • Pediatrics: Not recommended for use in pediatrics <16 years of age due to potential concerns regarding long-term use and hyperpigmentation.

Dosage form specific issues: • Latisse®: Patients receiving medications to reduce intraocular pressure should consult their healthcare provider prior to using; may interfere with desired reduction of intraocular pressure. Unintentional hair growth may occur on skin that has repeated contact with solution; apply to upper eyelid only, blot away excess. Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) Latanoprost: The concomitant use of Latanoprost and Bimatoprost may result in increased intraocular pressure. Risk D: Consider therapy modification Pregnancy Risk Factor C ( show table ) Pregnancy Implications Decreased gestation, decreased body weight, increased late resorptions, and increased mortality were observed in animal reproduction studies with oral doses achieving serum levels >33 times human exposure. Lactation Excretion in breast milk unknown/use caution Breast-Feeding Considerations It is not known if bimatoprost is excreted in breast milk. The manufacturer recommends that caution be exercised when administering bimatoprost to nursing women. Pricing: U.S. (Medi-Span®)

Solution (Lumigan Ophthalmic) 0.01% (5 mL): $251.27 International Brand Names Latisse (AR, HK, SG); Lumigan (AR, AT, AU, BE, BG, BR, CH, CL, CN, CO, CR, CZ, DE, DK, EC, EE, ES, FI, FR, GB, GR, GT, HK, HN, IE, IL, IN, IT, KP, MT, MX, MY, NL, NO, NZ, PA, PE, PH, PK, PL, PT, RU, SE, SG, SK, SV, TH, TR, TW, UY, VE, ZA); Malena (PE) Mechanism of Action As a synthetic analog of prostaglandin with ocular hypotensive activity, bimatoprost decreases intraocular pressure by increasing the outflow of aqueous humor. Bimatoprost may increase the percent and duration of hairs in the growth phase, resulting in eyelash growth. Pharmacodynamics/Kinetics Onset of action: Reduction of IOP: ~4 hours Peak effect: Maximum reduction of IOP: ~8-12 hours Distribution: V d : 0.67 L/kg Protein binding: ~88% Metabolism: Undergoes oxidation, N-deethylation, and glucuronidation after reaching systemic circulation; forms metabolites Half-life elimination: I.V.: ~45 minutes Time to peak: ≤10 minutes Excretion: Urine (≤67%); feces (25%) Use of UpToDate is subject to the Subscription and License Agreement . Topic 8931 Version 39.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.4 - C21.36 Licensed to: Southeast Alabama Med Ctr | Support Tag: [1005-122.72.76.133-EFD95E538C-S244013.14]