Can We Use Latanoprost and Bimatoprost Together?

Glaucoma is one of the most distressing eye diseases worldwide, as is the major cause of visual field loss in adults. According to research studies, intraocular pressure (IOP) is the most important risk factor for the eye condition and its rapid progression. Reduction of intraocular (IOP) is the only proven treatment for glaucoma, and ophthalmic solutions have been used for this purpose.

Among the current ocular hypotensive drugs employed in treating ocular hypertension and open-angle glaucoma, prostaglandins are considered the first-line treatments. These include products like Latanoprost and Bimatoprost. These prostaglandin analogues have been reported to act on a prostamide specific receptor, suggesting a new mode of action. The IOP lowering effects of Bimatoprost 0.03% are achieved by enhancing both the trabecular meshwork and uveoscleral outflow without diminishing the production of aqueous humour. Latanoprost eye drop is a widely accepted anti-glaucoma drug and the first commercially available prostaglandin analogue. However, if latanoprost is not effective enough to reduce IOP to target levels, switching treatment or adding another anti-glaucoma drug should be considered. Bimatoprost ophthalmic solution comes with unique properties. Some clinical reports suggest that bimatoprost eye drop has a greater IOP reduction than latanoprost and any other prostaglandin analogue. Many research studies show the ophthalmic solution 0.03% produces a greater IOP-lowering effect than latanoprost 0.005% ophthalmic solution.  

Combination topical therapy with latanoprost and bimatoprost had no additive effect on lowering the IOP in patients receiving combination therapy in the clinical trials. However, the combination treatment may increase the intraocular pressure in some patients. According to research reports, combination ophthalmic solutions cause a significant reduction in IOP in patients receiving a single medication. Patients achieve greater IOP reducing effects as compared with using two ophthalmic solutions. There have been no clinical trials on the IOP reduction efficacy and safety between bimatoprost and latanoprost in patients with glaucoma.

Is the combination therapy effective?

The combination of Careprost bimatoprost and latanoprost could produce an additive IOP lowering effect, considering the mode of action of these two pharmaceutical agents. Most of their IOP lowering effect is on unveoscleral outflow, where they ac, probably on different receptors. However, one ophthalmic preparation can interfere with the IOP lowering effect of the other, leading to an increase in the IOP.

Conclusion

Prostaglandin analogues are considered the first-line therapy for glaucoma in most cases because they are extremely effective at reducing intraocular (IOP) pressure and comes with minimal side effects. The combination topical therapy, which includes bimatoprost and latanoprost, should not be considered as a therapeutic option for lowering IOP because of the paradoxical increase in IOP. Discuss with your ophthalmologist before you considering the combination therapy.