Aflibercept

Aflibercept is a prescription medication for the treatment of people with wet age-related macular degeneration (wAMD, a common eye disease associated with aging) and macular edema. Aflibercept is also used to treat diabetic retinopathy in patients with diabetic macular edema.  Aflibercept belongs to a group of drugs called vascular endothelial growth factor A (VEGF-A) antagonists and placental growth factor (PlGF) antagonists. It works by inhibiting a protein that stimulates growth of new blood vessels and blood vessel leakage.

This medication comes in an injectable form to be given directly into the eye by a healthcare provider.

Common side effects of aflibercept include eye redness and pain, blood spots on the whites of eyes, and cataracts.

Aflibercept is a prescription medicine used to treat:

• Wet Age-related Macular Degeneration (wAMD)
• Diabetic Macular Edema (DME)
• Diabetic retinopathy in patients with diabetic macular edema
• Macular Edema following Retinal Vein Occlusion (RVO), which includes Macular Edema following Branch Retinal Vein Occlusion (BRVO) in addition Macular Edema following Central Retinal Vein Occlusion (CRVO)

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Aflibercept may be found in some form under the following brand names:

• Eylea

The most common aflibercept side effects include:

• conjunctival hemorrhage (bleeding in the eye)
• eye pain
• cataract
• vitreous detachment
• vitreous floaters
• increased pressure in the eye

This is not a complete list of aflibercept side effects. Ask your doctor or pharmacist for more information.

Serious side effects have occurred with aflibercept injections. See "Drug Precautions" section.

Because aflibercept is injected into the eye, only a very small amount of the drug reaches the bloodstream, making aflibercept unlikely to interact with most medications. However, be sure to tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Serious side effects have occurred with aflibercept injections including:

• serious infections inside the eye
• detached retinas
• cataracts
• inflammation inside the eye 
• increased eye pressure
• uncommonly, some patients have had serious, sometimes fatal, problems related to blood clots, such as heart attacks or strokes

If your eye becomes red, sensitive to light, or painful, or if you have a change in vision, call or visit your eye doctor right away.

After receiving an aflibercept injection, you may experience temporary vision problems. Do not drive or operate machinery until your vision has returned to normal.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of aflibercept there are no specific foods that you must exclude from your diet when receiving aflibercept.

Before receiving aflibercept, tell your doctor about all your medical conditions including if you:

• have an infection in or around your eye(s)
• have had a blood clot or stroke
• are allergic to any medication, food, or dyes
• are pregnant or breastfeeding

Tell your doctor about all the medications you take including prescription and non-prescription medications, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if aflibercept is excreted in human breast milk or if it will harm your nursing baby.

Aflibercept comes as a liquid to be injected into the eye by a healthcare provider in a medical office, hospital, or clinic.

Before you receive an aflibercept injection, your eye will be cleansed to prevent infection and numbed to reduce discomfort during the injection. You may feel pressure in your eye when the medication is injected. You should feel no pain.

After your injection, your doctor will need to examine your eyes before you leave the office.

You may receive a prescription for antibiotic eye drops to prevent infection after the procedure.

After receiving an aflibercept injection you may experience temporary vision problems. Do not drive or operate machinery until your vision has returned to normal.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

Wet Age-related Macular Degeneration (AMD): The recommended dose for aflibercept is 2 mg administered by injection in the eye every 2 months (8 weeks) following 3 initial monthly (4 weeks) injections. Aflibercept may be dosed once per month, but additional benefit was not seen with this dosing plan.

Macular Edema following Retinal Vein Occlusion (RVO): The recommended dose for aflibercept is 2 mg administered by injection in the eye monthly (every 4 weeks).

Diabetic Macular Edema (DME):  The recommended dose for aflibercept is 2 mg administered by injection in the eye every 2 months (8 weeks) following 5 initial monthly (4 weeks) injections. Aflibercept may be dosed once per month, but additional benefit was not seen with this dosing plan.

Diabetic retinopathy in patients with diabetic macular edema:  The recommended dose for aflibercept is 2 mg administered by injection in the eye every 4 weeks (monthly) for the first 5 injections then followed by 2 mg once every 8 weeks (2 months).

If aflibercept is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Keep all appointments with your healthcare provider for aflibercept injections. This medication must be taken as prescribed to receive the most benefit.