What is Aflibercept (ABZV): Uses, Dosage, Side Effects and More

Aflibercept is a medication that helps treat serious eye conditions that can threaten your vision. It's specifically designed to target a protein called VEGF that causes abnormal blood vessel growth in your eye. This medication is given as an injection directly into your eye by your doctor, and while that might sound intimidating, it's a well-established treatment that has helped many people preserve their sight.

What is Aflibercept?

Aflibercept is a type of medicine called a VEGF inhibitor that blocks harmful proteins in your eye. Think of VEGF as a signal that tells your eye to grow new blood vessels, but sometimes this signal goes haywire and creates vessels that leak or bleed. Aflibercept acts like a shield, blocking these faulty signals and helping your eye heal properly.

The medication is a lab-made protein that mimics your body's natural ability to control blood vessel growth. It's delivered through a very thin needle directly into the vitreous, which is the gel-like substance that fills the center of your eye. This direct delivery method ensures the medicine reaches exactly where it's needed most.

What is Aflibercept Used For?

Aflibercept treats several serious eye conditions that can lead to vision loss if left untreated. Your doctor might recommend this medication if you have wet age-related macular degeneration, diabetic macular edema, or certain types of retinal vein blockages.

The most common condition treated with aflibercept is wet age-related macular degeneration, where abnormal blood vessels grow under the retina and leak fluid or blood. This leaking can cause your central vision to become blurry or distorted, making it difficult to read, drive, or recognize faces.

People with diabetes may develop diabetic macular edema, where high blood sugar damages tiny blood vessels in the retina, causing them to leak fluid into the macula. This swelling can seriously affect your sharp, central vision that you use for detailed tasks.

Your doctor might also use aflibercept to treat retinal vein occlusions, which happen when blood vessels in your retina become blocked. This blockage can cause fluid to build up and lead to vision problems that range from mild blurriness to significant vision loss.

How Does Aflibercept Work?

Aflibercept works by blocking a protein called VEGF that encourages abnormal blood vessel growth in your eye. When you have certain eye conditions, your body produces too much VEGF, which signals your eye to create new blood vessels that are fragile and leak easily.

This medication is considered a strong and effective treatment for vision-threatening conditions. It binds to VEGF proteins like a key fitting into a lock, preventing them from triggering the growth of problematic blood vessels. By stopping this process, aflibercept helps reduce swelling, bleeding, and fluid leakage in your eye.

The effects of aflibercept can last for several weeks to months, which is why you don't need daily treatments. Your eye gradually processes the medication, and your doctor will monitor how well it's working through regular eye exams and imaging tests.

How Should I Take Aflibercept?

Aflibercept is only given as an injection into your eye by a qualified eye doctor in a medical setting. You cannot take this medication at home, and it's not available as eye drops or pills.

Before your injection, your doctor will clean your eye and the surrounding area thoroughly to prevent infection. They'll use numbing drops to make the procedure as comfortable as possible. The actual injection takes just a few seconds, though the entire appointment may last 30 minutes to an hour.

You don't need to fast or avoid eating before your appointment, but you should arrange for someone to drive you home afterward. Your eye may feel slightly uncomfortable or your vision might be temporarily blurry following the injection.

Your doctor will give you specific instructions about eye drops or other medications to use after the injection. It's important to follow these instructions carefully to reduce your risk of infection and help your eye heal properly.

How Long Should I Take Aflibercept For?

The length of treatment with aflibercept varies depending on your specific condition and how well you respond to the medication. Most people need ongoing treatment for months or even years to maintain their vision improvements.

Initially, you'll likely receive injections every 4 to 8 weeks for the first few months. Your doctor will monitor your progress closely during this time to see how your eye responds to the treatment. Some people notice improvements in their vision within a few weeks, while others may take several months to see significant changes.

After the initial treatment phase, your doctor may be able to extend the time between injections if your condition remains stable. Some people can eventually go 3 to 4 months between treatments, while others need more frequent injections to maintain their vision.

Your eye doctor will use special imaging tests and vision assessments to determine the best treatment schedule for you. Never stop treatment on your own, as this could lead to worsening of your condition and potential vision loss.

What Are the Side Effects of Aflibercept?

