Drug promises fuller lashes, but at what cost?

You may have heard about the new drug Latisse that promises—for about $120 a month—"longer, fuller and darker" eyelashes. The Food and Drug Administration recently approved the drug to treat what the manufacturer, Allergan, calls "inadequate" eyelashes. Allergan expects yearly sales of more than $500 million. But sales numbers aside, according to our consultants, the drug may also carry some serious risks to your vision, in addition to some not-so-desirable cosmetic side effects.

For starters, Latisse, which is painted on the eyelid with a nail-brush-style applicator once a day, may potentially mask undiagnosed glaucoma. Latisse (chemical name is bimatoprost) began life as the glaucoma drug Lumigan. When Lumigan went through clinical trials, some peculiar side effects became apparent, including thicker eyelash growth. The drugmaker apparently knew it was on to something. The FDA approved Latisse with just one safety and efficacy trial, basing their approval largely on what is already known about Lumigan.

But the Latisse trial excluded patients who had glaucoma and other eye problems. Because bimatoprost lowers eye pressure in glaucoma patients using Lumigan, it could have the same effect on cosmetic users of Latisse. Our consultants are concerned that because of that potential effect, people who develop glaucoma or other eye problems may not be diagnosed if they are using Latisse, potentially delaying necessary treatments.

If you go to the Latisse Web site you'll see an eye as blue as a tropical sea, surrounded by lush, palm-tree-like eyelashes. But that Caribbean-blue iris could change to dark brown in patients using the drug. Some people could see a permanent change in the color of their eyes, with lighter greens and blues turning to darker browns.

And then there's the possibility of a permanently darkened eyelid. We are concerned that the Latisse trial included too few African-Americans, who may be especially prone to this side effect. And it can cause itchy, red eyes in a significant number of users.

We're also worried that the people using Latisse for cosmetic reasons could be less likely than users of Lumigan to use the medication as directed. Might some people apply more than necessary in an effort to get even longer eyelashes? If so, it might exacerbate some of the cosmetic side effects that appeared in the drug's trials.

CR's Take: All drugs have risks that need to be weighed against their benefits. Those risks should be under greater scrutiny when the drug's benefits are cosmetic. One expert we consulted said she'd require patients to undergo a full eye exam before prescribing Latisse. That's not a bad idea for anyone considering using the drug, and patients who do use it should follow up with an annual eye exam to detect any changes in the eye.

—Kevin McCarthy, associate editor

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