Ranibizumab

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Generic Name of Ranibizumab - Learn More

Ranibizumab

Ranibizumab Precaution - What You Need to Know

- Allergic Reactions: Before receiving ranibizumab, inform your doctor if you have any allergies, especially to ranibizumab or any of its components. Allergic reactions can occur and may include symptoms such as rash, itching, swelling, and difficulty breathing.
- Infection Risk: Ranibizumab is administered via intravitreal injection, which carries a risk of infection. Endophthalmitis, a severe eye infection, is a rare but serious complication that can lead to vision loss. Proper aseptic techniques during administration are crucial to minimize this risk.
- Retinal Detachment: There is a risk of retinal detachment with the use of ranibizumab. Patients should be monitored for symptoms such as sudden onset of floaters, flashes of light, or a curtain-like shadow over the visual field, which may indicate retinal detachment.
- Increased Intraocular Pressure: Ranibizumab injections can temporarily increase intraocular pressure (IOP). Patients with glaucoma or ocular hypertension should be monitored closely, as elevated IOP can exacerbate these conditions.
- Thromboembolic Events: Although rare, there is a potential risk of thromboembolic events, such as stroke or heart attack, associated with the use of ranibizumab. Patients with a history of cardiovascular disease should be monitored closely.
- Pregnancy and Breastfeeding: There is limited data on the use of ranibizumab during pregnancy and breastfeeding. Animal studies have shown a low incidence of skeletal abnormalities in offspring when ranibizumab was administered to pregnant monkeys. Due to its mechanism of action, ranibizumab is considered potentially teratogenic and embryo/fetotoxic. Breastfeeding is not recommended during treatment with ranibizumab, as it may be excreted in human milk at low levels.
- Drug Interactions: Inform your doctor about all medications you are taking, including prescription and over-the-counter drugs, vitamins, and herbal supplements. Ranibizumab may interact with other medications, and it is important to ensure that it is safe to use with your current medications.
- Regular Monitoring: Regular follow-up appointments are essential to monitor the effectiveness of ranibizumab and to check for any adverse effects. Patients should adhere to the prescribed schedule of injections and attend all follow-up visits.
- Special Populations: Elderly patients and those with compromised immune systems may be at higher risk for complications. Close monitoring and individualized treatment plans are necessary for these populations.

Ranibizumab Indication - Uses and Benefits

- Neovascular (Wet) Age-Related Macular Degeneration (AMD): Ranibizumab is indicated for the treatment of wet AMD, a leading cause of vision loss in older adults. It works by inhibiting the growth of abnormal blood vessels in the eye, which can leak fluid and cause damage to the macula, the central part of the retina responsible for detailed vision.
- Macular Edema Following Retinal Vein Occlusion (RVO): Ranibizumab is used to treat macular edema, a condition where fluid builds up in the macula, leading to blurred or distorted vision. This can occur following a retinal vein occlusion, a blockage in the small veins that carry blood away from the retina.
- Diabetic Macular Edema (DME): Ranibizumab is indicated for the treatment of DME, a complication of diabetes that can cause vision loss. It helps to reduce the swelling in the macula caused by leaking blood vessels.
- Diabetic Retinopathy: Ranibizumab is used to treat diabetic retinopathy, a condition where high blood sugar levels damage the blood vessels in the retina. It helps to prevent the progression of the disease and preserve vision.
- Myopic Choroidal Neovascularization (mCNV): Ranibizumab is indicated for the treatment of mCNV, a condition where abnormal blood vessels grow in the choroid, the layer of blood vessels beneath the retina, in individuals with severe nearsightedness (myopia). This can lead to vision loss if left untreated.
- Choroidal Neovascularization (CNV) Secondary to Pathologic Myopia (PM): Ranibizumab is used to treat CNV associated with pathologic myopia, a condition where the eye is extremely nearsighted and prone to developing abnormal blood vessels in the choroid.
- CNV Secondary to Other Ocular Conditions: Ranibizumab is indicated for the treatment of CNV associated with other ocular conditions, such as angioid streaks, postinflammatory retinochoroidopathy, central serous chorioretinopathy, or idiopathic chorioretinopathy. These conditions can lead to the growth of abnormal blood vessels in the choroid, causing vision loss.
- Mechanism of Action: Ranibizumab is a recombinant humanized monoclonal antibody fragment that binds to and inhibits vascular endothelial growth factor A (VEGF-A), a protein involved in the growth of new blood vessels (angiogenesis) and increased vascular permeability. By blocking VEGF-A, ranibizumab helps to reduce the growth of abnormal blood vessels and leakage in the eye, thereby preserving vision.
- Administration: Ranibizumab is administered as an intravitreal injection, directly into the vitreous humor of the eye. The injection is typically given by an ophthalmologist in a clinical setting. The frequency of injections depends on the condition being treated and the patient's response to the medication.
- Efficacy: Clinical trials have shown that ranibizumab is effective in improving visual acuity and reducing the progression of vision loss in patients with wet AMD, DME, RVO, and other conditions associated with abnormal blood vessel growth in the eye. It is considered a first-line treatment for these conditions.

