What does it mean that Byooviz and Cimerli are biosimilars to Lucentis (ranibizumab)?

The [Byooviz](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e46db299-edd1-4457-89b2-c1e2e505f1b0) (ranibizumab-nuna) and [Cimerli](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e0e23118-1490-a554-e053-2995a90ab90c) (ranibizumab-eqrn) biosimilars are very similar versions of Lucentis (ranibizumab) with few differences in how they work, how well they work, and their side effects. The idea of biosimilars is similar to a generic medication. Unlike traditional medications, Lucentis (ranibizumab) is a [biologic](https://www.goodrx.com/drugs/biologics/what-are-biologics-and-biosimilars), which is a type of medication that comes from living sources like humans, animals, or other living organisms. Because of [how they're made](https://www.fda.gov/drugs/biosimilars/biosimilar-and-interchangeable-products), it's not easy to make an exact copy of a biologic. So instead of generics, biologics have biosimilars. However, keep in mind that __Cimerli__ is currently the only [interchangeable biosimilar](https://www.goodrx.com/drugs/biologics/interchangeable-biosimilar-drugs) to Lucentis (ranibizumab). This means that Cimerli can be substituted for Lucentis (ranibizumab) and can be used to treat all of the same conditions as Lucentis (ranibizumab). On the other hand, __Byooviz__ isn't interchangeable with Lucentis (ranibizumab), and it's only approved for a few of the same conditions as Lucentis (ranibizumab). If you're interested in using a biosimilar to Lucentis (ranibizumab), ask your provider which one is right for you.

Lucentis

ranibizumab

Used for Macular Degeneration

Lucentis (ranibizumab) is a medication used to prevent vision loss and blindness due to certain eye conditions such as macular degeneration or diabetic macular edema. It's given by a healthcare provider as an injection into your eye about once a month. There are two FDA-approved biosimilar medications to Lucentis (ranibizumab) called Byooviz and Cimerli.

Reviewed by:

Aileen Chu, PharmD, BCPS

Sarah Lobello Pearson, PharmD

Last reviewed on October 11, 2022

What is Lucentis (ranibizumab)?

What is Lucentis (ranibizumab) used for?

Conditions related to swelling or damage to the macula or retina (parts of the eye that are important for vision):

Lucentis and all its biosimilars

Neovascular (wet) age-related macular degeneration (AMD)
Macular edema following retinal vein occlusion (RVO)
Myopic choroidal neovascularization (mCNV)

Lucentis and Cimerli biosimilar only

Diabetic macular edema (DME)
Diabetic retinopathy (DR)

How Lucentis (ranibizumab) works

Lucentis (ranibizumab) is a vascular endothelial growth factor (VEGF) inhibitor. It blocks VEGF-A, which is a protein that plays a role in the formation of new blood vessels and inflammation. When new blood vessels form and inflammation occurs in parts of the eye (e.g., retina, macula), it can lead to certain eye conditions that negatively impact your vision. Lucentis (ranibizumab) prevents VEGF-A from having these effects in the eye, which helps lessen your chance of experiencing vision loss or blindness.

Are you looking for information on Cyramza (ramucirumab), Avastin (bevacizumab), or Susvimo (ranibizumab) instead?

Drug facts

Common Brands	Lucentis, Byooviz, Cimerli
Drug Class	Vascular endothelial growth factor (VEGF) inhibitor
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Lucentis, Byooviz, Cimerli

Drug Class

Vascular endothelial growth factor (VEGF) inhibitor

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Lucentis (ranibizumab)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Bleeding on the outer surface of the eye (up to 74%)
Eye pain (up to 35%)
Floaters in the eye fluid (up to 27%)
High eye pressure (up to 24%)

Less Common Side Effects

Eye irritation or discomfort
Eye itching
Eye redness
Watery or dry eye
Inflammation inside the eye
Cataract
Damage to the fluid inside the eye
Eyelid inflammation
Vision change or blurriness
Abnormal conditions of the retina or macula
Cold or seasonal allergy symptoms

Lucentis (ranibizumab) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Eye problem (e.g., infection, high eye pressure): severe eye pain, redness, worse vision
Stroke: sudden confusion, sudden headache, weakness on one side of the body, facial drooping, trouble talking or walking
Heart attack: chest pain that spreads to your arm, a cold sweat, shortness of breath

Source: DailyMed

The following Lucentis (ranibizumab) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Blindness

bloody eye

blurred vision or loss of vision

decreased vision or other changes in vision

disturbed color perception

dizziness

double vision

dry eye

eye pain

fainting

feeling of having something in the eye

halos around lights

headache

night blindness

overbright appearance of lights

pain or tenderness around the eyes and cheekbones

red, sore eyes

redness of the white part of the eyes or inside of the eyelids

redness, swelling, or itching of the eyelid

seeing flashes or sparks of light

seeing floating spots before the eyes, or a veil or curtain appearing across a part of vision

sensitivity of the eye to light

tearing of the eyes

tunnel vision

watering of the eyes

Less common

Body aches or pain

chest pain

chills

cough

difficulty with breathing

dry mouth

fainting

fast, slow, or irregular heartbeat

general feeling of discomfort or illness

head congestion

hoarseness, loss of voice, or other voice changes

loss of consciousness

muscle aches and pains

nasal congestion

pain in the chest, groin, or legs, especially the calves

painful blisters on the trunk of the body

pale skin

runny nose

severe, sudden headache

shivering

slow wound healing

slurred speech

sneezing

sore throat

sudden loss of coordination

sudden, severe weakness or numbness in the arm or leg

sudden, unexplained shortness of breath

sweating

tightness in the chest

trouble sleeping

unexplained weight loss

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Back pain

difficulty having a bowel movement (stool)

difficulty with moving

muscle stiffness

swelling or redness in the joints

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Pros and cons of Lucentis (ranibizumab)

