Daclatasvir (Daclatasvir )

Bimat + Applicators (Bimatoprost): Comprehensive Patient Guide for Australia

Basic Product Information

Mechanism of Action

For Patients:
Bimatoprost is a special kind of medicine called a prostaglandin analogue. It works by improving the flow of fluid (aqueous humour) out of the eye, which helps lower raised eye pressure. In Australia, this is important for people with glaucoma or ocular hypertension. Bimatoprost is also used to help eyelashes grow longer and fuller.

For Specialists:
Bimatoprost is a prostamide analogue that binds to prostaglandin FP receptors in the ciliary body, enhancing uveoscleral and trabecular outflow and thereby lowering intraocular pressure (IOP). When applied at the base of the eyelashes, it stimulates the growth phase (anagen) of the hair cycle for cosmetic indications.

Pharmacokinetics

• Absorption: Systemic absorption after ophthalmic use is very low; peak plasma level within 10 minutes, rapidly declining.
• Metabolism: Metabolised mainly in the liver via oxidase, N-deethylation, and glucuronidation pathways.
• Elimination: Eliminated via renal and biliary excretion; elimination half-life is under 45 minutes.
• Duration of Action: IOP-lowering effect lasts up to 24 hours per dose; eyelash effects develop within weeks of regular use.

Use in Everyday Life and Best Practices in Australia

Bimatoprost is primarily used in two situations: to control high eye pressure (glaucoma, ocular hypertension) and to promote thicker, longer eyelashes. It is supplied as eye drops along with single-use applicators to ensure hygiene and effective dosing.

• For Eye Conditions: Instil one drop in the affected eye(s) once daily, preferably in the evening.
• For Eyelash Growth: Use an applicator brush to apply a thin layer to the upper eyelid margin (base of lashes) once nightly. Do not apply to the lower lid.
• Wash hands before use. Remove contact lenses and reinsert at least 15 minutes after application.
• Use a fresh applicator each time to minimise the risk of infection.
• If a dose is missed, skip it and use the next at your usual time.

Bimatoprost is commonly used by Australians with glaucoma or people interested in eyelash enhancement, in line with local clinical guidelines from the Royal Australian and New Zealand College of Ophthalmologists (RANZCO).

Dosing in the Morning vs Evening

Evening use is preferred for both medical (glaucoma) and cosmetic (eyelash) indications for two reasons:

1. Evening application maintains stable intraocular pressure overnight, when risk is highest.
2. Any temporary eye redness (hyperemia) will likely resolve overnight, limiting cosmetic concerns during the day.

Consistency is key—take your dose at roughly the same time each evening. If morning dosing is required due to shift work or other reasons, discuss this with your pharmacist or doctor. Evidence on clinical outcomes regarding morning dosing is limited, although some patients may notice slightly higher side effects.

Taking with Food or on an Empty Stomach

Bimatoprost is applied topically and is not affected by meals or food intake. You can use it regardless of the timing your breakfast or dinner. Traditional Australian dietary habits (breakfast cereals, toast, etc.) will not interfere with the effectiveness of Bimatoprost.

• No dietary restrictions needed.
• Alcohol has no direct effect on Bimatoprost’s efficacy, but moderation is recommended as part of general healthy lifestyle advice.

Interaction Warnings

Drug and lifestyle interactions are uncommon, but it is important to let your healthcare provider know about all medicines and supplements you use. See the table below for key interactions:

Indications

Dosing According to Clinical Indications

Safety Profile and Side Effects

• Very Common (>10%): Mild eye redness (conjunctival hyperemia)
• Common (1–10%): Itchy sensation, dry eyes, eye irritation, increased eyelash growth, darkening of eyelid skin, mild burning after application
• Uncommon (0.1–1%): Iris colour darkening (more common with lighter coloured eyes), increased pigmentation of eyelid area
• Rare (<0.1%): Eye pain, eyelid swelling, allergic conjunctivitis, visual disturbance, macular oedema (particularly in patients with history of eye surgery or macular disease)

Warnings & Precautions:

• Inform your doctor about any history of eye inflammation, prior eye surgery, or existing macular oedema.
• Use care to avoid contact of the applicator with the eye or surrounding skin beyond upper lash margin to prevent unwanted hair growth.
• See your optometrist or ophthalmologist regularly, especially when using Bimatoprost for glaucoma.

