aflibercept at a glance
Medicine class
VEGF-pathway inhibitor and recombinant fusion protein
Eye treatment
Injected into the vitreous of the eye by an experienced healthcare professional
Cancer treatment
Given as a diluted intravenous infusion with FOLFIRI chemotherapy
What is aflibercept used for?
Selected products have two distinct groups of licensed uses:
Ophthalmic products: adults with wet age-related macular degeneration.
Ophthalmic products: visual impairment caused by macular oedema following branch or central retinal vein occlusion.
Ophthalmic products: visual impairment caused by diabetic macular oedema.
Ophthalmic products: visual impairment caused by myopic choroidal neovascularisation.
Intravenous product: metastatic colorectal cancer resistant to, or progressing after, oxaliplatin-containing treatment, with FOLFIRI chemotherapy.
How does aflibercept work?
Aflibercept acts as a soluble decoy receptor. It binds vascular endothelial growth factors and placental growth factor, preventing their usual receptor activation. In the eye this reduces abnormal vessel growth and fluid leakage; in cancer it restricts signals supporting tumour blood-vessel formation.
aflibercept preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 25 mg/mL
Injection
Route: Parenteral
Strengths: 40 mg/mL, 114.3 mg/mL
How to take aflibercept
Aflibercept is not self-administered. Ophthalmic products are injected into one eye under sterile conditions by a qualified professional. The cancer formulation is diluted and given intravenously by an oncology team. Do not drive until temporary visual disturbance after an eye injection or examination has resolved.
Tell the treating team about eye infection, inflammation, glaucoma, recent cardiovascular events, planned surgery, pregnancy, breastfeeding and all other medicines.
Never use the intravenous concentrate in the eye or substitute one formulation for another.
aflibercept side effects
Common or expected effects
- After eye injection: a small bleed or bruise on the white of the eye, soreness or grittiness, eye pain, blurred or reduced vision, floaters and temporarily raised eye pressure.
- With the cancer combination: diarrhoea, mouth inflammation, tiredness, reduced appetite, weight loss, headache, nosebleeds, abdominal discomfort and high blood pressure.
- Cancer-treatment blood or urine tests may show reduced white cells or platelets, protein in urine, altered liver enzymes or increased creatinine.
Get urgent medical advice
- Eye infection or inflammation, retinal tear or detachment, severe pressure rise, major visual deterioration or severe allergic reaction.
- During cancer treatment: serious infection, dehydration, severe bleeding, bowel perforation or fistula, blood clots, uncontrolled hypertension, kidney injury, impaired wound healing or posterior reversible encephalopathy syndrome.
aflibercept in pregnancy
Human pregnancy data are lacking, and animal studies found embryo-fetal toxicity. Ophthalmic aflibercept should generally be avoided unless a specialist judges that potential benefit outweighs fetal risk; individual assessment is also required for intravenous treatment. Effective contraception is required during treatment and for the product-specified period afterwards.
aflibercept while breastfeeding
Only very limited information is available. Small amounts may enter milk after eye treatment, but effects on an infant are unknown, so ophthalmic product information advises against breastfeeding as a precaution. For intravenous treatment, the oncology team must weigh the benefit of breastfeeding against the need for treatment.
aflibercept interactions
Formal interaction evidence is limited. The treatment team should review all prescribed, over-the-counter and complementary products.
Verteporfin photodynamic therapy
Combined use with ophthalmic aflibercept has not been studied, so its safety profile is not established.
Antithrombotic medicines
Eye studies found more conjunctival bleeding in people taking antithrombotics; do not stop these without prescriber advice.
Intravenous bisphosphonates
Concurrent or previous use may add to the risk of osteonecrosis of the jaw during intravenous treatment.
Common questions about aflibercept
Answers are fully visible for fast scanning and source review.
What is aflibercept used for?
It treats several retinal diseases when injected into the eye. A separate intravenous formulation is used with FOLFIRI for certain adults with metastatic colorectal cancer after previous oxaliplatin-containing treatment.
How is aflibercept given?
An eye specialist injects ophthalmic aflibercept into the vitreous of the eye. The cancer formulation is diluted and given into a vein by an oncology team.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.