Eylea (Aflibercept) – Intravitreal

What Is Eylea?

Eylea (aflibercept) is a prescription medication used to treat various conditions of the eye, including neovascular wet age-related macular degeneration (AMD), macular edema following retinal vein occlusion, diabetic macular edema (DME), or diabetic retinopathy (DR). Eylea is most commonly prescribed in adults 65 and older.

The drug is administered via intravitreal injection, which is when the drug is injected directly into the eyeball. Eylea is classified as a vascular endothelial growth factor (VEGF) inhibitor.

As a VEF inhibitor, Eylea works to stop the formation of specific proteins that can cause damage to the blood vessels in your eyes by allowing them to break and leak blood and fluid into areas of the eye, ultimately damaging your vision.

More specifically, Eylea as a VEGF is a substance that helps the growth of new blood vessels. In certain cases, your body can make more VEGF.

Regarding purchase and availability, aflibercept is only available as a brand-name product, as no generic equivalent is currently available. Moreover, Eylea is considered a specialty drug that needs to be obtained from a specialty pharmacy.

Drug Facts

Generic Name: Aflibercept

Brand Name: Eylea

Drug Availability: Prescription

Therapeutic Classification: VEGF inhibitor

Available Generically: No

Controlled Substance: N/A

Administration Route: Intravitreal

Active Ingredient: Aflibercept

Dosage Form: Intravitreal injection

What Is Eylea Used For?

Eylea is approved by the Food and Drug Administration (FDA) to treat the following conditions:

  • AMD, which is when fluid or blood leaks into and damages the macula, the part of your eye near the center of the retina that's responsible for helping you see fine details clearly.
  • Macular edema, which is swelling or fluid buildup in the macula, following retinal vein occlusion (RVO). RVO is a type of stroke that impacts the eye. It occurs when small veins carrying blood away from the retina are blocked.
  • DR for when your retina gets damaged largely due to poor blood sugar control in individuals with type 1 or type 2 diabetes.
  • DME is another potential complication of poor blood sugar control in diabetic individuals.

Eylea controls certain eye conditions, but it does not cure them. Your healthcare provider will watch you carefully to see how well the injection works for you.

Talk to your healthcare provider about how long you should continue treatment.

How to Take Eylea

Eylea is injected directly into the jelly-like part of the eye called the vitreous. Eylea is always administered by an ophthalmologist who is a retina specialist. Therefore, you will never inject Eylea yourself.

The injections are performed at your provider’s office or at a clinic. Your provider will use a device that holds your eyelid open for the duration of the injection.

The injection device contains a sterilized size 30-gauge needle, which is one of the thinnest needles available. You will receive anesthesia (medication to prevent pain from the Eylea injection) and an antibacterial to prevent infection.

Especially after your first injection, you will likely remain at the office or clinic for around an hour to be observed for side effects such as high intraocular pressure (high pressure inside the eye).

Storage

Eylea will most likely be stored by your healthcare provider in their office or clinic, and you will only be expected to show up and receive the medication. However, in some circumstances, you may be tasked with bringing the medication with you to your appointment. In this case, you will need to store and preserve it exactly according to the manufacturer's instructions.

If needed, Eylea should be stored in the refrigerator between 36 and 46 degrees F. It should not be frozen.

Additionally, if tasked with storing Eylea at home, be sure to keep it in the original carton to protect the medication from light. It's important to know that there is no need to open the carton or the sealed blister tray until your healthcare provider is ready to give you the injection.

How Long Does Eylea Take to Work?

Eylea works by stopping the leakage of abnormal blood vessels, which causes swelling in the macula and ultimately vision problems.

For this reason, you will most likely not see an immediate improvement in your vision. The fluid that was previously present and damaging the macula will remain there until it can get reabsorbed and cleared away, at which time improvements in your vision are most likely.

Remember, if Eylea causes eye pain that worsens over time or won’t go away, or if you experience other symptoms that seem severe, contact your healthcare provider immediately.

What Are the Side Effects of Eylea?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

As with all medications, Eylea can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

The following are the most common side effects of Eylea.

