Eylea HD
Eylea HD (aflibercept) is a medication that's used for adults with certain eye conditions related to the retina (a layer of cells in the back of the eye). It's typically injected into the eye by an eye specialist. The first 3 injections are given every month, and then the following injections are given every 2 to 4 months. Side effects can include eye pain, eye redness, and blurry vision. Like most other injections into the eye, there's also a rare risk for eye infection and eye damage.
What is Eylea HD (aflibercept)?
What is Eylea HD (aflibercept) used for?
How Eylea HD (aflibercept) works
Eylea HD (aflibercept) is a vascular endothelial growth factor (VEGF) inhibitor. It blocks VEGF, a protein that makes new blood vessels in the body. When there's too much of VEGF in the eye, it causes new, weak blood vessels to form. These weak blood vessels can leak fluid into the back of the eye.
By blocking VEGF proteins from working, Eylea HD (aflibercept) slows the growth of additional blood vessels and helps lessen the amount of fluid that leaks in the eye. This helps lower the risk of vision loss from different eye conditions.
Drug Facts
What are the side effects of Eylea HD (aflibercept)?
Common Side Effects
- Cataract (3-6%)
- Blurry vision (3-6%)
- Poor healing of the cornea (2-6%)
- Eye floaters (1-5%)
- Bleeding of the retina (3-4%)
- Blood spot on the whites of eye (2-4%)
- Eye pain or irritation (2-4%)
- Higher eye pressure (1-4%)
Other Side Effects
- Feeling like something is in your eye
- Watery eye
- Swollen eyelid
Serious Side Effects
- Eye infection (endophthalmitis): eye pain, eye redness, not able to look at bright lights, vision loss
- Retinal detachment: flashing lights, feeling like something is covering your vision, changes in your vision, vision loss, seeing floaters
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Blurry vision
- Eye pain
- Increased tears
- Small spots floating in vision
Pros and cons of Eylea HD (aflibercept)
Pros
Can help with multiple eye conditions related to the retina
Typically one of the first-choice options for treating wet AMD
Might extend the time between treatments up to every 4 months, so it's convenient for people with a busy schedule
Cons
Greater risk of eye infection or injury because it's an injection directly into the eye
Can only get injections from a trained eye specialist
No lower-cost generic available
Pharmacist tips for Eylea HD (aflibercept)
You'll typically get Eylea HD (aflibercept) injections at the eye specialist's office. A trained eye specialist must administer the medication because they have the right tools and proper technique to make sure the procedure is as safe as possible for you.
It's best to get your Eylea HD (aflibercept) injection regularly according to your eye specialist's treatment plan. Talk with your eye specialist right away about rescheduling your appointment if you missed an appointment for your injection.
Before your Eylea HD (aflibercept) injection, the eye specialist will give you a numbing medication that helps lessen the pain and discomfort from the procedure. They'll also place antibiotic eye drops or ointment into the eye to prevent infection.
Be prepared to stay at the office for a bit after your injection so that the eye specialist can check your eye pressure. This is because Eylea HD (aflibercept) can temporarily raise the pressure in your eye.
You might want to bring a pair of sunglasses to wear after your Eylea HD (aflibercept) injection. Your eyes might be more sensitive to light for a few hours after the injection since your eye specialist has dilated your eyes to check your eye pressure.
Don't drive a car or operate machinery until you know how Eylea HD (aflibercept) affects your vision. This medication can cause temporary visual changes. Have someone help drive you to and from your appointment.
Be sure to check your vision in between your Eylea HD (aflibercept) injections. Certain eye problems can get worse over time, so it's important to tell your eye specialist if you notice concerning changes in vision at any time. Your eye specialist should discuss with you about how to monitor your vision at home.
Tell the eye specialist right away if you have any eye pain, eye redness, blurry vision, or sensitivity to bright light after your Eylea HD (aflibercept) injections. These are signs of an eye infection or eye damage, which are serious risks that come with getting eye injections.
More on Eylea HD (aflibercept) tips
Frequently asked questions about Eylea HD (aflibercept)
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What are the risks and warnings for Eylea HD (aflibercept)?
Eylea HD (aflibercept) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Eye infection and damage
Very rarely, eye injections, such as with Eylea HD (aflibercept), can lead to endophthalmitis (an infection inside the eyeball) or detached retina (when the retina pulls away from the back of the eye). This can sometimes happen when the eye gets contaminated and infected with germs during the injection.
Your eye specialist might place an antibiotic eye drop or ointment in the eye before the injection to lower the risk of infection. They'll also have the proper techniques and tools to lower the risk of contamination during the procedure.
