Ranibizumab


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Ophth Macular degeneration; Macular oedema 0.5 mg mthly. Continue treatment until visual acuity is stable for 3 consecutive mth. Choroidal neovascularisation 0.5 mg as a single dose.
Dosage Details
Intravitreal
Neovascular (wet) age-related macular degeneration
Adult: 0.5 mg mthly into the affected eye as a single dose. Continue treatment until visual acuity is stable for 3 consecutive mth. Doses are given at intervals of at least 1 mth.

Intravitreal
Choroidal neovascularisation secondary to pathologic myopia
Adult: 0.5 mg into the affected eye as a single dose. Further injections may be given if monitoring reveals signs of disease activity (1-2 inj during the 1st yr; some patients may need more frequent treatment). Doses are given at intervals of at least 1 mth.

Intravitreal
Diabetic macular oedema, Macular oedema secondary to retinal vein occlusion
Adult: 0.5 mg mthly into the affected eye as a single dose. Continue treatment until visual acuity is stable for 3 consecutive mth. Doses are given at intervals of at least 1 mth. Discontinue treatment if no improvement in visual acuity after 3 initial inj.
Contraindications
Active or suspected ocular or periocular infection, active severe intraocular inflammation, signs of irreversible ischaemic visual function loss in patients w/ retinal vein occlusion.
Special Precautions
Patient w/ risk factors for retinal pigment epithelial tears, history of stroke or transient ischaemic attack, uncontrolled HTN, previous intravitreal inj, active systemic infections, proliferative diabetic retinopathy, diabetic macular oedema due to type 1 DM. Discontinue treatment if rhegmatogenous retinal detachment or stage 3 or 4 macular hole develops. Diabetic patients w/ glycosylated Hb over 12%.
Adverse Reactions
Ocular pain, hyperaemia, irritation and pruritus; increased intraocular pressure, vitritis, vitreous detachment, retinal haemorrhage, visual disturbance, vitreous floaters, conjunctival haemorrhage, foreign body sensation in eyes, increased lacrimation, blepharitis, dry eye, headache, nasopharyngitis, arthralgia, thromboembolic events. Less frequently, endophthalmitis, blindness, retinal detachment, retinal tear and iatrogenic traumatic cataract.
Patient Counseling Information
This drug may induce temporary visual disturbances, if affected do not drive or use machines.
MonitoringParameters
Monitor intraocular pressure prior to and 30 min following inj via tonometry. Consider checking for perfusion of the optic nerve head immediately following inj. Monitor for signs of ocular infection/inflammation, retinal perfusion, endophthalmitis and visual acuity.
Overdosage
Symptoms: Increased intraocular pressure, transient blindness, reduced visual acuity, corneal oedema, corneal pain, and eye pain. Management: Intraocular pressure should be monitored and treated by the attending physician, if necessary.
Drug Interactions
May enhance the adverse/toxic effect of belimumab. Serious intraocular inflammation may occur when used adjunctively w/ verteporfin photodynamic therapy (PDT).
Action
Description: Ranibizumab is a recombinant humanised IgG1 kappa monoclonal antibody fragment which binds to active forms of human vascular endothelial growth factor A (VEGF-A) and inhibits their biologic activity. Binding of ranibizumab to VEGF-A inhibits VEGF from binding to its receptors, thereby suppressing neovascularisation (angiogenesis), endothelial cell proliferation and vascular permeability.
Pharmacokinetics:
Absorption: Low systemic absorption.
Excretion: Elimination half-life: Approx 9 days.
Storage
Store between 2-8°C. Protect from light.
ATC Classification
S01LA04 - ranibizumab ; Belongs to the class antineovasculatisation agents. Used in the management of neovascular macular degeneration.
References
Anon. Ranibizumab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/08/2014.

Buckingham R (ed). Ranibizumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/08/2014.

Joint Formulary Committee. Ranibizumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2014.

Lucentis (Ranibizumab) Injection. U.S. FDA. https://www.fda.gov/. Accessed 08/08/2014.

Lucentis Injection, Solution (Genentech, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/08/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Ranibizumab (EENT). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/08/2014.

Disclaimer: This information is independently developed by MIMS based on Ranibizumab from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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