Susvimo
Susvimo (ranibizumab) is an eye implant used in adults to treat wet age-related macular degeneration (AMD). You can only use it if you've been treated with at least two eye injections of a medication called a VEGF inhibitor. It lessens the number of injections you need to get in your eye, but can sometimes cause eye infections, bleeding, or pain.
What is Susvimo (ranibizumab)?
What is Susvimo (ranibizumab) used for?
Wet age-related macular degeneration (AMD)
How Susvimo (ranibizumab) works
Susvimo (ranibizumab) is a vascular endothelial growth factor (VEGF) inhibitor. VEGF is a protein your body normally makes. But people with wet AMD have high levels of VEGF. Too much VEGF can lead to abnormal blood vessel growth in your eye. These blood vessels can leak into the eye which can lead to vision loss.
Susvimo (ranibizumab) works by blocking VEGF directly in your eye so that it slows down abnormal blood vessel growth. This can help protect and possibly improve your vision.
Drug Facts
What are the side effects of Susvimo (ranibizumab)?
Common Side Effects
- Eye bleeding (72%)
- Red eye (26%)
- Swelling of the colored part of your eye (23%)
- Eye pain (10%)
- Eye floaters (9%)
- Eye bleb (a fluid-containing blister in your eye, 9%)
- Feeling of something being in your eye (7%)
- Headache (7%)
Other Side Effects
- Vitreous detachment (vitreous part of your eye separates from the retina)
- Eye swelling
- Scratched cornea
- Swelling of the cornea
Serious Side Effects
- Eye infection (endophthalmitis): eye pain, sensitivity to light, loss of vision, eye redness
- Separation of the retina from the back of the eye (retinal detachment): flashing lights, feeling like something is covering your vision, changes in your vision, or vision loss
- Breakdown of the layer that lines your eye (conjunctival erosion): eye discharge, feeling like something is in your eye, watery eyes
- Opening of the layer that lines your eye (conjunctival retraction): eye discharge, feeling like something is in your eye, watery eyes
Source:Â DailyMed
The following 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
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
chills
difficulty with breathing
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
pain in the chest, groin, or legs, especially the calves
painful blisters on the trunk of the body
pale skin
severe, sudden headache
shivering
slow wound healing
slurred speech
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 Susvimo (ranibizumab)
Pros
A twice-yearly treatment for wet AMD
Implant isn't visible to others
Lowers the number of eye injections typically used for wet AMD treatment
Can help maintain vision for at least 40 weeks in people with wet AMD
Cons
Requires a surgical procedure to place (or remove) the implant into your eye
Must respond to two VEGF inhibitor injections in your eye before you can use it
Brand name only, so might be expensive
Raises your risk for eye infection
Pharmacist tips for Susvimo (ranibizumab)
You should get your Susvimo (ranibizumab) implant refilled about every 6 months. If you miss an appointment, reschedule another one with your provider right away so that you can get the injection as soon as possible. Waiting too long means there won't be enough medication in your eye to treat your condition.
After having surgery to place the Susvimo (ranibizumab) implant in your eye (or getting it removed), you'll need to keep your head above shoulder level for the rest of the day. Sleep with three or more pillows to prop your head up for the rest of the day.
Wear your eye shield at bedtime for 7 nights following your Susvimo (ranibizumab) implant surgery (or after removal). Don't remove your eye shield until your provider tells you it's okay to do so. This is to protect your eye and allow it to heal.
Your provider might give you eye medications to use after your Susvimo (ranibizumab) implant surgery. Make sure you use them as instructed by your provider so your eye heals properly.
Make sure you don't touch or rub your eye where the Susvimo (ranibizumab) implant is located for 30 days after your surgery, and for 7 days after you get your refills. This will make sure it stays in place while your eye heals. You should avoid rubbing and touching your eye while you have the Susvimo (ranibizumab) implant, but if you need to, make sure your hands are clean before touching your eye.