Ranibizumab Contraindications - Important Warnings

- Hypersensitivity: Ranibizumab is contraindicated in patients with a known hypersensitivity to the drug or any of its components. Allergic reactions can occur and may include symptoms such as rash, itching, swelling, and difficulty breathing.
- Ocular or Periocular Infections: Ranibizumab should not be administered to patients with active or suspected ocular or periocular infections, as the injection procedure can exacerbate the infection and lead to serious complications, including endophthalmitis.
- Severe Intraocular Inflammation: Ranibizumab is contraindicated in patients with severe intraocular inflammation, as it can worsen the condition and lead to further damage to the eye.
- Retinal Detachment: Ranibizumab should not be used in patients with rhegmatogenous retinal detachment or stage 3 or 4 macular holes, as it can exacerbate these conditions and lead to further vision loss.
- Pregnancy and Breastfeeding: There is limited data on the use of ranibizumab during pregnancy and breastfeeding. Animal studies have shown a low incidence of skeletal abnormalities in offspring when ranibizumab was administered to pregnant monkeys. Due to its mechanism of action, ranibizumab is considered potentially teratogenic and embryo/fetotoxic. Breastfeeding is not recommended during treatment with ranibizumab, as it may be excreted in human milk at low levels.
- Uncontrolled Glaucoma: Ranibizumab should be used with caution in patients with uncontrolled glaucoma, as the injection procedure can temporarily increase intraocular pressure (IOP), exacerbating the condition.
- Thromboembolic Events: Although rare, there is a potential risk of thromboembolic events, such as stroke or heart attack, associated with the use of ranibizumab. Patients with a history of cardiovascular disease should be monitored closely, and the risks and benefits of treatment should be carefully considered.
- Immunocompromised Patients: Ranibizumab should be used with caution in immunocompromised patients, as they may be at higher risk for infections and other complications associated with the injection procedure.

Ranibizumab Side Effects - What to Expect

- Endophthalmitis: Endophthalmitis is a rare but serious complication of intravitreal injections, including ranibizumab. It is a severe eye infection that can lead to vision loss if not treated promptly. Symptoms may include eye pain, redness, swelling, and decreased vision.
- Retinal Detachment: Ranibizumab injections can increase the risk of retinal detachment, a condition where the retina separates from the underlying tissue. Symptoms may include the sudden onset of floaters, flashes of light, or a curtain-like shadow over the visual field.
- Increased Intraocular Pressure (IOP): Ranibizumab injections can temporarily increase intraocular pressure (IOP), which can exacerbate conditions such as glaucoma or ocular hypertension. Symptoms may include eye pain, redness, and blurred vision.
- Intraocular Inflammation: Ranibizumab can cause intraocular inflammation, a condition where the eye becomes inflamed. Symptoms may include eye pain, redness, and decreased vision. In severe cases, it can lead to vision loss.
- Conjunctival Hemorrhage: Ranibizumab injections can cause conjunctival hemorrhage, a condition where a small blood vessel breaks beneath the conjunctiva, the clear membrane covering the white of the eye. This can result in a bright red spot on the eye, which usually resolves on its own.
- Eye Pain and Irritation: Ranibizumab injections can cause eye pain and irritation, which may include symptoms such as burning, stinging, or a foreign body sensation in the eye. These symptoms are usually mild and resolve on their own.
- Cataract: Ranibizumab injections can increase the risk of cataract formation, a condition where the lens of the eye becomes cloudy, leading to blurred vision. This is more common in patients who receive frequent injections.
- Vitreous Floaters: Ranibizumab injections can cause vitreous floaters, which are small spots or shadows that appear in the field of vision. These floaters are usually harmless and resolve on their own, but they can be bothersome for some patients.
- Systemic Adverse Events: Although rare, ranibizumab can cause systemic adverse events, such as thromboembolic events (stroke or heart attack), hypertension, and arterial thromboembolic events. These events are more common in patients with a history of cardiovascular disease.

