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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Durysta
Generic Name
Bimatoprost
Active Ingredient
BimatoprostCategory
Prostaglandin Analog [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 10 ug/1 | IMPLANT | INTRACAMERAL | 0023-9652 |
Detailed information about Durysta
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Durysta, you must consult a qualified healthcare professional.
Bimatoprost is a synthetic prostaglandin analog used primarily to reduce intraocular pressure in patients with open-angle glaucoma and to treat eyelash hypotrichosis by increasing hair growth and thickness.
For the treatment of Open-Angle Glaucoma or Ocular Hypertension, the standard dosage is one drop of bimatoprost 0.01% or 0.03% in the affected eye(s) once daily in the evening. It is critical not to exceed once-daily dosing, as studies have shown that more frequent administration may actually decrease the intraocular pressure-lowering effect of the medication.
For the treatment of Eyelash Hypotrichosis, the standard dosage is one drop of bimatoprost 0.03% applied to the skin of the upper eyelid margin at the base of the eyelashes once daily at bedtime. The solution should be applied using the sterile, single-use applicators provided with the product. One applicator is used for one eye, then discarded, and a new applicator is used for the other eye.
The safety and effectiveness of bimatoprost in pediatric patients under the age of 16 have not been established. Use in children is generally avoided unless specifically directed by a pediatric ophthalmologist, as the long-term effects on eye pigmentation and development are unknown.
Because systemic absorption of bimatoprost is minimal following topical ophthalmic application, no specific dosage adjustments are required for patients with renal impairment. However, clinical data in this population are limited.
Similar to renal impairment, the low systemic levels of bimatoprost suggest that dosage adjustments are unnecessary for patients with liver disease. In clinical trials, patients with a history of liver disease showed no adverse reactions related to hepatic function.
No overall differences in safety or effectiveness have been observed between elderly and younger patients. The standard adult dose is typically appropriate for geriatric populations.
If you miss a dose, skip the missed dose and apply the medication at the next scheduled time (usually the next evening). Do not apply a double dose to make up for the one you missed. Consistency is key to maintaining stable intraocular pressure or achieving lash growth.
An overdose of topical bimatoprost is unlikely to cause systemic toxicity due to the low concentration and small volume of the bottle. However, if the solution is accidentally swallowed, contact a poison control center or seek emergency medical attention. Symptoms of systemic prostaglandin exposure might include flushing, abdominal cramps, or diarrhea.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
The most frequently reported side effect of bimatoprost is conjunctival hyperemia (redness of the white part of the eye), occurring in approximately 15% to 45% of patients using the 0.03% solution. This is usually mild and often diminishes over time as the eye adjusts to the medication. Other common effects include:
> Warning: Stop using Bimatoprost and call your doctor immediately if you experience any of these:
With prolonged use, bimatoprost can lead to Prostaglandin-Associated Periorbitopathy (PAP). This condition involves the loss of fat around the eye socket (periorbital fat atrophy), which can cause the eyes to appear 'sunken' or deep-set. While this may reverse slowly after stopping the medication, it can persist in some individuals. Additionally, the permanent darkening of the iris is a significant long-term consideration for patients with light-colored eyes (blue, green, or hazel).
No FDA black box warnings are currently issued for Bimatoprost. However, the FDA-approved labeling includes strong precautions regarding permanent iris pigmentation and the risk of bacterial keratitis if the dropper tip becomes contaminated.
Report any unusual symptoms to your healthcare provider. You may also report side effects to the FDA at 1-800-FDA-1088.
Bimatoprost is intended for topical ophthalmic use only. It should not be injected into the eye (except for the specific Durysta implant) or taken orally. Patients should be aware that the effects of bimatoprost on eyelash growth and eye pressure will only persist as long as the medication is used. Once discontinued, eyelashes will typically return to their original appearance over several weeks to months, and intraocular pressure will likely return to pre-treatment levels.
No FDA black box warnings for Bimatoprost.
Patients using bimatoprost for glaucoma require regular monitoring of intraocular pressure by an ophthalmologist or optometrist. Periodic eye exams are necessary to check for changes in iris color, eyelash growth, and the health of the optic nerve. If you are using bimatoprost for eyelash growth, your provider may want to check your eyes periodically to ensure no unintended changes in eye pressure are occurring.
Bimatoprost may cause temporary blurred vision or stinging immediately after application. Do not drive, use machinery, or perform any activity requiring clear vision until you are certain your vision is stable. It is generally recommended to apply the drops at night to minimize the impact of daytime visual disturbances.
There are no known direct interactions between bimatoprost and alcohol. However, excessive alcohol consumption can sometimes interfere with the management of glaucoma and overall eye health. Discuss your alcohol intake with your doctor.
Do not stop using bimatoprost without consulting your healthcare provider. In glaucoma patients, stopping the medication can lead to a rapid increase in intraocular pressure, which may cause irreversible vision loss. There is no 'withdrawal syndrome,' but the underlying condition will no longer be managed.
> Important: Discuss all your medical conditions with your healthcare provider before starting Bimatoprost.
