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Are you ready to prescribe Latisse?

Did you know that California optometrists can now prescribe Latisse? In October 2017, AB 443 passed, which allows California (TPA) optometrists to treat hypotrichiasis with Latisse starting January 1st, 2018. Latisse is supposed to increase eyelash growth, ‘including length, thickness, and darkness’.

As you know, Latisse is one of the brand names for the medication bimatoprost (0.03%), which we have traditionally prescribed as Lumigan.

Latisse is not meant to be applied to the lower lid. The suggested dosing regimen calls for applications along the upper lash line only, twice a day.

Doctors of Optometry, here are some commonly asked questions that you may encounter.

How long will it take before I see any results?

About two months! So patients need to be…..patient. Latisse’s prescribing guidelines state that the medication’s full effect will not be complete until 16 weeks or 4 months of usage.

Is the eyelash growth effect of Latisse permanent?

Unfortunately, no. Eyelash improvement will only continue as long as the patient uses the medication. Once Latisse application is stopped, eyelashes will return to their original state.

What are some potential side effects?

Itchy, red eyes. Dry eyes. Darkened eyelids. Darkened iris pigmentation for hazel or blue eyes. (Which is rare, at 1%, but likely permanent!) Hair growth around the eyes if medication runs or drips or is applied incorrectly. All of these side effects happened in less than 4% of patients in the clinical trials.

Can I sell it in my office?

No. The fine print of AB 443 states that direct sales are not allowed by optometrists.

How much does it cost?

Since Latisse is used for cosmetic purposes and is non-medically necessary, insurance is unlikely to cover this medication. At a local San Gabriel Valley area CVS Pharmacy, the cash pay price was $129.99(!) for a ONE month supply.

Who should NOT use Latisse?

Latisse is contraindicated in patients with uveitis, as Latisse can activate ocular inflammation. Macular edema has been reported in Lumigan studies, so Latisse should be used with caution in aphakic patients and pseudophakic patients with a torn posterior lens capsule, or patients with known risk factors for macular edema.

In addition, Latisse needs to be prescribed cautiously for patients that are already using Lumigan or other prostaglandin analogs for the treatment of glaucoma because Latisse may interfere with desired IOP reduction.

Other tips and info.

- Latisse is suggested for patients at least 16 years old or older.

- Allergan states that more product will not produce more results, so if a day is skipped, encourage patients not to use extra product the next day. This will just waste the product and possibly increase side effects, like darkened eyelids.

- After three months, when the lashes are already much thicker, some dermatologists recommend every other day application to save a little money.

- Currently, there is no other lash product in the marketplace that is FDA approved to do the same thing.

- Latisse can cause discoloration on contact lenses too. Remove contacts lenses before application and insert contact lenses 15 minutes after Latisse application.

- Apply the medication as you would apply eyeliner. The brush only needs to be slightly wet. Dripping indicates that too much product has been picked up.

I hope you find this blog post educational. The power to prescribe Latisse comes from the efforts of SGVOS on the local level and COA on the state level. Please consider becoming a member of your local optometric society today!

Vivian Shih, O.D.

Membership Chair - SGVOS


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