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Prostaglandin analogue (topical IOP reduction) Pregnancy: Avoid — no adequate human data; animal studies show reproductive toxicity.

Bimatoprost 0.03% Eye Drops (Lumigan)

Brand names: Lumigan

Adult dose

Dose: 1 drop in affected eye(s) once daily in the evening
Route: Ophthalmic
Frequency: Once daily (evening)
Max: 1 drop per eye once daily; do not exceed — more frequent use may reduce IOP-lowering effect
Open-angle glaucoma and ocular hypertension. Evening dosing optimises IOP reduction. Wash hands before and after use. Punctal occlusion (press inner canthus 1–2 min) reduces systemic absorption and eyelash/skin side effects. Remove contact lenses before instilling (reinsert after 15 min).

Paediatric dose

Route: Ophthalmic
Frequency: Once daily
Max: 1 drop per eye once daily
Not licensed in children under 18 years. Used under specialist care for paediatric glaucoma refractory to other treatments.

Dose adjustments

Renal

No dose adjustment required.

Hepatic

No dose adjustment required; use with caution in significant hepatic impairment.

Clinical pearls

  • Most potent single-agent IOP reduction of all prostaglandin analogues (~30–33%)
  • Conjunctival hyperaemia more common than with latanoprost — warn patient; usually diminishes over weeks
  • Eyelash growth is a cosmetic concern — patients applying periocularly (misuse) may develop asymmetric lash growth
  • Fixed combination Ganfort (bimatoprost 0.03% + timolol 0.5%) available for added IOP reduction
  • Punctal occlusion essential to minimise periorbital skin darkening and systemic absorption

Contraindications

  • Hypersensitivity to bimatoprost
  • Uveitis or inflammatory ocular conditions (relative)
  • Macular oedema risk (aphakia, pseudophakia with torn posterior capsule)

Side effects

  • Conjunctival hyperaemia (very common — 25–45%; often temporary)
  • Iris pigmentation change (irreversible, brown)
  • Eyelash hypertrichosis (increased length, thickness, pigmentation — reversible on stopping)
  • Periorbital skin hyperpigmentation
  • Ocular pruritus and stinging
  • Macular oedema (rare)

Interactions

  • Other prostaglandin analogues — do not use concurrently (antagonistic)
  • Timolol eye drops — additive IOP reduction (combination product: Ganfort)

Monitoring

  • IOP (target >20% reduction)
  • Iris colour
  • Eyelash/eyelid appearance
  • Macular OCT if risk factors

Reference: BNFc; BNF; NICE CG85; EGS Glaucoma Guidelines 2020; Lumigan SPC. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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