Ranibizumab Pregnancy Category ID - Safety Information

3

Ranibizumab Mode of Action - How It Works

- VEGF-A Inhibition: Ranibizumab is a recombinant humanized monoclonal antibody fragment that binds to and inhibits vascular endothelial growth factor A (VEGF-A). VEGF-A is a protein involved in the growth of new blood vessels (angiogenesis) and increased vascular permeability, which can lead to the leakage of fluid into the surrounding tissues.
- Anti-Angiogenic Effect: By inhibiting VEGF-A, ranibizumab helps to reduce the growth of abnormal blood vessels in the eye, which can cause damage to the retina and lead to vision loss. This anti-angiogenic effect is particularly important in the treatment of conditions such as wet age-related macular degeneration (AMD), diabetic macular edema (DME), and macular edema following retinal vein occlusion (RVO).
- Reduction of Vascular Permeability: Ranibizumab also helps to reduce vascular permeability, which is the leakage of fluid from blood vessels into the surrounding tissues. This is important in the treatment of conditions such as DME, where fluid buildup in the macula can lead to blurred or distorted vision.
- Preservation of Vision: By inhibiting the growth of abnormal blood vessels and reducing vascular permeability, ranibizumab helps to preserve vision in patients with conditions such as wet AMD, DME, and RVO. Clinical trials have shown that ranibizumab is effective in improving visual acuity and reducing the progression of vision loss in these patients.
- Targeted Therapy: Ranibizumab is a targeted therapy that specifically inhibits VEGF-A, making it a highly effective treatment for conditions involving abnormal blood vessel growth in the eye. This targeted approach helps to minimize side effects and maximize efficacy.
- Intravitreal Administration: Ranibizumab is administered as an intravitreal injection, directly into the vitreous humor of the eye. This allows for targeted delivery of the drug to the site of action, further minimizing systemic side effects and maximizing efficacy.
- Long-Lasting Effects: Ranibizumab has a long-lasting effect, with a half-life of approximately 9 days in the vitreous humor. This allows for sustained inhibition of VEGF-A and long-lasting therapeutic effects, reducing the need for frequent injections.
- Safety Profile: Ranibizumab has a well-established safety profile, with a low incidence of serious adverse events. The most common adverse events are related to the injection procedure, such as endophthalmitis and retinal detachment, which are rare but serious complications.

Ranibizumab Drug Interactions - What to Avoid

- Drug Interactions: There are no known significant drug interactions with ranibizumab. However, it is important to inform your doctor about all medications you are taking, including prescription and over-the-counter drugs, vitamins, and herbal supplements. This is to ensure that ranibizumab is safe to use with your current medications.
- Concomitant Ocular Conditions: Patients with concomitant ocular conditions, such as glaucoma or cataracts, should be monitored closely when receiving ranibizumab. The injection procedure can temporarily increase intraocular pressure (IOP), which may exacerbate these conditions.
- Anticoagulants and Antiplatelet Agents: Patients taking anticoagulants or antiplatelet agents should inform their doctor before receiving ranibizumab. Although there is no known interaction, the risk of bleeding complications should be considered.
- Immunosuppressants: Patients taking immunosuppressants should be monitored closely when receiving ranibizumab, as they may be at higher risk for infections and other complications associated with the injection procedure.
- Allergic Reactions: Ranibizumab can cause allergic reactions, including anaphylaxis, a severe and potentially life-threatening allergic reaction. Patients with a history of allergies should be monitored closely when receiving ranibizumab.

Ranibizumab Adult Dose - Recommended Dosage

- Neovascular (Wet) Age-Related Macular Degeneration (AMD): The recommended dose of ranibizumab for the treatment of wet AMD is 0.5 mg (0.05 mL) administered by intravitreal injection once a month (approximately every 28 days). After the first three or four injections, the treatment interval may be extended based on the patient's response to the medication.
- Macular Edema Following Retinal Vein Occlusion (RVO): The recommended dose of ranibizumab for the treatment of macular edema following RVO is 0.5 mg (0.05 mL) administered by intravitreal injection once a month (approximately every 28 days). The treatment interval may be extended based on the patient's response to the medication.
- Diabetic Macular Edema (DME): The recommended dose of ranibizumab for the treatment of DME is 0.3 mg (0.05 mL) administered by intravitreal injection once a month (approximately every 28 days). The treatment interval may be extended based on the patient's response to the medication.
- Diabetic Retinopathy: The recommended dose of ranibizumab for the treatment of diabetic retinopathy is 0.3 mg (0.05 mL) administered by intravitreal injection once a month (approximately every 28 days). The treatment interval may be extended based on the patient's response to the medication.
- Myopic Choroidal Neovascularization (mCNV): The recommended dose of ranibizumab for the treatment of mCNV is 0.5 mg (0.05 mL) administered by intravitreal injection once a month (approximately every 28 days). The treatment interval may be extended based on the patient's response to the medication.
- Administration: Ranibizumab is administered as an intravitreal injection, directly into the vitreous humor of the eye. The injection is typically given by an ophthalmologist in a clinical setting. The frequency of injections depends on the condition being treated and the patient's response to the medication.
- Monitoring: Regular follow-up appointments are essential to monitor the effectiveness of ranibizumab and to check for any adverse effects. Patients should adhere to the prescribed schedule of injections and attend all follow-up visits.
- Special Populations: Elderly patients and those with compromised immune systems may be at higher risk for complications. Close monitoring and individualized treatment plans are necessary for these populations.

