Susvimo
Susvimo (ranibizumab) is an eye implant for adults with wet age-related macular degeneration (AMD). It's also approved for adults with diabetic macular edema (DME) or diabetic retinopathy (DR). This medication works as a vascular endothelial growth factor (VEGF) inhibitor. You can only get this eye implant if you've already done well with at least two eye injections of a VEGF inhibitor. Once placed in the eye, the implant releases medication over several months before it needs to get refilled at an eye specialist's office. This helps you need fewer eye injections. But side effects can include blood spots on the eye and eye pain.
What is Susvimo (ranibizumab)?
What is Susvimo (ranibizumab) used for?
How Susvimo (ranibizumab) works
Susvimo (ranibizumab) is a VEGF inhibitor, or vascular endothelial growth factor inhibitor. It works by blocking a protein in the eye called VEGF. This helps slow abnormal blood vessels from growing in the eye. It keeps fluid and other proteins from leaking out of these vessels and into the eye. This can help protect your eyesight and possibly improve it.
Drug facts
| Common Brands | Susvimo |
|---|---|
| Drug Class | VEGF inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Susvimo (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
- Blood spot in the eye (62%)
- Red eye (15%)
- Swelling of the colored part of your eye (14%)
- Eye pain (13%)
- Cataract (11%)
- Eye bleb (a fluid-containing blister in your eye; 8%)
- Headache (6%)
- Eye floaters (4%)
Less Common Side Effects
- Feeling of something is in your eye
- Eye swelling
- Scratched cornea
- Swelling of the cornea
- Vitreous detachment (vitreous part of your eye separates from the retina)
- Other problems with the conjunctiva of the eye (the clear tissue covering the white of your eye)
Note: Side effects were reported by adults with diabetic macular edema. Side effects might be a little different for those with wet AMD or diabetic retinopathy.
Susvimo (ranibizumab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Eye infection (endophthalmitis): eye pain, eye redness, vision loss, sensitivity to light, cloudy eye, eye discharge
- Separation of the retina from the back of the eye (retinal detachment): flashing lights, new floaters, gray or black spots in your vision, feeling like something is covering your vision
- Problems related to the conjunctiva of the eye: eye discharge, watery eyes, feeling like something is in your eye, watery eyes
The following Susvimo (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
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
- Only need to get the implant refilled every 6 or 9 months, depending on your eye condition
- Can't see the implant in the eye
- Helps you need fewer eye injections per year for treating wet AMD, DME, or DR
- Can help maintain vision over several months
Cons
- Must have a surgical procedure to place (or remove) the implant into your eye
- Must have already done well with two VEGF inhibitor injections in your eye before you can get this eye implant
- Can make eyesight less clear or sharp during the months right after getting the implant
- Raises your risk of a serious eye infection
Pharmacist tips for Susvimo (ranibizumab)
Tips for after getting the Susvimo (ranibizumab) implant put into the eye:
- You'll get the Susvimo (ranibizumab) implant put into your eye in a one-time procedure. A trained eye specialist will do this at their office. Make sure to have someone with you who can take you back home after it's done.
- 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 and also at night after the surgery. This will help the implant stay in place.
- Don't take off your eye shield until your eye specialist tells you it's okay. Wear your eye shield to bed for 7 nights after your implant surgery. This protects your eye and lets it heal.
- Make sure to use the eye medications your eye specialist gave you after your implant surgery. Use them as instructed so your eye heals properly.
- To be safe and to keep others safe, don't drive or use any machines until you can take off your eye shield and your vision is back to normal after the surgery.
- Don't push on the eye, rub it, or touch the area where the implant is for 30 days after your surgery. The implant should be underneath the eyelid in the upper and outer part of the eye. This helps make sure the implant stays in place while your eye heals. After the first 30 days, try not to rub or touch the area as much as possible. If you really need to, make sure your hands are clean beforehand.
- Ask your eye specialist when it's safe to do any strenuous activities like exercise. It's usually recommended to wait 30 days after the surgery.
- If you need to get a magnetic resonance imaging (MRI) at any time, tell the medical team you have Susvimo (ranibizumab) in your eye. This is important information they need to know so you can get your MRI properly and safely.
Tips for getting the Susvimo (ranibizumab) implant refilled:
- Mark the dates on your calendar to get your Susvimo (ranibizumab) implant refilled with medication. This helps you remember when to go to your eye specialist's office for these refills. If you have wet AMD or diabetic macular edema, refills are about every 6 months. If you have diabetic retinopathy, refills are about every 9 months.
- If you miss a refill appointment, call the office to reschedule as soon as possible. There won't be enough medication in the implant to help treat your condition if you wait too long.
- Make sure you don't touch or rub your eye where the implant is for 7 days after you get each refill. During the time between refills, avoid rubbing and touching your eye as much as possible. But if you need to, wash your hands well with soap and water beforehand and be careful.
- If you notice any changes in vision, don't drive or use machines until your eyesight is clear enough. Call your eye specialist right away if you're worried about any changes in your vision. This can include flashing lights, dim vision, sensitivity to light, and vision loss. Your eye specialist can check to see if there's a more serious problem.