If you experience any of these adverse effects and feel like they are severe or they do not go away, or if your eye symptoms worsen, notify your healthcare provider as soon as possible:

  • Increased intraocular pressure (IIP) is usually temporary and experienced within an hour of injection, but it’s possible that it could last longer. Your eye pressure should be tested regularly and monitored by your healthcare provider.
  • Conjunctival hemorrhage occurs when a tiny blood vessel breaks just beneath the clear surface of your eye, causing a small red spot on the white of your eye. This is usually harmless and often requires no treatment.
  • General eye pain and discomfort typically are experienced from the injection.
  • Cataracts are a clouding of the normally clear lens of your eye that makes it seem like you are looking through a cloudy window.
  • Vitreous detachment occurs when the vitreous separates from the retina. Vitreous floaters (spots in vision that look like black or gray specks or strings that drift across the eyes) or flashes of light may be noticed in your field of vision.

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

The following are serious side effects associated with Eylea use:

  • Endophthalmitis, inflammation of the fluids within your eye, is usually due to infection. Endophthalmitis is considered a medical emergency and needs to be treated quickly. Symptoms include eye pain that continues to worsen after your injection, eye redness, white or yellow pus or discharge from the eyes, and decreased vision. Immediately report these symptoms to your healthcare provider.
  • Retinal detachment is the separation of your retina from its normal position in the back of your eye. Symptoms are sudden and include blurred vision or seeing flashing lights in your field of vision. Retinal detachment is another eye emergency and needs to be treated immediately in order to avoid permanent vision loss.
  • Arterial thromboembolic events (ATEs) after receiving Eylea are rare but possible. These ATEs may include nonfatal stroke and nonfatal myocardial infarction (heart attack).

Report Side Effects

Eylea may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Eylea Should I Take?

This medication is administered by an ophthalmologist (eye doctor). Your healthcare provider will determine the dosage you receive of Eylea.

Modifications

Users should be aware of the following before beginning Eylea:

In pregnancy and nursing: It is not well known or well studied whether Eylea poses a risk in human pregnancy or if the drug is present in human breast milk. Therefore, it should be used during pregnancy or when nursing only if the benefit of treatment outweighs any potential risk to the fetus or infant.

In children: Eylea has not been studied or proven to be safe or effective in children. Therefore, Eylea is not approved for people under the age of 18.

Older adults: In clinical studies of Eylea, where approximately 76% of people were older than 65 and 46% were older than 75, no significant differences in efficacy or safety were observed in people over 75 vs. those younger than 75.

Regardless, speak with your healthcare provider if you believe your age or general well-being may impact your ability to tolerate Eylea.

People with outstanding kidney (renal) issues: In one wet AMD study, a subgroup of people, 43% of whom had varying kidney issues, experienced no differences regarding plasma concentrations (the amount of drug in the bloodstream) of Eylea after intravitreal injections of either four or eight weeks. As such, no general dose adjustment based on renal impairment status is needed for either wet AMD, RVO, or DME patients.

Missed Dose

The dosing frequency for Eylea ranges from every four weeks to every twelve weeks, with every eight weeks being the most common schedule. Make sure you understand how often you’re supposed to receive an injection.

Each time you receive an injection, your healthcare provider should schedule your next appointment before you leave the office.

Set reminders on your phone or put your injection dates in your calendar so you don’t forget appointments.

If you miss a dose, contact your healthcare provider’s office to get another appointment scheduled so that you can stay on top of your injection schedule.

Overdose: What Happens If I Take Too Much Eylea?

Since Eylea is an injection that you receive just once every four to twelve weeks, in addition to being a medication administered by a healthcare professional, overdose is unlikely.

Nonetheless, if you are instructed to store Eylea at home to take into your healthcare provider’s office and a child or a pet mistakenly consumes it, contact the Poison Control Center immediately.

What Happens If I Overdose on Eylea?

If you keep Eylea at home, and someone in your household, such as a child or a pet, mistakenly consumes the medicine, contact the Poison Control Center immediately.

If someone collapses or isn't breathing after taking Eylea, call 911 immediately.

Precautions

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Your eye doctor will want to check your progress closely and at regular visits, especially during the first few days after you receive this medicine, to make sure this medicine is working properly and to check for unwanted effects.

Receiving this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control before the first dose, during treatment, and for 3 months after the last dose to keep from getting pregnant. If you think you have become pregnant while receiving this medicine, tell your doctor right away.

Serious eye problems may occur with this medicine. Check with your eye doctor right away if your eye becomes red, sensitive to light, or painful, or if you see flashes or sparks of light, have a change in vision, or feel increased pressure in the eye several days after the injection.

This medicine may increase your risk of blood clots. Check with your doctor right away if you have pain in your chest, groin, or legs, especially the calves, difficulty with breathing, a severe, sudden headache, slurred speech, a sudden loss of coordination, severe weakness or numbness in your arm or leg, or vision changes.

