Lumigan (Bimatoprost) Dosing for Glaucoma and Ocular Hypertension
The recommended dose of Lumigan (bimatoprost 0.03%) is one drop in the affected eye(s) once daily in the evening. 1
Critical Dosing Instructions
Do not administer bimatoprost more than once daily, as more frequent administration of prostaglandin analogs has been shown to decrease the IOP-lowering effect. 1 In fact, studies demonstrate that bimatoprost once daily is more effective than twice daily dosing. 2
Timing and Administration
- Administer in the evening as a single daily dose 1
- Onset of action: IOP reduction begins approximately 4 hours after first administration 1
- Peak effect: Maximum IOP lowering occurs within 8-12 hours after administration 1
- When using multiple eye drops: Wait at least 5 minutes between different topical ophthalmic medications to prevent washout 1, 3
Expected IOP Reduction
Bimatoprost provides robust IOP lowering:
- Mean IOP reduction: 6.8-9.2 mmHg (approximately 30-40% reduction from baseline) 4, 5
- Superior to timolol: Bimatoprost once daily lowers IOP more effectively than timolol 0.5% twice daily at all time points 2
- Comparable or superior to other prostaglandins: Demonstrates efficacy similar to or greater than latanoprost and travoprost 6, 7
Combination Therapy Considerations
If monotherapy with bimatoprost does not achieve target IOP:
- Fixed combination available: Bimatoprost 0.03%/timolol 0.5% (BTFC) provides additional IOP lowering beyond bimatoprost alone (39.9% vs 30.2% reduction) 5
- Combination therapy timing: When using multiple separate medications, maintain the 5-minute interval between drops 1
Target IOP Goals
Set target IOP at approximately 20% lower than baseline mean IOP measurements as the initial goal. 7, 8 This target should be reassessed at each visit based on optic nerve structure and visual field stability. 7
Common Pitfalls to Avoid
- Never increase dosing frequency beyond once daily - this reduces efficacy rather than improving it 1, 2
- Do not discontinue abruptly without ophthalmology guidance - untreated glaucoma leads to irreversible vision loss 3
- Avoid corticosteroid eye drops for managing side effects without ophthalmologist supervision, as they can increase IOP 3
Important Safety Considerations
Bimatoprost is contraindicated in patients with hypersensitivity to bimatoprost or any ingredient. 1
Key warnings include:
- Iris pigmentation changes: May be permanent even after discontinuation; periorbital and eyelash changes are typically reversible 1
- Eyelash changes: Increased length, thickness, and number are common and usually reversible 1
- Use with caution: In patients with active intraocular inflammation (uveitis), aphakic patients, or those with torn posterior lens capsule due to macular edema risk 1