Agafi

Indications

Aflibercept intravitreal injection is used to treat eye diseases in which abnormal blood vessels grow or leak in the retina (the light-sensitive layer at the back of the eye): wet (neovascular) age-related macular degeneration, swelling of the macula caused by diabetes (diabetic macular oedema), macular swelling after retinal vein blockage, myopic choroidal neovascularisation, and in some cases retinopathy of prematurity in babies. A different, intravenous form of Aflibercept is used for colorectal cancer and is not covered here.

How It Works

Aflibercept is a laboratory-made protein that acts as a decoy receptor. It binds VEGF (vascular endothelial growth factor) and placental growth factor, signals that drive abnormal blood vessel growth and leakage. By blocking them, it reduces leakage and swelling in the retina and helps stabilise or improve vision.

Dosage and Administration

The injection is given only by an eye specialist into the eye (intravitreal injection) under sterile conditions after numbing drops. Treatment usually starts with monthly injections, followed by longer gaps depending on response, as prescribed by the eye specialist.

Interactions

No significant interactions with other medicines are known, as very little reaches the bloodstream. Tell the specialist about any other eye treatments or blood-thinning medicines.

Contraindications

• Infection in or around the eye.
• Active severe inflammation inside the eye.
• Allergy to Aflibercept or any ingredient.

Side Effects

Common effects include eye redness or a small bleed on the white of the eye, eye pain, floaters, blurred vision and a temporary rise in eye pressure. Rare but serious problems include eye infection (endophthalmitis), retinal detachment, cataract and inflammation.

Get urgent medical help, ideally from your eye specialist, if after an injection you have increasing eye pain or redness, sudden loss or blurring of vision, many new floaters or flashes of light, or sensitivity to light. Also seek urgent care for chest pain, weakness on one side or trouble speaking.

Pregnancy and Lactation

Aflibercept should not be used in pregnancy unless the benefit clearly outweighs the risk. Women who could become pregnant should use effective contraception during treatment and for at least 3 months after the last injection. Breastfeeding is not recommended during treatment.

Precautions and Warnings

Eye pressure and the eye are checked after each injection. Vision may be blurred for a while, so do not drive until it clears. Use with care in people with poorly controlled glaucoma or a recent stroke or heart attack.

Overdose

Too large a volume can raise eye pressure, which the specialist checks and treats.

Therapeutic Class

Ophthalmic anti-VEGF agent (fusion protein, anti-neovascular).

Storage

Store in a refrigerator at 2 to 8°C, do not freeze, in the original carton to protect from light. Hospital product: handle as directed on the pack.