LUMIGAN SIDE EFFECTSOphthalmologist Carolina Valdivia, MD answers a question about Lumigan side effects and explains procedures that can help to control them.  A 60 year-old woman from California, USA writes:Hi Dr. Valdivia, First, Thank you for this website. I am a glaucoma patient. I use the drugs Levobunolol and Lumigan to control it. My question relates to Lumigan side effects. I read elsewhere on your website where I shouldn't be too concerned about glaucoma eye drops dripping down the side of my eyes. And I loved your finding on holding the inner eye so the glaucoma eye drops can be contained in the eye. I have been using Lumigan eye drops now for about 4 years. And I notice that the drops have made a slight darkening of my skin and fuzzy hair growth (not noticeable to others, but only to me) around the outer corner of the eye where the drops have fallen. I want to know if it is okay to get hair removal done for the fuzzy hair. I also want to know if there are any skin lighteners I can use to disguise the darkness. So far, I've been using makeup to disguise the darkness. I am hoping, however, that it doesn't get darker and darker. I have no other health problems at this time which could be causing the darkness and I'm told by the optometrist that this is caused by the Lumigan eye drops. I would like to get your opinion on these matters.
Lumigan (Bimatoprost) is a member of a class of medications known as prostaglandin analogs. Other glaucoma eye drops in this class, such as Xalatan (Latanoprost) and Travatan (Travoprost) have a similar mechanism of action as Lumigan eye drops, but the skin darkening and hair growth may be less intense. In response to your specific questions, the degree of skin darkening that occurs with Lumigan (Bimatoprost) varies from patient to patient. When blotching does occur, there is no way to predict in advance how dark it will be in any given patient. Skin darkening also is dependent upon the degree to which correct procedures for administering Lumigan eye drops are followed, with more blotching occurring with poor technique.When present, skin darkening associated with Lumigan (Bimatoprost) use typically reaches a plateau, meaning that blotching comes to a peak hue and is maintained, but does not get darker beyond it. If the Lumigan eye drops are discontinued, the blotching usually clears up over time. However, any changes in iris color will remain. The fuzzy hair growth that you have noticed also will not go away on its own if you stop using Lumigan eye drops. You might be wondering. With these Lumigan side effects, why bother using the glaucoma eye drops at all? The reason is that Lumigan (Bimatoprost) has significant advantages over other glaucoma medicines, I mentioned earlier that good technique for the administration of eye drops is essential for controlling Lumigan side effects. If you are experiencing difficulties, then it is better to ask someone to help you administer them rather than attempt to push ahead on your own. The eye lacks sufficient capacity to accept the total volume of one drop administered into it. Some of the excess will overflow to the sides of the eye, which is where you are reporting skin blotching and hair growth. In fact, only 1-7% of the eye drop actually enters the eye through the cornea. But this is sufficient to have the desired effect of lowering elevated eye pressure. It therefore is not necessary to apply a second drop, even though it may appear that a significant amount of liquid exits the eye. One drop is sufficient. Of course, if you miss the eye completely with the first drop or if you shut your eye completely before the drop is applied, then you will have to reapply the eye drop.
The video recommends using a moistened cotton ball or cosmetic square to clean excess medication that leaves the eye. However, for Lumigan eye drops (or other drugs in the prostaglandin analog class), I recommend the following procedure.
It is important that you allow 2-5 minutes for the medicine to infuse into your eye before washing your face. Cleaning your face with soap and water following administration of Lumigan (Bimatoprost) will remove residual medication from your skin and eyelashes. Do not wash vigorously or with a lot of pressure on or around your eyes. A simple cleaning is sufficient. I understand your apprehension about the Lumigan side effects that you are experiencing. Before trying over-the-counter skin lightening and/or hair removal products (including electrolysis or laser hair removal), I strongly recommend that you first speak to your eye doctor. Express your concerns openly and ask if she or he can recommend a dermatologist to evaluate you. There are a lot of products on the market with questionable ingredients and effectiveness. A dermatologist is a medical doctor that can work with your eye doctor to ensure that you are using the safest and most effective treatments.Your eye doctor still may recommend that you continue with Lumigan (Bimatoprost), despite the unwanted effects you are reporting. Remember, his or her decision always is based on what is the safest and most effective way to control elevated eye pressure and prevent vision loss from your glaucoma. The benefits of using Lumigan (Bimatoprost) to control elevated eye pressure usually far outweigh its limitations in terms of side effects. On the other hand, it is possible that your eye doctor will suggest a change to a different class of glaucoma eye drops in place of Lumigan. This seems unlikely, as you already are taking Levobunolol, a beta blocker. Nevertheless, it is important that any decision to change your medications be made taking into consideration the course of your glaucoma over time and your experience with medical treatments used in the past. A change in medication always requires a close monitoring of your intraocular pressure to determine its effectiveness. I hope that this sufficiently addresses your questions and concerns about Lumigan side effects. Remember, the first priority must always be to prevent optic nerve damage associated with elevated eye pressure and subsequent vision loss. Carolina Valdivia, MD
REFERENCE:Sweetman SC. Martindale: The Complete Drug Reference, 36th Ed. London: Pharmaceutical Press, 2009:1878.
My goal in answering your questions is to provide you with information, clear up misconceptions, and to explain options so that you can have an informed conversation with your doctor. However, under no circumstances should my response to your question be considered a substitute for ongoing consultation and examination with your doctor. Since I have not examined you, I only can speak in terms of generalities, whereas your doctor has sufficient clinical details to evaluate your case specifically.
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Lumigan (Bimatoprost 0.03%) is one of the most effective medications available for lowering elevated
in that it both is effective in controlling elevated eye pressure and it prevents transient eye-pressure spikes that occur in some patients under treatment with other anti-glaucoma medications.