Drug Interaction:
Allow at least 5 minutes between application of other topical opthalmic agents
Indication:
LUMIGAN® 0.01% and 0.03% (bimatoprost ophthalmic solution)
Initial U.S. Approval: 2001
LIST OF DRUGS DURING 2006
Sr.No- 73
Name of the Drug- Bimatoprost 300mg +
Timolol (as maleate) 5mg/ml eye drops Pharmacological Classification- For reduction of IOP
Date of Approval- 05-07-2006
Approved by U.S.FDA on 30-12-2006 (Ref- FDA approved List
Glaucoma or ocular hypertension
Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
1. Bimatoprost Anti-Glaucoma 08-01-2002
2.Binatoprost 300mg + Timolol maleate 05-07-2006
5mg/ml eye drops
For reduction of IOP
3. Binatoprost eye drops 0.1mg.ml 05-08-2010
For the treatment of hypotrichosis of the eye lashes by
increasing their growth including length, thickness and
darkness
4. Binatoprost ophthalmic solution 09-10-2010
0.1% w/v - Addl. stgth
same as approved
5. Binatoprost ophthalmic solution 0.03% 30-03-2009
For the treatment of hypotrichosis of the eye lashes by
increasing their growth including length, thickness and
darkness
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
1.Bimaprost 0.3mg+ 28-02-2006
Timolol maleate IP eq.to Ttimlol 5.0mg
eye drops
For the reduction of IOP patients with open angle glaucoma, who are
insufficiently responsive to topical beta blockers or prptaglandin
analouges
2.Bimsprost 300mg+ 07-05-2006
Timolol maleate 5mg/ml eye drops
For reduction of IOP
Adverse Reaction:
Conjuntival hyperaemia Pain, irritation Growth and darkening of ey lashes , eye lids, iris discoloration (may be permanent )
Foreign body sensation, keratitis
Headache, visual disturbances
Ocular pruritus, itching or dryness,
Blepharitis, cataract Photophobia, infection
Asthenia, hirutism Hypertension
Conjunctival headache, raised liver enzymes
Contra-Indications:
Lactation
Special precautions
Hepatic , renal or respiratory impairment
History of significant ocular viral infection
Uveitis, or iritis
Risk factors of bradycardia, hypotension or macular oedema
Warn patients of possible eye lash growth, darkenening of eye lids, and change in color which may not be noticeble until several months
Monitor keratopathy in patients with dry eyes Contact lens ( leave interval of 15 minutes before reinserting )
Ocular inflammation
Pregnancy
Dosages/ Overdosage Etc:
Glaucoma or ocular hypertension
Dosage-
1 drop in affected eye( s) once daily in the evening
Apply pressure to tear duct immediately following application
Wait for 5 minutes beforeapplying to the other eye medication
Do not exceed the recommended dose
Not recommended for children below 18 years
Patient Information:
PATIENT COUNSELING INFORMATION
1 Potential for Pigmentation
Patients should be advised about the potential for increased brown pigmentation
of the iris, which may be permanent.
Patients should also be informed about the possibility of eyelid skin darkening,
which may be reversible after discontinuation of LUMIGAN® 0.01% and 0.03%
(bimatoprost ophthalmic solution).
2. Potential for Eyelash Changes
Patients should also be informed of the possibility of eyelash and vellus hair changes
in the treated eye during treatment with LUMIGAN® 0.01% and 0.03%.
These changes may result in a disparity between eyes in length, thickness,
pigmentation, number of eyelashes or vellus hairs,and/or direction of eyelash growth.
Eyelash changes are usually reversible upon discontinuation of treatment.
3. Handling the Container
Patients should be instructed to avoid allowing the tip of the dispensing container
to contact the eye, surrounding structures, fingers, or any other surface in order
to avoid contamination of the solution by common bacteria known to cause
ocular infections.
Serious damage to the eye and subsequent loss of vision may result from using
contaminated solutions.
4. When to Seek Physician Advice
Patients should also be advised that if they develop an intercurrent ocular condition
(e.g., trauma or infection), have ocular surgery, or develop any ocular reactions,
particularly conjunctivitis and eyelid reactions, they should immediately seek
their physician’s advice concerning the continued use of LUMIGAN® 0.01% and 0.03%.
5. Use with Contact Lenses
Patients should be advised that LUMIGAN® 0.01% and 0.03% contains benzalkonium
chloride,which may be absorbed by soft contact lenses. Contact lenses should be
removed prior to instillation of LUMIGAN® and may be reinserted 15 minutes
following its administration.
6. Use with Other Ophthalmic Drugs
Patients should be advised that if more than one topical ophthalmic drug is being used,
the drugs should be administered at least five (5) minutes between applications.
© 2012 Allergan, Inc. Irvine, CA 92612 ® marks owned by Allergan, Inc.
U.S. Patents 5,688,819 and 6,403,649
Pharmacology/ Pharmacokinetics:
CLINICAL PHARMACOLOGY
1. Mechanism of Action
Bimatoprost, a prostaglandin analog, is a synthetic structural analog of prostaglandin
with ocular hypotensive activity. It selectively mimics the effects of naturally
occurring substances, prostamides. Bimatoprost is believed to lower intraocular
pressure (IOP) in humans by increasing outflow of aqueous humor through both
the trabecular meshwork and uveoscleral routes. Elevated IOP presents a
major risk factor for glaucomatous field loss. The higher the level of IOP,
the greater the likelihood of optic nerve damage and visual field loss.
2. Pharmacokinetics
Absorption: After one drop of bimatoprost ophthalmic solution 0.03% was administered
once daily to both eyes of 15 healthy subjects for two weeks, blood concentrations
peaked within 10 minutes after dosing and were below the lower limit of detection
(0.025 ng/mL) in most subjects within 1.5 hours after dosing.
Mean Cmax and AUC0-24hr values were similar on days 7 and 14 at approximately
0.08 ng/mL and 0.09 ng•hr/mL, respectively, indicating that steady state was reached
during the first week of ocular dosing. There was no significant systemic drug
accumulation over time.
Distribution: Bimatoprost is moderately
Pregnancy and lactation:
USE IN SPECIFIC POPULATIONS
1. Pregnancy
Pregnancy Category C
There are no adequate and well-controlled studies of LUMIGAN® 0.01% and 0.03%
(bimatoprost ophthalmic solution) administration in pregnant women.
Because animal reproductive studies are not always predictive of human response
LUMIGAN® should be administered during pregnancy only if the potential benefit
justifies the potential risk to the fetus.
2. Nursing Mothers
It is not known whether LUMIGAN® 0.01% and 0.03% is excreted in human milk,
although in animal studies, bimatoprost has been shown to be excreted in breast milk.
Because many drugs are excreted in human milk, caution should be exercised
when LUMIGAN® is administered to a nursing woman.
3. Pediatric Use
Use in pediatric patients below the age of 16 years is not recommended because
of potential safety concerns related to increased pigmentation following
long-term chronic use.
4. Geriatric Use
No overall clinical differences in safety or effectiveness have been observed
between elderly and other adult patients.