Aflibercept

EYLEA

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Pronunciation: a-FLIB-er-sept

Aflibercept ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Aflibercept ballicule

Aflibercept EYLEA mascot mnemonic cartoon — Visual mnemonic: Aflibercept mascot
**“A fly-bear intercepts Eye lesions”**

What it isIntravitreal VEGF decoy receptor trapping VEGF-A, VEGF-B and placental growth factor; wet AMD, diabetic macular edema and retinal vein occlusion.

Why this oneIts fusion-protein trap binds more ligands than antibody-based agents and can permit longer injection intervals.

What limits itIntravitreal injection risks endophthalmitis, retinal detachment, inflammation and transient pressure elevation.

Principal riskEndophthalmitis and retinal detachment after intravitreal injection

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Sedation liability0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

FDA label

Read the full label on DailyMed ↗

NO BOXED WARNINGS

FDA dosing	Population	Start	Target
Neovascular (wet) AMD	Adults	2 mg intravitreal q4wk x3	2 mg q8wk
Macular edema following RVO	Adults	2 mg intravitreal q4wk	2 mg q4wk
Diabetic macular edema (DME) & diabetic retinopathy (DR)	Adults	2 mg intravitreal q4wk x5	2 mg q8wk
Retinopathy of prematurity (ROP)	Preterm infants	0.4 mg intravitreal, single dose per eye

Renal Undefined

Hepatic Undefined

ROP: interval between doses in the same eye should be at least 10 days

Instructions

Ophthalmic intravitreal injection by a qualified physician only
Do not use prefilled syringe for ROP

Available strengths

inj 40 mg/mL

Contraindications

Ocular or periocular infection
Active intraocular inflammation

Cautions

Endophthalmitis, retinal detachment, retinal vasculitis
Increased intraocular pressure
Thromboembolic events

Adverse reactions

Conjunctival hemorrhage
Eye pain
Cataract
Vitreous detachment/floaters
Increased intraocular pressure

Pregnancy Anti-VEGF mechanism may pose embryofetal risk; use only if benefit justifies risk.

Lactation Not recommended during breastfeeding.

Cost

Aflibercept (EYLEA)

Strength		#/mo	generic $/unit	CostPlus
40 mg/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Aflibercept is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

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Self-check

Which three ligands does aflibercept trap?
VEGF-A, VEGF-B and placental growth factor.
What serious infection can follow intravitreal aflibercept injection?
Endophthalmitis.