ranibizumab: clinical use

Prescribing considerations

• Administration is restricted to ophthalmologists experienced in intravitreal injection, using appropriate anaesthesia, ocular antisepsis and aseptic technique.
• Record product name and batch number to maintain biological-medicine traceability.
• Assess previous hypersensitivity, recent or planned intraocular surgery, retinal breaks or detachment, macular holes, uncontrolled hypertension and previous stroke or transient ischaemic attack.
• Do not administer concurrently with another ocular or systemic anti-VEGF treatment.

Contraindications and cautions

• Hypersensitivity to ranibizumab or an excipient
• Active or suspected ocular or periocular infection
• Active severe intraocular inflammation

Monitoring

• Assess visual function and retinal anatomy, including optical coherence tomography or angiography where appropriate.
• Monitor intraocular pressure and optic-nerve-head perfusion around administration.
• Monitor during the following week and ensure rapid access to assessment for possible endophthalmitis, inflammation or retinal complications.

Clinical pharmacology

Ranibizumab is a recombinant humanised antibody Fab fragment that binds VEGF-A and prevents activation of VEGFR-1 and VEGFR-2. Systemic concentrations after intravitreal administration are generally low relative to vitreous concentrations.

Formulation and product differences

• The selected product is a clear, colourless to pale-yellow, sterile solution in a single-use pre-filled syringe.
• The pre-filled syringe contains excess solution that must be expelled during professional preparation; the complete syringe contents must not be injected.
• The pre-filled syringe is silicone-oil-free, and the injection needle is not supplied.

Injection

Route: Parenteral

Strengths: 10 mg/mL