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Ranibizumab (Intraocular)

Medically reviewed by Drugs.com. Last updated on Jan 22, 2022.

Intraocular route(Implant)

Warning: EndophthalmitisThe ranibizumab implant has been associated with a 3-fold higher rate of endophthalmitis than monthly intravitreal injections of ranibizumab. Many of these events were associated with conjunctival retractions or erosions. Appropriate conjunctiva management and early detection with surgical repair of conjunctival retractions or erosions may reduce the risk of endophthalmitis. In clinical trials, 2% of patients receiving a ranibizumab implant experienced at least one episode of endophthalmitis .

Commonly used brand name(s)

In the U.S.

  • Byooviz
  • Lucentis
  • Susvimo

Available Dosage Forms:

  • Solution
  • Implant

Therapeutic Class: Ophthalmologic Agent

Pharmacologic Class: Monoclonal Antibody Fragment

Uses for ranibizumab

Ranibizumab is used to treat neovascular (wet) age-related macular degeneration (AMD). Susvimo™ is used in patients who have responded to at least 2 injections of a vascular endothelial growth factor (VEGF) inhibitor. AMD is a disorder of the retina in the eye that causes blurring of vision or blindness. Ranibizumab works by changing the amount of blood that gets to the eye.

Ranibizumab is also used to treat myopic choroidal neovascularization (mCNV).

Ranibizumab is used to treat macular edema (swelling of the back of the eye) after retinal vein occlusion (a blood vessel in the eye is blocked). It is also used in diabetic patients who have diabetic macular edema (DME). Macular edema can cause loss of vision. Ranibizumab is also used to treat diabetic retinopathy (eye problem caused by diabetes).

Ranibizumab is to be given only by or under the direct supervision of your doctor.

Before using ranibizumab

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ranibizumab, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ranibizumab or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ranibizumab in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ranibizumab in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving ranibizumab, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ranibizumab with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Tofacitinib

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of ranibizumab. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems or
  • Glaucoma—Use with caution. May make these conditions worse.
  • Eye infection or
  • Eye swelling, active—Should not be used in patients with these conditions.

Proper use of ranibizumab

Lucentis®: An ophthalmologist (eye doctor) will give you ranibizumab as a shot into the eye. Ranibizumab is usually given once a month (about every 28 days). In some patients, it may be given once every 3 months after the first 4 injections.

Susvimo™: Ranibizumab is an implant that is inserted through the white part of the eye (sclera) by a doctor. Your doctor will refill the implant device every 6 months (at least every 24 weeks). Your doctor will give you instructions to follow after you receive the implant or the refill, and after the implant is removed.

Ranibizumab should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Missed dose

Call your doctor or pharmacist for instructions.

Precautions while using ranibizumab

Your eye doctor will want to check your progress at regular visits, especially during the first few days after you receive ranibizumab, to make sure ranibizumab is working properly and to check for unwanted effects.

Receiving ranibizumab while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and for at least 12 months after the last dose. If you think you have become pregnant while receiving ranibizumab, tell your doctor right away.

Serious eye or vision problems (eg, eye infection or bleeding, retinal detachment, conjunctival bleb, erosion, or retraction) may occur with ranibizumab. Check with your eye doctor right away if your eye becomes red, sensitive to light, painful, or watery, or if you have eye bleeding or discharge, a feeling that something is in your eye, or a change or loss of vision several days after you receive ranibizumab. Also, tell your eye doctor if you feel increased pressure in your eye.

Tell your doctor right away if your implant has moved out of place. You may need a surgery to correct this movement.

Damage to the implant septum (self-sealing part where ranibizumab is given to fill the implant) may occur with Susvimo™. This may cause problems when you receive a refill for your implant. Your doctor may remove the implant or change your treatment if your implant has been damaged.

Tell your doctor that you have Susvimo™ implanted in your eye before you have an MRI.

Do not drive or do anything else that could be dangerous until your eye shield can be removed and you can see. Do not rub or touch the area of the eye where the implant is inserted. Wash your hands first, if you have to touch your eye.

Ranibizumab may increase your risk of blood clots, heart attack, or stroke. Check with your doctor right away if you are having pain in your chest, groin, or legs, especially the calves, difficulty or trouble breathing, a severe, sudden headache, slurred speech, sudden loss of coordination, sudden, severe weakness or numbness in your arm or leg, or vision changes.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Ranibizumab side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  • Blindness
  • bloody eye
  • blurred vision or loss of vision
  • decreased vision or other changes in vision
  • disturbed color perception
  • dizziness
  • double vision
  • dry eye
  • eye pain
  • fainting
  • feeling of having something in the eye
  • halos around lights
  • headache
  • night blindness
  • overbright appearance of lights
  • pain or tenderness around the eyes and cheekbones
  • red, sore eyes
  • redness of the white part of the eyes or inside of the eyelids
  • redness, swelling, or itching of the eyelid
  • seeing flashes or sparks of light
  • seeing floating spots before the eyes, or a veil or curtain appearing across a part of vision
  • sensitivity of the eye to light
  • tearing of the eyes
  • tunnel vision
  • watering of the eyes

Less common

  • Body aches or pain
  • chest pain or tightness
  • chills
  • cough
  • difficulty or trouble breathing
  • dry mouth
  • fainting
  • fast, slow, or irregular heartbeat
  • general feeling of discomfort or illness
  • head congestion
  • hoarseness, loss of voice, or other voice changes
  • loss of consciousness
  • muscle aches and pains
  • pain in the chest, groin, or legs, especially the calves
  • painful blisters on the trunk of the body
  • pale skin
  • runny or stuffy nose
  • severe, sudden headache
  • shivering
  • slow wound healing
  • slurred speech
  • sneezing
  • sore throat
  • sudden loss of coordination
  • sudden, severe weakness or numbness in the arm or leg
  • sweating
  • trouble sleeping
  • unexplained weight loss
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Back pain
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • muscle stiffness
  • swelling or redness in the joints

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.