Aflibercept belongs to the class of medications called antineovascularization agents. These medications work by preventing the growth of new blood vessels. It is used to treat neovascular (wet) age-related macular degeneration (AMD). AMD is a deterioration of the macula, a part of the eye that is responsible for sharp, detailed vision. "Wet" AMD occurs when new blood vessels grow around and behind the macula. Aflibercept works by preventing the growth of these new blood vessels in the eye.

This medication is also used to treat visual impairment due to macular edema (swelling) caused by diabetic macular edema, macular edema caused by vein occlusion in the central retinal vein or one or more of the main branches of the retinal vein, and myopic choroidal neovascularization (a severe form of near-sightedness).

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

To treat "wet" age-related macular degeneration, the recommended adult dose of aflibercept is 2 mg (0.05 mL) given by intravitreal (into the eye) injection every month for 3 months, then every 2 months afterwards for the first 12 months of treatment. After the first year, the interval between treatments may be extended to every 3 months, based on your response.

To treat diabetic macular edema, the recommended adult dose of aflibercept is 2 mg (0.05 mL) given by intravitreal (into the eye) injection every month for 5 months, then every 2 months afterwards.

To treat central or branch retinal vein occlusion, the recommended adult dose of aflibercept is 2 mg (0.05 mL) given by intravitreal (into the eye) injection every month. The treatment interval may be extended to every 3 months based on your response.

To treat myopic choroidal neovascularization, the recommended adult dose of aflibercept is a single dose of 2 mg (0.05 mL) given by intravitreal (into the eye) injection. The need for additional doses will be determined by your response to treatment.

Aflibercept must be administered by a doctor who is experienced in administering intravitreal injections. Very careful handling of this medication is required. It is always given under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation and administration of this medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive aflibercept, contact your doctor as soon as possible to reschedule your appointment.

Store this medication in the refrigerator, in its original package, protect it from light and moisture, and keep it out of the reach of children.

Each 1 mL of clear, colourless-to-pale-yellow, iso-osmotic aqueous solution for intravitreal injection contains 40 mg of aflibercept. Nonmedicinal ingredients: polysorbate 20, sodium phosphate, monobasic, monohydrate; sodium phosphate, dibasic, heptahydrate; sodium chloride; sucrose and water for injection.

This medication is available in a single dose vial or a prefilled syringe for injection.

Do not take aflibercept if you:

• are allergic to aflibercept or any ingredients of the medication
• have inflammation of the eye
• have an infection in or around the eye

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bloodshot eye
• decreased sharpness of vision
• eye pain or bleeding at the injection site
• floaters (moving spots in vision)
• increased tear production
• sensation of something in the eye
• sensitivity to light
• swelling or irritation of the eye lid

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• cloudy vision
• damage to the front layer of the eyeball
• increased pressure in the eye
• pus in the eye
• signs of a hole in the macula (e.g., vision distortion, blurriness, straight lines appearing wavy)
• signs of damage to the cornea (e.g., eye pain, blurred vision, tearing extreme sensitivity to light)
• signs of detachment of the retina (e.g., floaters, flashes of light or shadows of part of the field of vision)
• signs of eye infection (e.g., pain, swelling around the eye, light sensitivity, worsening vision)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of shock (e.g., cold, damp skin; confusion; shakiness; nausea; weak, rapid pulse)
• signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clotting: The risk of blood-clot-related problems such as stroke, heart attack, or clots in the deep veins of your leg may be increased with this medication. If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Eye problems: Aflibercept can cause eye problems such as infection of the inside part of the eye, pain or redness, detachment or tear of the retina, or clouding of the lens. If you experience eye pain, increased eye discomfort, worsening eye redness, blurred or reduced vision, increased sensitivity of the eyes to light, or an increase in the number of small particles in your vision, contact your doctor immediately.

Glaucoma: Aflibercept may cause an increase in the pressure in the eye, possibly causing symptoms of glaucoma to worsen. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vision changes: Intravitreal injection of aflibercept may cause temporary changes to vision. Avoid driving, operating machinery, or performing other similar tasks until your vision returns to normal.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Effective birth control should be used while using this medication and for 3 months afterwards as this medication may harm the baby if used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if aflibercept passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of aflibercept have not been determined for this age group.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.