Aflibercept
EYLEA
Pronunciation: a-FLIB-er-sept
“A fly-bear intercepts Eye lesions”
What it isIntravitreal VEGF decoy receptor trapping VEGF-A, VEGF-B and placental growth factor; wet AMD, diabetic macular edema and retinal vein occlusion.
Why this oneIts fusion-protein trap binds more ligands than antibody-based agents and can permit longer injection intervals.
What limits itIntravitreal injection risks endophthalmitis, retinal detachment, inflammation and transient pressure elevation.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Neovascular (wet) AMD | Adults | 2 mg intravitreal q4wk x3 | 2 mg q8wk | |
| Macular edema following RVO | Adults | 2 mg intravitreal q4wk | 2 mg q4wk | |
| Diabetic macular edema (DME) & diabetic retinopathy (DR) | Adults | 2 mg intravitreal q4wk x5 | 2 mg q8wk | |
| Retinopathy of prematurity (ROP) | Preterm infants | 0.4 mg intravitreal, single dose per eye |
Renal Undefined
Hepatic Undefined
ROP: interval between doses in the same eye should be at least 10 days
Instructions
- Ophthalmic intravitreal injection by a qualified physician only
- Do not use prefilled syringe for ROP
Available strengths
- inj 40 mg/mL
Contraindications
- Ocular or periocular infection
- Active intraocular inflammation
Cautions
- Endophthalmitis, retinal detachment, retinal vasculitis
- Increased intraocular pressure
- Thromboembolic events
Adverse reactions
- Conjunctival hemorrhage
- Eye pain
- Cataract
- Vitreous detachment/floaters
- Increased intraocular pressure
Pregnancy Anti-VEGF mechanism may pose embryofetal risk; use only if benefit justifies risk.
Lactation Not recommended during breastfeeding.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 40 mg/mL | inj | per unit | not offered |
NO BOXED WARNINGS
Principal riskEndophthalmitis and retinal detachment after intravitreal injection