Ranibizumab Child Dose - Dosage for Children

- General Considerations: The use of ranibizumab in pediatric patients is limited, and there is no established dosing regimen for children. The safety and efficacy of ranibizumab in pediatric patients have not been fully evaluated, and its use in this population is off-label.
- Off-Label Use: Ranibizumab has been used off-label in pediatric patients for the treatment of conditions such as retinopathy of prematurity (ROP), a disease that affects premature infants and can lead to vision loss or blindness. The dosing regimen for these uses should be determined by a healthcare provider based on the individual patient's needs and response to the medication.
- Dosing Regimen: In pediatric patients, the dosing regimen for ranibizumab is typically based on the adult dosing regimen, with adjustments made for the child's age, weight, and condition being treated. The recommended dose is usually 0.3 mg or 0.5 mg (0.05 mL) administered by intravitreal injection, with the frequency of injections determined by the healthcare provider.
- Monitoring: Pediatric patients receiving ranibizumab should be monitored closely for side effects, particularly those related to the injection procedure, such as endophthalmitis and retinal detachment. Regular follow-up appointments are essential to monitor the effectiveness of ranibizumab and to check for any adverse effects.
- Special Populations: Infants and young children may be at higher risk for complications due to their smaller size and developing immune systems. Close monitoring and individualized treatment plans are necessary for these populations.
- Administration: Ranibizumab is administered as an intravitreal injection, directly into the vitreous humor of the eye. The injection is typically given by an ophthalmologist in a clinical setting. The frequency of injections depends on the condition being treated and the patient's response to the medication.
- Precautions: The same precautions that apply to adult patients also apply to pediatric patients receiving ranibizumab. These include the risk of endophthalmitis, retinal detachment, increased intraocular pressure, and other adverse effects associated with the injection procedure.
- Contraindications: Ranibizumab is contraindicated in pediatric patients with a known hypersensitivity to the drug or any of its components. It should also not be administered to pediatric patients with active or suspected ocular or periocular infections, severe intraocular inflammation, or rhegmatogenous retinal detachment.

Ranibizumab Renal Dose - Dosage for Kidney Conditions

- General Considerations: Ranibizumab is administered as an intravitreal injection, and its systemic exposure is low. Therefore, no dose adjustment is typically required for patients with renal impairment. However, patients with severe renal impairment or those on dialysis should be monitored closely for any adverse effects.
- Mild to Moderate Renal Impairment: In patients with mild to moderate renal impairment, no dose adjustment is necessary. The standard dosing regimen can be followed, with injections administered once a month (approximately every 28 days) and the treatment interval extended based on the patient's response to the medication.
- Severe Renal Impairment: In patients with severe renal impairment (creatinine clearance less than 30 mL/min) or those on dialysis, no specific dose adjustment is recommended. However, these patients should be monitored closely for any adverse effects, as they may be more sensitive to the drug's effects.
- Hemodialysis: Ranibizumab is not significantly removed by hemodialysis. Therefore, no additional dose is needed after dialysis. The standard dosing regimen can be followed in patients undergoing hemodialysis.
- Monitoring: Patients with renal impairment should be monitored for side effects, particularly those related to the injection procedure, such as endophthalmitis and retinal detachment. Regular follow-up appointments are essential to monitor the effectiveness of ranibizumab and to check for any adverse effects.
- Dosing Regimen: The standard dosing regimen for ranibizumab can be followed in patients with renal impairment. For the treatment of wet age-related macular degeneration (AMD), macular edema following retinal vein occlusion (RVO), diabetic macular edema (DME), diabetic retinopathy, and myopic choroidal neovascularization (mCNV), the recommended dose is 0.3 mg or 0.5 mg (0.05 mL) administered by intravitreal injection once a month (approximately every 28 days). The treatment interval may be extended based on the patient's response to the medication.
- Special Populations: Elderly patients with renal impairment may be at higher risk for complications. Close monitoring and individualized treatment plans are necessary for these populations.