Make sure to follow up with the eye specialist after your appointment so they can check for any visual changes. Let the eye specialist know right away if your eye becomes red, sensitive to light, or painful or if you have changes in vision. These can be signs of eye infection or retinal detachment.
Higher eye pressure
Risk factor: Regular injections of Eylea HD (aflibercept)
People who get Eylea HD (aflibercept) injections can sometimes have higher eye pressure because there's more fluid in the eye from the injection. The rise in eye pressure typically happens within an hour after the injection and is usually temporary. But it can stay high in some people, especially for people who get regular eye injections.
You'll need to get your eye pressure checked each time after your Eylea HD (aflibercept) injection so the eye specialist can make sure this medication continues to be safe for you. Talk with your eye specialist right away if you have intense eye pain when you move your eye around. This can be a sign of very high eye pressure.
Risk for heart attack or stroke
Risk factors: History of heart attack or stroke
Getting Eylea HD (aflibercept) injections might potentially put you at risk for serious blood clot problems, such as heart attack and stroke. Symptoms of a stroke include sudden confusion, severe headache, facial drooping, weakness on one side of the body, slurred speech, or trouble walking. Symptoms of a heart attack include chest pain that travels to your arm or jaw, sweating, or shortness of breath. Get medical help right away if you have symptoms of a stroke or heart attack.
Eylea HD (aflibercept) dosage forms
Typical dosing for Eylea HD (aflibercept)
Eylea HD (aflibercept) is given as an injection into the back of the eye(s) by an eye specialist at their office.
Wet AMD: The typical starting dose is 8 mg injected into the eye(s) once a month for 3 months. After that, the dose is 8 mg is injected into the eye(s) once every 2 to 4 months.
Diabetic macular edema: The typical starting dose is 8 mg injected into the eye(s) once a month for the first 3 months. After that, the dose is 8 mg injected into the eye(s) once every 2 to 4 months.
Diabetic retinopathy: The typical starting dose is 8 mg injected into the eye(s) once a month for the first 3 months. After that, the dose is 8 mg injected into the eye(s) once every 2 to 3 months.
Eylea HD (aflibercept) contraindications
Infection in or around the eye
Active eye inflammation (e.g., swelling, pain, redness)
Allergy to aflibercept (e.g., Eylea)
What are alternatives to Eylea HD (aflibercept)?
Neovascular (wet) age-related macular degeneration (AMD)
Macular edema following retinal vein occlusion (RVO)
Myopic choroidal neovascularization (mCNV)
Diabetic macular edema (DME)
Diabetic retinopathy (DR)
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Eylea HD (aflibercept) images
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References
Best studies we foundAmerican Optometric Association. (n.d.). Ocular hypertension.
Flaxel, C. J., et al. (2019). Age-related macular degeneration PPP 2019. American Academy of Ophthalmology.
MedlinePlus. (2016). Retinal disorders.
MedlinePlus. (2022). Cornea.
MedlinePlus. (20024). Retinal vein occlusion.
Moraru, A., et al. (2017). Incidence of ocular hypertension after intravitreal injection of anti-VEGF agents in the treatment of neovascular AMD. Romanian Journal of Ophthalmology.
Mukamal, R. (2023). What is endophthalmitis? American Academy of Ophthalmology.
Mukamal, R. (2024). Comparison of anti-VEGF treatment for wet AMD. American Academy of Ophthalmology.
National Eye Institute. (2023). Retinopathy of prematurity.
Penn, J. S., et al. (2008). Vascular endothelial growth factor in eye disease. Progress in Retinal and Eye Research.
Regeneron Pharmaceuticals, Inc. (2023). Eylea HD- aflibercept injection, solution [package insert]. DailyMed.
Regeneron Pharmaceuticals. (2023). Amsler grid.
Regeneron Pharmaceuticals. (2024). Appointment & treatment tips for Eylea HD.
Sachdeva, M. M., et al. (2016). Endophthalmitis following intravitreal injection of anti-VEGF agents: Long-term outcomes and the identification of unusual micro-organisms. Journal of Ophthalmic Inflammation and Infection.
The Foundation of the American Society of Retina Specialists. (n.d.). Age-related macular degeneration. American Society of Retina Specialists.
The Foundation of the American Society of Retina Specialists. (n.d.). Endophthalmitis. American Society of Retina Specialists.
The Foundation of the American Society of Retina Specialists. (n.d.). Intravitreal injections. American Society of Retina Specialists.
Wykoff, C. C., et al. (2023). Effect of high-dose intravitreal aflibercept, 8 mg, in patients with neovascular age-related macular degeneration. Journal of the American Medical Association Ophthalmology.
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