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Bimatoprost/timolol
Combination of
Bimatoprost	Prostaglandin analogue
Timolol	Beta blocker
Clinical data
Trade names	Ganfort
AHFS/Drugs.com	UK Drug Information
Routes of; administration	Eye drops
ATC code	S01ED51 (WHO) ;
Legal status
Legal status	UK: POM (Prescription only); EU: Rx-only; In general: ℞ (Prescription only);
Identifiers
CAS Number	946163-60-6;
KEGG	D10840;

Bimatoprost/timolol, sold under the brand name Ganfort, is a medication for the treatment of certain conditions involving high pressure in the eyes, specifically open angle glaucoma and ocular hypertension.^[1]^[3] It is available as eye drops.^[1]^[3]

It was approved for medical use in the European Union in May 2006.^[3]

Medical uses

Bimatoprost/timolol is used for the treatment of open angle glaucoma or ocular hypertension in people for whom single-component eye drops such as prostaglandin analogs or beta blockers are insufficient.^[4]

Contraindications

Because of the timolol component, which is a beta blocker, the drops are contraindicated in people with lung problems such as asthma or severe chronic obstructive pulmonary disease, or with heart problems such as sinus bradycardia (slow heartbeat), sick sinus syndrome, sino-atrial block, or severe atrioventricular block.^[4]

Adverse effects

The most common side effect is conjunctival hyperaemia (increased bloodflow in the outer layer of the eye), which occurs in over 10% of people taking the drug. Side effects in less than 10% of people include other eye problems such as itching, foreign body sensation or dry eye, as headache or hyperpigmentation (darkening) of the skin around the eye.^[4]

Hyperpigmentation is an adverse effect of bimatoprost,^[5] while the others are fairly common for eye drops in general.

Interactions

No formal interaction studies have been done with bimatoprost/timolol eye drops. As timolol (in tablet form) can be used to lower blood pressure and heart rhythm, it might add to the effect of other antihypertensive (pressure lowering) drugs. Also, drugs that block the liver enzyme CYP2D6 may increase the effects of timolol.^[4]

Pharmacology

Bimatoprost is a prostaglandin analog and lowers pressure in the eye by increased draining of aqueous humor via the trabecular meshwork. Timolol is a nonselective beta blocker, which lowers eye pressure by reducing aqueous humor production.^[4]

References

^ ^a ^b ^c "Ganfort 0.3 mg/ml + 5 mg/ml eye drops, solution - Summary of Product Characteristics (SmPC)". (emc). 20 February 2020. Archived from the original on 17 December 2023. Retrieved 1 March 2020.
^ "Ganfort 0.3 mg/ml + 5 mg/ml eye drops, solution, in single-dose container - Summary of Product Characteristics (SmPC)". (emc). 25 February 2020. Archived from the original on 20 April 2021. Retrieved 26 February 2021.
^ ^a ^b ^c ^d "Ganfort EPAR". European Medicines Agency (EMA). 26 February 2020. Archived from the original on 2 March 2020. Retrieved 1 March 2020.
^ ^a ^b ^c ^d ^e "Ganfort: EPAR – Product information" (PDF). European Medicines Agency. 26 February 2020. Archived (PDF) from the original on 2 March 2020. Retrieved 26 February 2021.
^ "Bimatoprost solution/drops". DailyMed. 18 September 2019. Archived from the original on 21 September 2020. Retrieved 26 February 2021.

Cheng JW, Cheng SW, Gao LD, Lu GC, Wei RL (2012). "Intraocular pressure-lowering effects of commonly used fixed-combination drugs with timolol: a systematic review and meta-analysis". PLOS ONE. 7 (9): e45079. Bibcode:2012PLoSO...745079C. doi:10.1371/journal.pone.0045079. PMC 3441590. PMID 23028770.
Fang Y, Ling Z, Sun X (2015). "Fixed-combination treatments for intraocular hypertension in Chinese patients - focus on bimatoprost-timolol". Drug Design, Development and Therapy. 9: 2617–25. doi:10.2147/DDDT.S80338. PMC 4435054. PMID 25999695.
Guven Yilmaz S, Degirmenci C, Karakoyun YE, Yusifov E, Ates H (August 2018). "The efficacy and safety of bimatoprost/timolol maleate, latanoprost/timolol maleate, and travoprost/timolol maleate fixed combinations on 24-h IOP". International Ophthalmology. 38 (4): 1425–1431. doi:10.1007/s10792-017-0601-8. PMID 28616797. S2CID 4019275.
Quaranta L, Biagioli E, Riva I, Rulli E, Poli D, Katsanos A, et al. (May 2013). "Prostaglandin analogs and timolol-fixed versus unfixed combinations or monotherapy for open-angle glaucoma: a systematic review and meta-analysis". Journal of Ocular Pharmacology and Therapeutics. 29 (4): 382–9. doi:10.1089/jop.2012.0186. hdl:11379/277321. PMID 23231442.
Xing Y, Zhu L, Zhang K, Huang S (2020). "The efficacy of the fixed combination of latanoprost and timolol versus other fixed combinations for primary open-angle glaucoma and ocular hypertension: A systematic review and meta-analysis". PLOS ONE. 15 (2): e0229682. Bibcode:2020PLoSO..1529682X. doi:10.1371/journal.pone.0229682. PMC 7046276. PMID 32106236.

[Ganfort_SmPC-1] "Ganfort 0.3 mg/ml + 5 mg/ml eye drops, solution - Summary of Product Characteristics (SmPC)". (emc). 20 February 2020. Archived from the original on 17 December 2023. Retrieved 1 March 2020.

[2] "Ganfort 0.3 mg/ml + 5 mg/ml eye drops, solution, in single-dose container - Summary of Product Characteristics (SmPC)". (emc). 25 February 2020. Archived from the original on 20 April 2021. Retrieved 26 February 2021.

[Ganfort_EPAR-3] "Ganfort EPAR". European Medicines Agency (EMA). 26 February 2020. Archived from the original on 2 March 2020. Retrieved 1 March 2020.

[EPAR-4] "Ganfort: EPAR – Product information" (PDF). European Medicines Agency. 26 February 2020. Archived (PDF) from the original on 2 March 2020. Retrieved 26 February 2021.

[Bimatoprost_label-5] "Bimatoprost solution/drops". DailyMed. 18 September 2019. Archived from the original on 21 September 2020. Retrieved 26 February 2021.

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Bimatoprost/timolol