Bimat Eye Drops

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Bimat is a synthetic prostamide, structurally related to prostaglandins F2άlfa. However, the action that reduces IOP in this drug is not in binding to prostaglandin receptors, but in selectively simulating the effect of prostamides. The exact mechanism of action is unknown since there are no found receptors in the human body at present.

The effect of reducing IOP is to increase the outflow through the trabecular meshwork and uveoscleral outflow of intraocular fluid. The effect of the drug begins approximately 4 hours after administration. It reaches its maximum after 8-12 hours. The overall effect duration is at least 24 hours.

Pharmacokinetics

Bimat penetrates the cornea and sclera. It has a very small systemic effect after application. It is not capable of cumulation. So, with a single application per day, the maximum concentration in the blood comes after 10 minutes and decreases to the lower limit of sensitivity of laboratory methods (about 0.025 ng/ml) for 1.5 hours. The intravenous half-life is about 45 minutes.

Plasma proteins bind approximately 88% of bimatoprost. The remaining amount is in free form. The excretion is carried out mainly by the kidneys: up to 67% of it is excreted in the urine, 25% – the feces.

Dosing regimen

The recommended dose is 1 drop in the evening in the affected eye. Increasing the frequency of application may reduce the drug effect. If the next dose was missed, the use should be continued without changing the scheme. That is no more than 1 drop per day in the affected eye. At the same time taking Bimat with other prostaglandin analogs, IOP levels should be carefully monitored.

Indications for use

Ophthalmic hypertension and open-angle glaucoma.

Clinical researches

According to the results of the study in patients with an initial average IOP level of 26 mm Hg. Art. (P0) in the treatment of 0.03% solution of Bimat, there was a decrease of 7-8 mm Hg. Art. When comparing the effects of 0.01% and 0.03% solution of the drug in patients with an average IOP of 23.5 mm Hg. Art. the hypotensive effect in the first case was 7.5 mm Hg. st, which is 0.5 mm Hg. Art. less than the drug with a higher concentration.

Contraindications

Hypersensitivity to bimatoprost.

Side effects

The most frequent side effect is conjunctival hyperemia (15-45% of cases). It progressively decreases to almost complete disappearance by the third year of application of these drops. In 0.5-3% people find it the reason for drug withdrawal. Other common side effects are eyelash growth, itching (15-45%).

In 1-10% of cases dryness, burning, pain, irritation in the eye, visual impairment, foreign body sensation, pigmentation of the periocular area, blepharitis, cataracts, superficial keratitis, periorbital erythema, darkening of the eyelashes, secretion from the eyes, tearing, photophobia can be detected. There may be also observed allergic conjunctivitis, asthenopia, increased iris pigmentation, conjunctival edema, hyposphagma, abnormal hair growth.

In less than 1% of cases, intraocular inflammation (iritis) occurs.

The systemic side effects are colds and upper respiratory infections which are considered the most common (about 10%). About 1-5% of patients may complain of headaches, increased liver enzymes in laboratory tests, asthenic conditions.

Drug interaction

The interaction of Bimat with other medical substances is unlikely to achieve due to its extremely low concentration in the blood after application. As shown by preclinical studies, the drug is biotransformed in various ways, does not affect the liver enzymes involved in the metabolism of other drugs.

Studies have not shown interactions with various types of β-blockers when used together. Interaction with other antiglaucoma drugs has not been studied.

Overdose

No overdose has been reported. If they occur, symptomatic treatment is required.