Speak with your provider about when it's safe to perform strenuous activities (e.g., exercise) after your Susvimo (ranibizumab) implant surgery. It's usually recommended to wait 30 days after the surgery or 14 days after removing the implant.
If you need to have magnetic resonance imaging (MRI) done, let the provider know that you have the Susvimo (ranibizumab) implanted in your eye. This will tell them important information they need to know so you can get your MRI done properly.
For your safety and the safety of others, don't drive or operate machinery until you can remove your eye shield and your vision has fully recovered after the Susvimo (ranibizumab) surgery.
If you experience any eye pain, bleeding, redness, swelling, discharge, or vision changes (e.g., flashing lights, loss in vision, moving spots) after getting Susvimo (ranibizumab), contact your provider. These might be signs of an infection or problem with your implant.
If the Susvimo (ranibizumab) implant needs to be removed for some reason, your provider will perform a procedure to do so.
Frequently asked questions about Susvimo (ranibizumab)
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What are the risks and warnings for Susvimo (ranibizumab)?
Susvimo (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 (endophthalmitis)
Susvimo (ranibizumab) implant has been shown to have a higher rate of eye infections compared to monthly ranibizumab eye injections. It's important to make sure you don't have an active eye infection or another severe infection when you get the Susvimo (ranibizumab) implant placed into your eye. If you experience signs of an eye infection like discharge coming out of your eye, eye pain, loss of vision, sensitivity to light, or eye redness, tell your provider right away so you can be treated. You'll need to delay getting refills until your infection clears up.
Separation of the retina from the back of the eye (retinal detachment)
Susvimo (ranibizumab) can cause retinal detachment. This is a condition where your retina (tissue in the back of your eye that senses light and helps you see) pulls away from its normal place in your eye. When this happens, you can experience flashing lights, changes in your vision, or vision loss. Let your provider know if you have trouble seeing or anything that seems unusual about your vision. You'll need to delay getting refills until this is treated.
Movement of the implant
Sometimes the Susvimo (ranibizumab) implant can move away from where it's supposed to be in your eye. This requires urgent surgery to fix. Contact your provider if you experience eye pain, redness, swelling, or have a feeling like something is in your eye that won't go away.
Eye bleeding
Risk factors: Taking blood-thinning medications
Susvimo (ranibizumab) can cause bleeding in your eye that can result in temporary vision loss, especially within the first month of the implantation procedure. In some cases, surgery might be required to fix this problem. Your risk might be higher if you're taking blood-thinning medications, like warfarin (Coumadin), aspirin, or non-steroidal anti-inflammatory drugs (NSAIDS). If you're taking blood-thinning medications, your provider might have you stop taking them for your Susvimo (ranibizumab) implant procedure. If you notice any vision changes, such as cloudy vision or floaters, let your provider know so you can be examined for eye bleeding.
Eye damage during surgery
There is a risk of eye damage during the surgery placing the Susvimo (ranibizumab) implant into your eye, including a breakdown of your conjunctiva (a tissue that provides protection and lubrication for your eye) and conjunctival blebs (a blister-like fluid collection in your eye). In some cases, you might need surgery to fix these problems. Make sure to go to your follow-up appointments so your provider can examine your eye and make sure it's healing properly.
Vision problems
After you get the Susvimo (ranibizumab) implant placed into your eye, your vision might get worse. This can lower your ability to read the letters in an eye exam. It should recover after your procedure, but this can take time. Don't drive or operate machinery until your vision returns to normal after your procedure. If you have concerns, speak to your provider.
Susvimo (ranibizumab) dosage forms
Typical dosing for Susvimo (ranibizumab)
The Susvimo (ranibizumab) implant is placed into your eye during a procedure performed by a healthcare provider.
The typical dose is 2 mg continuously released in your eye by the implant with a refill about every 6 months.
Interactions between Susvimo (ranibizumab) and other drugs
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
Susvimo (ranibizumab) contraindications
Eye infection
Eye inflammation
What are alternatives to Susvimo (ranibizumab)?
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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