Update on the mechanism of action of bimatoprost: A review and discussion of new evidence

Bimatoprost is a pharmacologically unique and highly efficacious anti-glaucoma agent. It appears to mimic the activity, of the prostamides, which are biosynthesized from the natural endocannabinoid anandamide by the enzyme cyclo-oxygenase 2 (COX-2). Bimatoprost has also been suggested to lower intraocular pressure by behaving as a prodrug or, alternatively, by stimulating FP receptors directly. These three distinctly different hypotheses for the mechanism of bimatoprost activity are discussed in the light of current evidence. (Surv Ophthalmol 49(Suppl 1):S5-S11.. 2004. (C) 2004 Elsevier Inc. All rights reserved.).