Latisse®
Bimatoprost 0.03% · ophthalmic solution
Aesthetics/Presbyopia
Approved uses
Eyelash hypotrichosis
One drop on a sterile applicator applied along the skin of the upper eyelid margin at the base of the lashes, once nightly, one applicator per eye
Most see no visible change before 2 months, and lashes return to baseline after stopping.
Eyelash hypotrichosis after chemotherapy
One drop on a sterile applicator applied to the upper eyelid margin, once nightly, one applicator per eye
About 4 in 10 respond by month 4 after chemotherapy, with further gain out to 12 months.
OFF-LABELNot in the FDA label for this product
Eyebrow hypotrichosis
Bimatoprost 0.03% solution applied to each eyebrow once daily; the trial dosed daily for 9 months
Pilot RCT · n=20
Randomized, double-blind, vehicle-controlled pilot study, n=20 with mild to moderate eyebrow hypotrichosis. Investigator-assessed eyebrow appearance improved from baseline at 6 months (P=.002) and 7 months (P=.005) in the group treated for 9 months, while the group crossed to 4 months of bimatoprost was not significant at any time point and no adverse effects were observed; pilot-sized, so the estimate is imprecise.
Contraindications
Hypersensitivity to bimatoprost or any component
Available Forms0.03% (0.3 mg/mL) solution, 3 mL bottle with 70 applicators, 5 mL bottle with 140 applicators
Mechanism of ActionStructural prostaglandin analog. The precise mechanism is unknown; lash growth is attributed to increasing the percentage of hairs in the anagen phase and prolonging that phase.
Warnings & Precautions
- IOP-lowering interference: In patients using a prostaglandin analog for elevated IOP, concomitant use may blunt the desired IOP reduction; monitor IOP closely. In trials, in patients with or without elevated IOP, IOP fell, but the magnitude was not judged clinically concerning.
- Iris pigmentation: Increased brown iris pigmentation, likely permanent, from increased melanin content in melanocytes rather than more melanocytes. Spreads concentrically from the pupil and may take months to years to appear; treatment can be continued.
- Lid pigmentation: Darkening of periorbital tissue and lashes, expected to increase as long as dosing continues; reported reversible on discontinuation in most patients.
- Hair growth outside treatment area: Repeated skin contact beyond the upper eyelid margin can grow hair there; blot runoff before it reaches the cheek or other skin.
- Intraocular inflammation: Caution with active intraocular inflammation such as uveitis, which may be exacerbated.
- Macular edema: Cystoid macular edema reported with bimatoprost given for elevated IOP; caution in aphakia, pseudophakia with a torn posterior capsule, or other risk factors for macular edema.
- Applicator contamination: One applicator per eye, then discard; bottle tip must not touch any surface. Bacterial keratitis has been reported with contaminated multiple-dose ophthalmic containers.
- Benzalkonium chloride: May be absorbed by and discolor soft contact lenses; remove lenses before application and reinsert 15 minutes after.
Common Side Effects
- Ocular, most common: Eye pruritus and conjunctival hyperemia, each approximately 3% to 4%; ocular irritation and dry eye symptoms under 4%; foreign body sensation reported without a frequency.
- Periocular skin: Skin hyperpigmentation approximately 3% to 4%; periorbital erythema under 4%; dry skin and skin exfoliation of the eyelid or periocular area postmarketing.
- Pigmentation: Iris hyperpigmentation and periorbital skin discoloration.
- Lash changes: Abnormal hair growth, madarosis, trichorrhexis, and trichiasis; disparity between eyes in length, thickness, pigmentation, number, or direction of lashes.
- Periorbital fat atrophy: Skin tightness with deepening of the eyelid sulcus and eyelid ptosis; postmarketing.
- Other ocular, postmarketing: Eye swelling, eyelid edema, hordeolum, increased lacrimation, blurred vision, local allergic reactions.
- Systemic, reported with the IOP-lowering formulation: Headache, asthenia, colds and upper respiratory infections.
Pregnancy & LactationPregnancy: No adequate and well-controlled studies in pregnant women; postmarketing experience shows no increase in major birth defects or miscarriage. Oral dosing during organogenesis caused abortion and early delivery in mice and rats at oral doses at least 33 times (mice) and 94 times (rats) human exposure by AUC, and these effects were not seen at 2.6 times (mice) or 47 times (rats). Use only if the benefit justifies fetal risk.
Lactation: Unknown whether topical ocular use yields detectable quantities in human milk; present in rat milk at an IV dose 324 times the recommended human ophthalmic dose on a mg/m2 basis.
Pediatric UseStudied in patients 5 to 17 with no new safety issues; benefit seen only in adolescents 15 to 17 with hypotrichosis.