There are no absolute drug-drug contraindications that require complete avoidance of bimatoprost. However, using bimatoprost simultaneously with other Prostaglandin Analogs (such as latanoprost, travoprost, or tafluprost) is generally discouraged. Clinical studies suggest that using two different prostaglandin analogs can paradoxically increase intraocular pressure rather than lowering it further.
There are no known interactions between bimatoprost and specific foods or beverages. Unlike many oral medications, bimatoprost's efficacy is not affected by diet, grapefruit juice, or caffeine.
There is limited data on interactions between bimatoprost and herbal supplements. However, patients should be cautious with supplements that may affect eye pressure or blood flow, such as:
Bimatoprost is not known to interfere with standard blood or urine laboratory tests. Its effects are localized to the ocular tissues and do not reach high enough systemic concentrations to alter biochemical markers.
To manage potential interactions between multiple eye drops:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Bimatoprost must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis by a physician include:
Patients who have experienced a severe allergic reaction to other prostaglandin analogs, such as latanoprost (Xalatan), travoprost (Travatan Z), or tafluprost (Zioptan), may also be sensitive to bimatoprost. While they are chemically distinct, their similar structures increase the possibility of cross-reactivity.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Bimatoprost.
Bimatoprost is classified under Pregnancy Category C (based on older FDA nomenclature). There are no adequate and well-controlled studies of bimatoprost use in pregnant women. In animal studies, bimatoprost was found to be fetotoxic (causing miscarriage or preterm delivery) when administered orally at doses much higher than the human ocular dose. Because systemic exposure from eye drops is extremely low, the risk to the fetus is considered minimal, but bimatoprost should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Physicians often recommend 'punctal occlusion' (pressing on the tear duct) to further reduce systemic absorption during pregnancy.
It is not known whether bimatoprost is excreted in human milk. In animal studies, bimatoprost has been detected in the milk of lactating rats. Because many drugs are excreted in human milk, caution should be exercised when bimatoprost is administered to a nursing woman. If used, the mother should monitor the infant for any unusual symptoms, though systemic levels in the infant are expected to be negligible.
The safety and efficacy of bimatoprost have not been established in children under 16 years of age. The primary concern in pediatric populations is the potential for permanent changes in iris pigmentation, which could have lifelong cosmetic implications. Use in children is typically reserved for cases of refractory pediatric glaucoma where other treatments have failed.
No overall differences in safety or effectiveness have been observed between elderly (65 years and older) and younger adult patients. Bimatoprost is a preferred option for many elderly patients because it does not carry the cardiovascular or pulmonary risks associated with beta-blocker eye drops. However, elderly patients should be assessed for their ability to correctly self-administer the drops, as arthritis or tremors can make application difficult.
Bimatoprost has not been specifically studied in patients with renal impairment. However, given the minimal systemic absorption and the fact that it is not primarily cleared by the kidneys in its active form, no dosage adjustments are expected to be necessary for patients with kidney disease or those on dialysis.
Bimatoprost has not been studied in patients with hepatic impairment. However, clinical trials included patients with mild liver disease, and no adverse effects on liver function or drug metabolism were noted. No dosage adjustment is currently recommended for patients with liver dysfunction.
> Important: Special populations require individualized medical assessment.
Bimatoprost is a synthetic prostamide, structurally related to prostaglandin F2α. Its primary molecular mechanism involves mimicking the effects of naturally occurring prostamides. It acts as a selective agonist at prostamide receptors, which are distinct from the traditional FP prostanoid receptors (though it does have some activity there). In the eye, this activation leads to a remodeling of the extracellular matrix in the ciliary muscle, reducing resistance to fluid flow. This results in increased uveoscleral outflow and trabecular meshwork outflow of aqueous humor, effectively lowering intraocular pressure. For hair growth, bimatoprost is believed to stimulate the transition of hair follicles from the telogen (resting) phase to the anagen (growth) phase while increasing the duration of the anagen phase.
| Parameter | Value |
|---|---|
| Bioavailability | Very low (systemic); High (local ocular) |
| Protein Binding | ~88% |
| Half-life | ~45 minutes (systemic) |
| Tmax | 10 minutes (post-instillation) |
| Metabolism | Oxidation, N-deethylation, glucuronidation |
| Excretion | Renal 67%, Fecal 25% |
Bimatoprost is a member of the Prostaglandin Analog [EPC] class. Related medications in this class include Latanoprost (Xalatan), Travoprost (Travatan Z), and Tafluprost (Zioptan). It is distinguished from these by its specific prostamide structure, which some studies suggest provides superior IOP-lowering efficacy in certain patient populations.
Common questions about Durysta
Bimatoprost is primarily used for two distinct medical purposes. First, it is prescribed as an eye drop (such as Lumigan) to lower high pressure inside the eye in patients with open-angle glaucoma or ocular hypertension, which helps prevent vision loss. Second, it is used as a topical solution (such as Latisse) applied to the base of the upper eyelashes to treat hypotrichosis, a condition where there are not enough eyelashes. By increasing the growth phase of the hair cycle, it makes lashes longer, thicker, and darker. It is a synthetic version of a natural substance called prostamide. Always use the specific formulation prescribed for your condition, as the application methods differ significantly.