This medicine may cause temporary blurred vision. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

What Are Reasons I Shouldn't Take Eylea?

You shouldn’t use Eylea if you have:

  • An ocular or periocular infection, such as conjunctivitis
  • Active inflammation inside your eye, such as uveitis
  • Known hypersensitivity to aflibercept or any ingredients in Eylea
  • Symptoms of hypersensitivity reactions that may include rash, pruritus (skin itch), urticaria (hives), or severe intraocular inflammation
  • Glaucoma, IIP: People with a history of glaucoma (an eye disease that can damage your optic nerve) should consult their healthcare provider before use. IIP has occurred within 60 minutes of Eylea injection in some patients.
  • Recent ocular surgery: Intravitreal injections have been associated with endophthalmitis. Any ocular surgery that disrupts the integrity of the globe can lead to endophthalmitis (e.g., cataracts, retinal surgeries, or radial keratotomy). Patients who have received or will receive Eylea and have recently undergone or will undergo eye surgery should be monitored for signs and symptoms of endophthalmitis.

What Other Medications May Interact With Eylea?

Since Eylea is injected into your eye, you are receiving a very small dose of medicine. Therefore, very little will be absorbed into your system to interact with other drugs that you've taken by mouth or otherwise.

If you regularly use eye drops, ask your healthcare provider about how to space these out around your Eylea injections.

What Medications Are Similar?

Other intravitreal medications used to treat diseases of the eye such as retinopathy and macular degeneration include the following VEGF inhibitors:

  • Beovu (brolucizumab-dbll) is an intravitreal preparation used to treat macular degeneration and macular edema.
  • Lucentis (ranibizumab) is an intravitreal preparation used to treat macular degeneration, retinopathy, macular edema, and myopic choroidal neovascularization.
  • Susvimo (ranibizumab) is an ocular implant that stays in your eye and delivers the medication into your vitreous continuously over a period of six months.
  • Byooviz (ranibizumab-nuna) is a biosimilar (a drug that is almost an identical version of an original product that is manufactured by a different company) product to Lucentis.
  • Cimerli (ranibizumab-eqrn) is a biosimilar to Lucentis.

This is a list of drugs also used for certain diseases of the eye. It is not a list of drugs recommended to take with Eylea. Ask your pharmacist or a healthcare practitioner if you have questions.

Frequently Asked Questions

  • What is Eylea used for?

    Eylea is used to treat various eye diseases, including wet AMD, muscular edema, and DR used typically in older adults. The drug is given by intravitreal injection, which is injected directly into a part of your eye called the vitreous.

  • How does Eylea work?

    Eylea is a VEGF inhibitor. It stops the formation of specific proteins that can cause damage to the blood vessels in your eyes. This damage can lead to the blood vessels breaking and leaking blood and fluid into areas of the eye, which ultimately decreases vision.

  • What are the side effects of Eylea?

    Common side effects of Eylea include conjunctival hemorrhage (bleeding in the conjunctiva, the mucous membrane covering the front of the eye and inner eyelids), increased pressure inside your eye, eye pain, or cataracts. Severe side effects include endophthalmitis and retinal detachment.

How Can I Stay Healthy While Taking Eylea?

AMD is the most common cause of vision loss in older adults. Other conditions affecting vision such as DR are of great concern for individuals with diabetes. Losing your vision can cause frustration and a feeling of losing control.

The eye is an intricate organ, and diseases of the eye are complicated. There is currently no cure for macular degeneration, and quite often damage caused by DR is not reversible. However, there are treatments like Eylea that can help slow damage to your vision or sometimes even improve it.

The thought of receiving an injection in your eye may seem scary, but the procedure is done in a controlled environment, with an extremely thin needle, and the area is numbed so that you do not feel the injection.

If you are experiencing vision loss, you may need to make adjustments to your day-to-day life. Your eye health provider or a therapist will be able to suggest small changes in your home that can make getting around easier and allow you to remain independent for as long as possible.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Shao EH, Yates WB, Ho IV, Chang AA, Simunovic MP. Endophthalmitis: Changes in Presentation, Management and the Role of Early Vitrectomy. Ophthalmol Ther. 2021;10(4):877-890.

  5. Prescribers' Digital Reference. Eylea (aflibercept) drug summary.

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By Sara Hoffman, PharmD
Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.