Pros

Prevents blindness due to various eye conditions
Usually taken once a month
Has two biosimilars that work similarly to Lucentis (ranibizumab)

Cons

Injected into the eye, and it can cause pain and bleeding
Must be given by a provider in a clinic or hospital
Can be expensive if not covered by insurance

Pharmacist tips for Lucentis (ranibizumab)

Lucentis (ranibizumab) is only given in a clinic or hospital setting, since it has to be injected into the eye by a healthcare provider with the proper supplies and technique.
Before your injection, you can expect to get some numbing medication to help with pain and antibiotics to prevent infection.
After your injection, you'll need to wait at least 30 minutes before you can go home. This waiting time is important because your provider needs to monitor you, repeat an eye exam, and check your eye pressure to make sure the medication isn't causing any problems.
After you go home, your provider might recommend pain medications like acetaminophen (Tylenol) to help with any discomfort. You might be given antibiotic eye drops to use for a few days as well to prevent infection.
If you experience severe eye pain, redness, or worse vision after receiving Lucentis (ranibizumab), contact your provider immediately.

Common questions about Lucentis

Lucentis is used to treat swelling or damage to the macula or retina (parts of the eye that are important for vision) due to abnormal blood vessel growth, blockage, or diabetes. These specific eye conditions usually get worse with time and can lead to blindness. Lucentis helps prevent you from losing your eyesight.

Yes, some people may experience better vision after receiving Lucentis. For example, in the clinical studies for AMD, 31% to 37% of people who got Lucentis injections every month had better vision 12 months into treatment. Remember, it can take a few months before you see an effect, and not everyone who uses this medication will have better vision (but it can help prevent your vision from getting worse).

The number of Lucentis injections that you get will depend on your specific eye condition. For most of the approved conditions, this medication can be given for 1 to 3 years. For the treatment of mCNV, it's less likely that you'll be getting it long term, since the clinical studies only lasted 3 months.

Lucentis can raise your risk of stroke. Eye injections with VEGF inhibitors like Lucentis are linked to serious blood clotting problems that can lead to stroke (when there's a blood clot in a vessel that delivers blood to the brain). Though this isn't a common side effect of Lucentis, it can be very serious or life-threatening. If you think you're having a stroke, call 911 immediately.

The Byooviz (ranibizumab-nuna) and Cimerli (ranibizumab-eqrn) biosimilars are very similar versions of Lucentis with few differences in how they work, how well they work, and their side effects. The idea of biosimilars is similar to a generic medication. Unlike traditional medications, Lucentis is a biologic, which is a type of medication that comes from living sources like humans, animals, or other living organisms. Because of how they're made, it's not easy to make an exact copy of a biologic. So instead of generics, biologics have biosimilars. However, keep in mind that Cimerli is currently the only interchangeable biosimilar to Lucentis. This means that Cimerli can be substituted for Lucentis and can be used to treat all of the same conditions as Lucentis. On the other hand, Byooviz isn't interchangeable with Lucentis, and it's only approved for a few of the same conditions as Lucentis. If you're interested in using a biosimilar to Lucentis, ask your provider which one is right for you.

Risks and warnings for Lucentis (ranibizumab)

Lucentis (ranibizumab) 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

Eye injections like Lucentis (ranibizumab) can lead to infection of the fluid inside the eyeball (a condition called endophthalmitis) or damage to the retina (retinal detachment). These complications can cause vision loss or blindness. Possible eye infection and damage are some reasons why Lucentis (ranibizumab) must be given by a healthcare provider who has the right supplies and skills to prevent contamination and infection. Follow up with your provider as scheduled after your injection to monitor for side effects. If you experience severe eye pain, redness, or worse vision after your injection, contact your provider immediately.

High eye pressure

Various eye conditions and medications like Lucentis (ranibizumab) can cause high eye pressure. Your provider will check your eye pressure on a regular basis to make sure it doesn't go too high.

Blood clots

Risk factors: History of stroke or heart attack

Eye injections with VEGF inhibitors like Lucentis (ranibizumab) are linked to serious blood clotting problems, such as stroke, heart attack, and other life-threatening conditions. Symptoms of a stroke include sudden confusion, sudden headache, weakness on one side of the body, facial drooping, or trouble talking or walking. Symptoms of a heart attack include chest pain that spreads to your arm, a cold sweat, or shortness of breath. If you think you're having a stroke or a heart attack, call 911 right away.

Higher risk of death in people with eye problems related to diabetes

Risk factors: Diabetic macular edema | Diabetic retinopathy

Based on studies, there is a possibility that eye injections with Lucentis (ranibizumab) can raise the risk of death in people who have eye problems due to uncontrolled diabetes (DME or retinopathy). If you have diabetes-related eye problems, talk to your provider about the risks and benefits of this medication.

Lucentis (ranibizumab) dosage

Typical dosage for Lucentis (ranibizumab)

Lucentis (ranibizumab) is only given in a clinic or hospital setting, since it has to be injected into the eye by a healthcare provider. Depending on your eye condition, the typical dose is 0.3 mg or 0.5 mg once a month (every 28 days).

Interactions between Lucentis (ranibizumab) and other drugs

Lucentis (ranibizumab) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Lucentis (ranibizumab). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Tofacitinib

Lucentis (ranibizumab) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Lucentis (ranibizumab) will not be safe for you to take.