The most common side effect of bimatoprost eye drops is redness in the white part of the eye, known as conjunctival hyperemia, which affects up to 45% of users. Many patients also report eye itching, irritation, or a feeling like something is in the eye. When used for eyelash growth, common side effects include redness and itching of the eyelids and darkening of the skin where the medicine is applied. Another frequent 'side effect' is the growth and darkening of the eyelashes themselves. Most of these symptoms are mild, but you should report persistent or severe irritation to your doctor. Some side effects, like eye redness, may improve as your body adjusts to the medication.
There is no known direct chemical interaction between bimatoprost and alcohol. Because bimatoprost is applied topically to the eye or eyelid, very little of the drug enters the bloodstream, making systemic interactions unlikely. However, it is important to note that alcohol can sometimes affect eye pressure or interact with other medications you may be taking for glaucoma. If you experience dizziness or blurred vision as a side effect of bimatoprost, alcohol could potentially worsen these effects. It is always best to consume alcohol in moderation and discuss your lifestyle habits with your ophthalmologist. Ensuring you do not miss your daily dose due to alcohol consumption is critical for managing eye pressure.
Bimatoprost is generally not recommended during pregnancy unless the potential benefit to the mother clearly outweighs the risk to the fetus. It is classified as Pregnancy Category C, meaning animal studies have shown some risk, but there are no comprehensive studies in humans. While the amount of drug that reaches the bloodstream from eye drops is very small, doctors often exercise caution. If you must use it while pregnant, your doctor may teach you how to perform punctal occlusion (pressing on the corner of the eye) to minimize systemic absorption. Always inform your obstetrician and ophthalmologist if you are pregnant or planning to become pregnant. Alternative treatments for eye pressure may be considered during this time.
The time it takes for bimatoprost to work depends on what you are treating. For lowering eye pressure, the effect begins about 4 hours after the first drop, with the maximum effect reached within 8 to 12 hours. For eyelash growth, the process is much slower because it relies on the natural hair growth cycle. Most patients begin to see a noticeable increase in lash length after 4 to 8 weeks of daily use. The full results for thicker and darker lashes are typically seen after 16 weeks of consistent application. If you stop using the medication, your eye pressure will rise or your lashes will return to their original state within a few months.
You should never stop taking bimatoprost suddenly without first consulting your healthcare provider, especially if you are using it for glaucoma. Stopping the medication will cause your intraocular pressure to return to its previous high levels, which can lead to permanent optic nerve damage and vision loss. In glaucoma management, bimatoprost is usually a lifelong treatment. If you are using it for eyelash growth, stopping the medication is safe, but you will lose the results you achieved. Your eyelashes will gradually return to their original length and thickness over several weeks. Always discuss your reasons for wanting to stop the medication with your doctor to find a suitable alternative.
If you miss a dose of bimatoprost, simply skip the missed dose and wait until your next scheduled application time, which is usually the following evening. Do not apply extra drops or use the medication twice in one day to make up for the missed dose. Using more bimatoprost than prescribed can actually make the medication less effective at lowering eye pressure and may increase the risk of side effects like eye redness. To help you remember, try to incorporate the application into your nightly routine, such as after brushing your teeth. If you find yourself missing doses frequently, talk to your doctor about strategies to stay consistent.
There is no clinical evidence to suggest that bimatoprost causes weight gain. Because bimatoprost is applied topically and has extremely low systemic absorption, it does not affect the metabolic processes or hormones typically associated with weight changes. If you experience unexplained weight gain while using bimatoprost, it is likely due to another factor, such as a different medication, diet, or an underlying medical condition. Always discuss significant changes in your weight or overall health with your primary care physician. Bimatoprost's side effects are almost exclusively localized to the eyes and the skin immediately surrounding them.
Bimatoprost can generally be used alongside other medications, but there are important considerations for other eye drops. If you are using more than one type of eye drop, you must wait at least 5 minutes between each medication to ensure they are properly absorbed and not washed out. You should avoid using bimatoprost with other prostaglandin analogs, as this can paradoxically increase eye pressure. While systemic drug interactions are rare, you should always provide your doctor with a full list of your oral medications, vitamins, and herbal supplements. Special care should be taken if you use contact lenses, as they must be removed before using bimatoprost.
Yes, bimatoprost is available as a generic medication for both the 0.01% and 0.03% ophthalmic solutions. Generic versions are typically more cost-effective than brand-name versions like Lumigan or Latisse while containing the same active ingredient and meeting the same FDA standards for safety and efficacy. When purchasing generic bimatoprost for eyelash growth, ensure you are receiving the sterile applicators if they are required for your treatment. The availability of generics may vary depending on your location and insurance coverage. Talk to your pharmacist or healthcare provider to see if a generic version is a suitable and more affordable option for you.
Other drugs with the same active ingredient (Bimatoprost)