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Ranibizumab ophthalmic Side Effects

In Summary

Commonly reported side effects of ranibizumab ophthalmic include: cataract, increased intraocular pressure, and intraocular inflammation. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to ranibizumab ophthalmic: intraocular solution

As well as its needed effects, ranibizumab ophthalmic may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking ranibizumab ophthalmic, check with your doctor or nurse immediately:

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 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
  • chills
  • cough
  • difficulty with 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
  • nasal congestion
  • pain in the chest, groin, or legs, especially the calves
  • painful blisters on the trunk of the body
  • pale skin
  • runny nose
  • severe, sudden headache
  • shivering
  • slurred speech
  • sneezing
  • sore throat
  • sudden loss of coordination
  • sudden, severe weakness or numbness in the arm or leg
  • sudden, unexplained shortness of breath
  • sweating
  • tightness in the chest
  • trouble sleeping
  • unexplained weight loss
  • unusual tiredness or weakness

Severity: Minor

Some ranibizumab ophthalmic side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

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

For Healthcare Professionals

Applies to ranibizumab ophthalmic: intraocular solution


Cardiovascular side effects including peripheral edema (up to 6%) and atrial fibrillation (up to 5%).

Although a low rate of arterial thromboembolic events were observed in clinical trials, there is a potential risk of ATE's (nonfatal stroke, nonfatal myocardial infarction, or vascular death) following intravitreal use of VEGF inhibitors.[Ref]


Gastrointestinal side effects including nausea (up to 10%), constipation (up to 8%), and gastroesophageal reflux disease (up to 6%) have been reported.[Ref]


General side effects including wound healing complications (up to 1%) have been reported.[Ref]


Hematologic side effects including anemia (up to 11%) have been reported.[Ref]


The pretreatment incidence of immunoreactivity to ranibizumab was 0% to 5% across treatment groups. After monthly dosing with ranibizumab for 6 to 24 months, antibodies to ranibizumab were detected in approximately 1% to 8% of patients. The immunogenicity data reflect the percentage of patients whose test results were considered positive for antibodies to ranibizumab in immunoassays and are highly dependent on the sensitivity and specificity of the assay. The clinical significance of immunoreactivity to ranibizumab is unclear at this time, although some patients with the highest levels of immunoreactivity were noted to have iritis or vitritis.[Ref]

Immunologic side effects including seasonal allergies (up to 8%) and immunogenicity have been reported.[Ref]


Metabolic side effects include hypercholesterolemia (up to 7%).[Ref]


Musculoskeletal side effects including arthralgia (up to 11%) have been reported.[Ref]

Nervous system

Nervous system side effects including headache (up to 12%) and peripheral neuropathy (up to 5%) have been reported.[Ref]


Conjunctival hemorrhage (up to 74%), eye pain (up to 35%), vitreous floaters (up to 27%), increased intraocular pressure (up to 24%), vitreous detachment (up to 21%), intraocular inflammation (up to 18%), cataract (up to 28%), foreign body sensation in the eye (up to 16%), eye irritation (up to 15%), increased lacrimation (up to 14%), blepharitis (up to 12%), dry eye (up to 12%), visual disturbance or blurred vision (up to 18%), eye pruritus (up to 12%), ocular hyperemia (up to 11%), retinal disorder (up to 10%), maculopathy (up to 11%), retinal degeneration (up to 8%), ocular discomfort (up to 7%), conjunctival hyperemia (up to 7%), posterior capsule opacification (up to 7%), and injection site hemorrhage (up to 5%) have also been reported.

Ocular side effects including endophthalmitis, rhegmatogenous retinal detachments, and iatrogenic traumatic cataracts are serious adverse events related to the injection procedure that have occurred in less than 0.1% of intravitreal injections.

Tear of the retinal pigment epithelium among neovascular AMD patients has been identified postmarketing.[Ref]


Renal side effects including renal failure (up to 7%) and chronic renal failure (up to 6%) have been reported.[Ref]


Respiratory side effects including nasopharyngitis (up to 16%), bronchitis (up to 11%), cough (up to 9%), upper respiratory tract infection (up to 9%), sinusitis (up to 8%), influenza (up to 7%), and chronic obstructive pulmonary disease (up to 6%) have been reported.[Ref]


1. Blick SK, Keating GM, Wagstaff AJ "Ranibizumab." Drugs 67 (2007): 1199-206

2. "Product Information. Lucentis (ranibizumab ophthalmic)." Genentech, South San Francisco, CA.

It is possible that some side effects of ranibizumab ophthalmic may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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