Trade Name(s)

  • Vabysmo

Ther. Class.

ocular agents

Pharm. Class.

vascular endothelial growth factor antagonists

monoclonal antibodies

angiopoietin-2 inhibitors


  • Neovascular (wet) age-related macular degeneration.
  • Diabetic macular edema.


Inhibits vascular endothelial growth factor-A (VEGF-A), preventing the binding of endogenous VEGF-A, resulting in decreased endothelial proliferation, vascular leakage and new vessel formation. Also inhibits angiopoietin-2, which promote vascular stability and protects blood vessels from the effects of VEGF-A.

Therapeutic Effect(s):

Decreased progression of visual loss.


Absorption: Intravitreal injection results in complete local bioavailability. Very low serum levels are achieved.

Distribution: Unknown.

Metabolism and Excretion: Catabolized in lysosomes to small peptides and amino acids that are excreted renally.

Half-life: 7.5 days.




Contraindicated in:

  • Hypersensitivity
  • Ocular/periocular infections
  • Active intraocular inflammation.

Use Cautiously in:

  • OB:   Safety not established in pregnancy;
  • Lactation:  Safety not established in lactation;
  • Rep:   Women of reproductive potential
  • Pedi:   Safety and effectiveness not established in children.

Adverse Reactions/Side Effects


EENT: cataract, ↑ intraocular pressure, ↑ lacrimation, conjunctival hemorrhage, endophthalmitis, eye irritation, eye pain, intraocular inflammation, retinal detachment, retinal pigment epithelial tear, vitreous floater

Misc: hypersensitivity reactions

* CAPITALS indicate life-threatening.
Underline indicate most frequent.



None reported


Neovascular (wet) Age-related Macular Degeneration

Intravitreal (Adults): 6 mg every 4 wks for four doses. Subsequent doses are individualized based on optical coherence tomography and visual acuity evaluations performed 8 and 12 weeks later, and are administered as one of the following regimens:  Every 8–wk regimen: 6 mg on Weeks 20, 28, 36, and 44; or  Every 12–wk regimen: 6 mg on Weeks 24, 36, and 48; or  Every 16–wk regimen: 6 mg on Weeks 28 and 44. Some patients may require dosing every 4 wks following the initial 4 doses.

Diabetic Macular Edema

Intravitreal (Adults): Administer one of the following regimens:  Fixed interval regimen: 6 mg every 4 wks for six doses, followed by 6 mg every 8 wks; or  Variable interval regimen: 6 mg every 4 wks for at least four doses, followed by 6 mg every 4–16 wks (based on optical coherence tomography and visual acuity evaluations).


Solution for intravitreal injection: 120 mg/mL


  • Assess eye for signs of infection frequently during wk following injection.
  • Check perfusion of optic nerve head immediately after injection, use tonometry to measure intraocular pressure prior to and 60 min following the injection.


  • Intravitreal 

    For ophthalmic intravitreal injection only. Must be administered by a qualified physician. Allow vial to reach room temperature before use. May be kept at room temperature for up to 24 hrs. Keep vial in original carton to protect from light. Solution is clear to opalescent and colorless to brownish-yellow liquid solution; do not use solutions that are discolored or contain particulate matter. To ensure all liquid settles at the bottom of vial, place vial upright on a flat surface for about 1 minute after removal from packaging. Gently tap vial with finger, as liquid may stick to the top of the vial. Using the 18-gauge x 1½ inch transfer filter needle included in package, push transfer filter needle all the way in, then tilt the vial slightly so that the needle touches the bottom edge of the vial. Hold vial slightly inclined and slowly withdraw all the liquid from the vial. Replace transfer needle with a 30-gauge x ½ inch injection needle. Expel contents until plunger tip is aligned with line marking 0.05 mL on syringe. Use each vial for the treatment of a single eye. If contralateral eye requires treatment, use new vial and equipment. Refrigerate solution and protect from light; do not freeze.

    • Immediately following intravitreal injection, monitor for elevation in intraocular pressure. Monitoring may consist of a check for perfusion of the optic nerve head or tonometry.

Patient/Family Teaching

  • Advise patient to notify ophthalmologist immediately if eye becomes red, sensitive to light, painful, or develops a change in vision.
  • May cause temporary visual disturbances. Caution patient to avoid driving or other activities requiring good eyesight until response to medication is known.
  • Rep:  May cause fetal harm. Advise females of reproductive potential to use highly effective contraception during and 3 mo after last dose. Advise females of reproductive potential to notify health care professional promptly if pregnancy is planned or suspected or if breastfeeding. May impair fertility.

Evaluation/Desired Outcomes

Decreased progression of visual loss.