Comparative Pharmacology
Head-to-head clinical analysis: ALPROSTADIL versus BIMATOPROST.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALPROSTADIL versus BIMATOPROST.
ALPROSTADIL vs BIMATOPROST
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Alprostadil is a synthetic prostaglandin E1 (PGE1) that causes vasodilation by binding to prostanoid EP receptors, increasing intracellular cAMP, and relaxing smooth muscle. It also inhibits platelet aggregation.
Bimatoprost is a synthetic prostamide analog that selectively mimics the effects of prostamide F2α. It binds to prostaglandin F (FP) receptors on ciliary muscle cells and trabecular meshwork cells, increasing uveoscleral outflow and possibly trabecular outflow of aqueous humor, thereby reducing intraocular pressure. It also directly stimulates the prostaglandin FP receptor, leading to increased matrix metalloproteinase activity and remodeling of the extracellular matrix in the ciliary body.
Initial: 20-40 mcg IV bolus over 1-2 seconds; then 30-70 mcg/min continuous IV infusion for erectile dysfunction via intracavernosal injection: 2.5-10 mcg; for patent ductus arteriosus: 0.05-0.1 mcg/kg/min continuous IV infusion.
One drop of 0.01% or 0.03% ophthalmic solution instilled into the affected eye(s) once daily in the evening.
None Documented
None Documented
Clinical Note
moderateBimatoprost + Unoprostone
"Bimatoprost may increase the hypotensive activities of Unoprostone."
Clinical Note
moderateBimatoprost + Hydrochlorothiazide
"Bimatoprost may increase the hypotensive activities of Hydrochlorothiazide."
Clinical Note
moderateAlprostadil + Limaprost
"Alprostadil may increase the antiplatelet activities of Limaprost."
Clinical Note
moderateBimatoprost + Epoprostenol
"Bimatoprost may increase the hypotensive activities of Epoprostenol."
5-10 minutes; rapidly metabolized in the lungs, clinical effect lasts longer due to continuous infusion.
Terminal half-life: ~45 minutes (intravenous); after topical ocular administration, systemic half-life is similar due to rapid systemic clearance, with clinical effect lasting 24 hours due to ocular tissue binding
Primarily via urine (90%) as metabolites; 10% unchanged; minimal fecal excretion.
Renal: <67% (unchanged and metabolites), Biliary/fecal: ~25%
Category C
Category C
Prostaglandin Analog
Prostaglandin Analog