faricimab: clinical use

Prescribing considerations

• Use appropriate aseptic intravitreal technique, topical antimicrobial preparation and adequate anaesthesia.
• Exercise particular caution with poorly controlled glaucoma, risk factors for retinal pigment epithelial tear, or a history of stroke, transient ischaemic attack or myocardial infarction.
• Safety and efficacy of simultaneous bilateral administration have not been established.
• Consider the limited evidence in uncontrolled hypertension, active systemic infection and certain advanced diabetic or extensive neovascular retinal presentations.
• Record the product name and batch number for biologic traceability.

Contraindications and cautions

• Ocular or periocular infection.
• Active intraocular inflammation.
• Hypersensitivity to faricimab or any excipient.

Monitoring

• Assess for infection or active inflammation before injection.
• Immediately assess intraocular pressure and optic nerve-head perfusion after injection, managing elevations appropriately.
• Monitor visual and anatomical outcomes to determine whether treatment remains beneficial.
• Ensure patients report vision loss, pain, photophobia, redness, blurred vision or increased floaters without delay.

Clinical pharmacology

Faricimab is a humanised bispecific IgG1 antibody that neutralises VEGF-A and angiopoietin-2. It acts locally within the eye, with very low systemic exposure, and is expected to be broken down into peptides and amino acids.

Formulation and product differences

• The selected presentation is a single-use pre-filled syringe for intravitreal use in one eye only.
• Inspect for particles, cloudiness or discolouration; do not shake or use damaged packaging.
• The unopened syringe requires refrigerated, light-protected storage but has a limited permitted period at room temperature before use.
• The syringe contains excess solution that must be expelled according to its instructions before administration.

Injection

Route: Parenteral

Strengths: 120 mg/mL