Ranibizumab Ophthalmic Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Macular Degeneration

Neovascular (Wet) Age-Related Macular Degeneration (AMD):
0.5 mg (0.05 mL of 10 mg/mL) administered by intravitreal injection once a month (approximately every 28 days).

Usual Adult Dose for Macular Edema

Macular Edema Following Retinal Vein Occlusion (RVO):
0.5 mg (0.05 mL of 10 mg/mL) administered by intravitreal injection once a month (approximately every 28 days).

Diabetic Macular Edema (DME):
0.3 mg (0.05 mL of 6 mg/mL) administer by intravitreal injection once a month (approximately every 28 days).

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Data not available.

Dose Adjustments

Although less effective, treatment for neovascular (wet) age-related macular degeneration may be reduced to one injection every three months after the first four injections if monthly injections are not feasible. Compared to continued monthly dosing, dosing every three months will lead to an approximate five letter (one line) loss of visual acuity benefit, on average, over the following nine months.

In macular edema following retinal vein occlusion studies, patients received monthly injections of ranibizumab ophthalmic for 6 months. In spite of being guided by optical coherence tomography and visual acuity retreatment criteria, patients who were then not treated at month 6 experienced on average, a loss of visual acuity at month 7, whereas patients who were treated at month 6 did not. Patients should be treated monthly.

Precautions

Endophthalmitis and retinal detachments may occur following intravitreal injections. Patients should be monitored following the injection, and patients should be instructed to report any symptoms of endophthalmitis (red eyes, sensitivity to light, pain, or vision changes).

Increases in intraocular pressure have been noted both pre- and post-injection (at 60 minutes), patients should be monitored prior to and 30 minutes following the intravitreal injection.

Safety and effectiveness have not been established in pediatric patients (less than 18 years old).

Dialysis

Data not available

Other Comments

The intravitreal injection procedure should be carried out under controlled aseptic conditions, which include the use of sterile gloves, a sterile drape, and a sterile eyelid speculum (or equivalent). Adequate anesthesia and a broad-spectrum microbicide should be given prior to the injection.

Following the intravitreal injection, patients should be monitored for elevation in intraocular pressure and for endophthalmitis. Monitoring may consist of a check for perfusion of the optic nerve head immediately after the injection and tonometry within 30 minutes following the injection. Patients should be instructed to report any symptoms suggestive of endophthalmitis without delay.

Each vial should only be used for the treatment of a single eye. If the contralateral eye requires treatment, a new vial should be used and the sterile field, syringe, gloves, drapes, eyelid speculum, filter, and injection needles should be changed before ranibizumab ophthalmic is administered to the other eye.

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