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Pavblu (aflibercept-ayyh)
aflibercept intravitreal
Adult Dosing .
Dosage forms: INJ (pre-filled syringe): 2 mg per 0.05 mL; INJ (vial): 2 mg per 0.05 mL
Special Note
- [formulation clarification]
- Info: nonproprietary name = aflibercept-ayyh
age-related macular degeneration, neovascular
- [2 mg intravitreally q8wk]
- Start: 2 mg intravitreally q4wk x3 doses; Info: may consider q12wk maint. dosing after 1y of tx; some pts may require q4wk maint. dosing
macular edema, retinal vein occlusion-associated
- [2 mg intravitreally q4wk]
diabetic macular edema
- [2 mg intravitreally q8wk]
- Start: 2 mg intravitreally q4wk x5 doses; Info: some pts may require q4wk maint. dosing
diabetic retinopathy
- [2 mg intravitreally q8wk]
- Start: 2 mg intravitreally q4wk x5 doses; Info: some pts may require q4wk maint. dosing
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ (vial): 2 mg per 0.05 mL
Special Note
- [formulation clarification]
- Info: nonproprietary name = aflibercept-ayyh
retinopathy of prematurity (off-label)
- [0.4 mg intravitreally x1]
- Info: if giving to both eyes, may admin. on same day; may repeat tx after at least 10 days
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- ocular infection
- periocular infection
- intraocular inflammation, active
- caution: female pts of reproductive potential
Drug Interactions .
Overview
aflibercept
VEGF directed antibody
- thrombogenic effects
Avoid/Use Alternative
- tranexamic acid
- vaccinia immune globulin
Monitor/Modify Tx
- abemaciclib
- abrocitinib
- aminocaproic acid
- angiotensin II
- anthrax immune globulin
- anti-inhibitor coagulant complex
- antihemophilic factor (factor VIII)/von Willebrand factor complex
- asciminib
- asparaginase
- atidarsagene autotemcel
- avatrombopag
- axitinib
- baricitinib
- bazedoxifene
- bevacizumab
- binimetinib
- botulism immune globulin
- brolucizumab
- C1 esterase inhibitor
- cabozantinib
- calaspargase
- carfilzomib
- celecoxib
- chorionic gonadotropin
- clozapine
- coagulation factor IX
- coagulation factor VIIa
- coagulation factor XIII A-subunit
- concizumab
- cytomegalovirus immune globulin
- danazol
- darbepoetin alfa
- deflazacort
- desogestrel (contraceptive)
- deuruxolitinib
- dexamethasone
- diclofenac
- diclofenac topical
- dienogest (contraceptive)
- diflunisal
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- eltrombopag
- epirubicin
- epoetin alfa
- estetrol (contraceptive)
- estradiol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- ethinyl estradiol (contraceptive)
- ethinyl estradiol (hormone replacement)
- ethynodiol (contraceptive)
- etodolac
- etonogestrel (contraceptive)
- everolimus
- factor XIII concentrate
- faricimab
- fedratinib
- fenofibrate
- fenofibric acid
- fenoprofen
- fitusiran
- flurbiprofen
- follitropin
- fruquintinib
- hepatitis B immune globulin
- ibuprofen
- immune globulin
- indomethacin
- iohexol
- iopamidol
- ketoprofen
- ketorolac
- lazertinib
- lenalidomide
- lenvatinib
- levonorgestrel (contraceptive)
- levonorgestrel (hormone replacement)
- luspatercept
- lusutrombopag
- meclofenamate
- medroxyprogesterone (contraceptive)
- medroxyprogesterone (hormone replacement)
- mefenamic acid
- megestrol
- meloxicam
- menotropins
- methoxy polyethylene glycol-epoetin beta
- methyltestosterone
- momelotinib
- nabumetone
- naproxen
- necitumumab
- nintedanib
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norethindrone acetate (hormone replacement)
- norgestimate (contraceptive)
- norgestimate (hormone replacement)
- norgestrel (contraceptive)
- olaparib
- ospemifene
- oxaprozin
- pacritinib
- pazopanib
- pegaspargase
- piroxicam
- pomalidomide
- ponatinib
- porfimer
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- prothrombin complex concentrate (human)
- raloxifene
- ramucirumab
- ranibizumab
- Rho(D) immune globulin
- ritlecitinib
- romiplostim
- ruxolitinib
- ruxolitinib topical
- salsalate
- segesterone (contraceptive)
- sipuleucel-T
- sodium tetradecyl sulfate
- sotatercept
- sulindac
- tamoxifen
- testosterone
- thalidomide
- tivozanib
- tofacitinib
- tolmetin
- toremifene
- trametinib
- tretinoin
- upadacitinib
- vadadustat
- valoctocogene roxaparvovec
- vamorolone
- varicella zoster immune globulin
- von Willebrand factor
- vorinostat
- ziv-aflibercept
Adverse Reactions .
Serious Reactions
- endophthalmitis
- retinal detachment
- retinal vasculitis
- retinal vascular occlusion
- IOP incr.
- cataracts
- MI
- stroke
- thromboembolism
- hypersensitivity rxn
- retinopathy reactivation (retinopathy of prematurity use)
- scleritis
Common Reactions
- conjunctival hemorrhage
- ocular pain
- cataracts
- vitreous floaters
- IOP incr.
- vitreous detachment
- corneal erosion
- conjunctival hyperemia
- arterial thromboembolism
- retinal pigment epithelial detachment
- foreign body sensation
- lacrimation incr.
- injection site pain
- retinal pigment epithelial tear
- ocular inflammation
Safety/Monitoring .
Monitoring Parameters
IOP (optic nerve head perfusion or tonometry) immed. post-injection
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available, though risk of fetal harm not expected based on minimal systemic absorption; risk of embryo-fetal toxicity based on animal data at 6x systemic exposure; possible risk of fetal harm based on drug's mechanism of action
Individuals of Reproductive Potential
avoid pregnancy by using effective contraception before tx start, during tx and for at least 3mo after D/C in female pts
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on minimal maternal systemic absorption and drug properties
Pharmacology .
Metabolism: unknown; CYP450: unknown; Info: minimal systemic absorption
Excretion: unknown; Half-life: 5-6 days (IV route)
Subclass: Antineoplastics, Ophthalmic ; Macular Diseases ; VEGF Inhibitors, Ophthalmic
Mechanism of Action
binds and inhibits vascular endothelial growth factor A and placental growth factor, decreasing neovascularization and vascular permeability
Formulary .
No Formulary Selected
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