Like all medications, aflibercept can cause side effects, though many people tolerate it well. Most side effects are mild and temporary, affecting your eye or the injection site.

Here are the most common side effects you might experience after your injection:

• Mild eye pain or discomfort that typically lasts a few hours
• Temporary blurred vision or seeing spots or floaters
• Slight redness or irritation around the injection site
• Increased sensitivity to light for a day or two
• Feeling like something is in your eye
• Mild headache that usually resolves within a day

These common side effects are usually not serious and improve within a few days. However, you should contact your doctor if they persist or worsen.

More serious side effects are rare but require immediate medical attention. These include signs of infection such as severe eye pain, significant vision changes, or discharge from your eye. Other concerning symptoms include severe headache, sudden vision loss, or seeing flashing lights.

Very rarely, aflibercept can cause serious complications like retinal detachment, severe inflammation inside the eye, or increased eye pressure. Your doctor will monitor you carefully for these rare but serious side effects during your regular follow-up appointments.

Some people may experience systemic side effects affecting their whole body, such as high blood pressure or increased risk of blood clots. Your doctor will discuss these risks with you based on your overall health and medical history.

Who Should Not Take Aflibercept?

Aflibercept isn't suitable for everyone, and your doctor will carefully evaluate whether it's safe for you. People with active infections in or around the eye should not receive this medication until the infection is completely treated.

If you have a known allergy to aflibercept or any of its ingredients, you should not receive this medication. Your doctor will ask about your allergy history before starting treatment and may recommend allergy testing if needed.

People with certain cardiovascular conditions may need special monitoring or alternative treatments. This includes those with recent heart attacks, strokes, or uncontrolled high blood pressure. Your doctor will weigh the benefits of treatment against these potential risks.

Pregnant women should avoid aflibercept unless the benefits clearly outweigh the risks. If you're planning to become pregnant or are already pregnant, discuss this with your doctor to explore safer alternatives.

If you're breastfeeding, talk to your doctor about whether aflibercept is safe for you and your baby. The medication may pass into breast milk, though the effects on nursing infants are not well understood.

Aflibercept Brand Names

Aflibercept is available under the brand name Eylea, which is the most commonly prescribed form of this medication. Eylea is manufactured by Regeneron Pharmaceuticals and is the version most eye doctors use for treating retinal conditions.

You might also hear your doctor refer to biosimilar versions of aflibercept, which are medications that work very similarly to the original but may have slight differences in how they're made. These biosimilars must meet strict safety and effectiveness standards before they're approved for use.

Always make sure you understand which specific version of aflibercept you're receiving, and let your doctor know if you have any concerns about switching between different forms of the medication.

Aflibercept Alternatives

If aflibercept isn't suitable for you or doesn't work well enough, your doctor has several other treatment options available. Other VEGF inhibitors like ranibizumab (Lucentis) and bevacizumab (Avastin) work in similar ways and might be better choices for your specific situation.

Ranibizumab is specifically designed for eye treatments and has a long track record of safety and effectiveness. It's given as injections similar to aflibercept, though the dosing schedule might be different.

Bevacizumab was originally developed to treat cancer but has been found to be effective for eye conditions as well. It's often less expensive than other options, though it's used off-label for eye treatments.

For some conditions, your doctor might recommend laser therapy, photodynamic therapy, or steroid injections instead of or in addition to VEGF inhibitors. The best treatment choice depends on your specific condition, overall health, and how well you respond to different medications.

Is Aflibercept Better Than Ranibizumab?

Both aflibercept and ranibizumab are excellent medications for treating retinal conditions, and neither is universally better than the other. The choice between them depends on your specific condition, how often you can come for treatments, and how your eye responds to each medication.

Aflibercept may have a slight advantage in that it can often be given less frequently than ranibizumab, which means fewer trips to the doctor's office. Some studies suggest that aflibercept may work slightly better for certain types of diabetic eye disease.

Ranibizumab has been available longer and has an extensive safety record, which some doctors and patients prefer. It's also specifically designed for eye treatments, while aflibercept is used for both eye and cancer treatments.

Your eye doctor will consider factors like your specific diagnosis, how advanced your condition is, your overall health, and your personal preferences when choosing between these medications. Many people do well with either option, and you can often switch between them if needed.