Guidelines for Proper Use (Australia-Specific Advice)

• Store at room temperature (below 25°C); avoid direct sunlight and extreme humidity.
• Do not freeze. Do not use if the solution becomes cloudy or changes colour.
• Dispose of applicators after each use. Do not reuse.
• If you travel, keep the medication in your hand luggage to avoid exposure to temperature extremes and check local customs regulations for interstate flights within Australia.
• If you experience any severe side effects, contact your pharmacist, GP, or visit your nearest emergency department.
• Bimatoprost is not recommended during pregnancy or breastfeeding unless advised by your doctor.
• Do not drive or operate machinery immediately after use if vision is blurry.

Alternative Treatment Options

• Latanoprost: Widely used, similar efficacy, reimbursed under the PBS for glaucoma; may be less likely to cause eyelid pigmentation.
• Travoprost: Equivalent pressure-lowering, longer shelf life after opening.
• Tafluprost: Preservative-free, suitable for patients with sensitive eyes/allergies.
• Beta-blocker (e.g. timolol): Often used in combination; fewer cosmetic side effects but not as effective for night IOP control.
• Brimonidine or carbonic anhydrase inhibitors: Alternative class, prescribed when prostaglandins are unsuitable.

Pros: Bimatoprost has strong evidence for effective IOP control and eyelash growth.
Cons: Slightly greater risk of eyelid/iris pigmentation than some alternatives.

Legal, Registration, and Reimbursement Status in Australia

• Bimatoprost is registered with the Therapeutic Goods Administration (TGA, Australia) for primary open-angle glaucoma and ocular hypertension. Certain brands (such as Latisse) are also approved for eyelash growth.
• It is a Prescription Only Medicine (Schedule 4/S4), requiring a valid Australian prescription from a GP or ophthalmologist.
• Under the Pharmaceutical Benefits Scheme (PBS), certain Bimatoprost brands are reimbursed for glaucoma and ocular hypertension but not for cosmetic (eyelash) uses.
• Private health insurance policies may cover or partially reimburse the cost depending on the indication and brand.

Latest Research and Clinical Guidance (2022–2025)

• Recent studies (Miglior et al., 2023, "Prostaglandin Analogue Treatments in Glaucoma: Current Perspectives", Australian and New Zealand Journal of Ophthalmology) confirm Bimatoprost's role as a first-line medicine for intraocular hypertension.
• Cosmetic use for eyelashes remains popular, but long-term safety requires more research, particularly regarding risk of periorbital fat atrophy and pigmentation (Br J Ophthalmol, 2024).
• RANZCO guidelines (2023) continue to support once-daily application, with monitoring of ocular surface health and patient education regarding proper technique.
• No new safety concerns identified; pharmacovigilance ongoing via the TGA and the Australian Adverse Drug Reactions Committee.

Availability and Delivery

Bimatoprost (with applicators) is widely available at most community and online pharmacies in Australia. Pack sizes vary and are typically:

• 3mL bottle (with 30 single-use applicators) – ~1 month's supply
• 5mL bottle (with 60 single-use applicators) – ~2 months' supply

*Prices as of June 2024. Cosmetic/elective uses are not PBS-reimbursed. Your actual cost may differ by pharmacy and location.

FAQ – Common Patient Questions & Answers

• Q: How soon can I expect results for eyelash growth?
  A: Most people begin to see noticeable eyelash growth after 4–8 weeks of nightly use, with full results in 12–16 weeks.
• Q: What should I do if I miss a dose?
  A: Skip the missed dose and resume your usual schedule. Do not double the dose.
• Q: Can I use Bimatoprost eye drops if I wear contact lenses?
  A: Yes, but always remove contact lenses before use and wait at least 15 minutes before reinserting.
• Q: Will Bimatoprost change my eye colour?
  A: There is a small risk of gradual increased brown pigment in the coloured part of the eye, especially in those with mixed-colour irises.
• Q: Is it safe to use Bimatoprost during pregnancy or breastfeeding?
  A: Its safety has not been established in pregnancy or breastfeeding. Consult your doctor before use.

For more information, please visit your GP, talk to your pharmacist, or refer to www.tga.gov.au for up-to-date Australian medical information.