Tips for after getting the Susvimo (ranibizumab) implant removed from the eye:
- If you need to have the Susvimo (ranibizumab) implant taken out for some reason, a trained eye specialist will help you. They will give you the surgery to remove the implant at their office.
- After you get the implant taken out, be sure to keep your head above the level of your shoulders for the rest of the day. Prop your head up with three or more pillows to prop your head up for the rest of the day and also at night.
- Don't remove your eye shield until your care team tells you it's okay. Wear the eye shield at bedtime for 7 nights after the removal surgery. This helps protect your eye and let it recover.
- Talk to your eye specialist about when you can do strenuous activities like exercise after you get the implant taken out. It's usually recommended to wait 14 days after the surgery.
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)
In studies, people who got the Susvimo (ranibizumab) implant had a higher rate of endophthalmitis than those who got monthly ranibizumab eye injections. Endophthalmitis is a type of eye infection that can be very serious and cause vision loss.
Before you get the Susvimo (ranibizumab) implant or a refill, tell your eye specialist if you have an eye infection. They'll also check your eye to make sure it's safe to give you the implant and or refill.
Call your eye specialist right away if you notice signs of an eye infection. Look out for severe eye pain and trouble seeing. Also watch for discharge from the eye, white cloudiness in the eye, and sensitivity to light. If you do have an infection, your eye specialist can help treat it as soon as possible. You'll probably need to wait until it clears up before continuing this medication.
Separation of the retina from the back of the eye (retinal detachment)
Some people using Susvimo (ranibizumab) have had a problem called retinal detachment. This happens when the retina (the part of your eye that senses light and helps you see) pulls away from where it should be.
Tell your eye specialist right away if you have any trouble seeing or if your vision seems strange. Signs can include flashing lights, gray or black spots, dim vision, or other changes. Retinal detachment needs fast treatment for a better chance to protect your eyesight. You'll need to wait until this problem gets treated before getting refills.
Movement of the implant in the eye
In studies, the Susvimo (ranibizumab) implant sometimes moved from where it was first put in the eye. Your eye specialist will follow guidelines to prevent the implant from moving out of place. But if it does, you'll need urgent surgery to fix it. Tell your eye specialist as soon as you can if you think the implant has moved from where it should be.
Bleeding in the eye
- Risk factors: Taking blood-thinning medications
Some people who got the Susvimo (ranibizumab) implant had bleeding in their eye. This can sometimes lead to temporary vision loss. In studies, the bleeding happened within the first month after they got the implant put in. Most of the time, the bleeding went away by itself. But some people needed surgery to stop it.
Your risk of bleeding might be higher if you take blood thinners, like warfarin (Coumadin). It's also higher if you take medications that can make you bleed more easily. Examples include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS). Before getting the Susvimo (ranibizumab) implant, tell your eye specialist about all the medications you take. If needed, they might ask you to stop taking these medications for a short time before the procedure. This helps lower your chance of bleeding.
If you notice any changes in your vision, like cloudy eyesight or floaters, tell your eye specialist right away. They can check your eye for bleeding. If bleeding happens, you might need to wait until it's treated before getting the implant refilled with medication.
Eye damage
There's a risk of eye damage after getting the Susvimo (ranibizumab) implant put into your eye. It can be problems with your conjunctiva (the clear tissue protecting the white of your eye). These problems can lead to having your implant exposed. Conjunctival blebs are also possible. These are blister-like fluid collections in your eye.
To lower the risk, your eye specialist will follow careful instructions to place the Susvimo (ranibizumab) implant in the eye and refill it. Go to your follow-up appointments so they can examine your eye and make sure it's healing properly.
Tell your eye specialist right away if you feel like there's something in your eye. Also tell them if you have eye discharge or very watery eyes. These can be signs of eye damage. If there's damage, you might need surgery to fix it.
Possible vision problems after the implant procedure
After you get the Susvimo (ranibizumab) implant placed into your eye, your vision might get worse. In studies, people had more trouble reading the letters on an eye chart in the first 2 months after the implant. After more time goes by, your eyesight should go back to how it was before.
Don't drive or use heavy machines until you can see more clearly after your procedure. Talk to your eye specialist if you're worried about this risk.
Susvimo (ranibizumab) dosage
Typical dosage for Susvimo (ranibizumab)
The Susvimo (ranibizumab) implant is placed into your eye during a one-time surgical procedure. A trained healthcare professional will perform this procedure at an eye specialist's office.
Then, you'll need to get the implant refilled with medication at the office every several months.
- Wet AMD or diabetic macular edema: The typical dose that the implant delivers is 2 mg continuously into the eye over about 6 months. Get the implant refilled with medication about every 6 months.
- Diabetic retinopathy: The typical dose that the implant delivers is 2 mg continuously into your eye over about 9 months. Get the implant refilled with medication about every 9 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
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 Susvimo (ranibizumab) will not be safe for you to take.
- Eye infection
- Infection around the eye
- Eye inflammation
- Allergy to Lucentis (ranibizumab)
What are alternatives to Susvimo (ranibizumab)?
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
Lucentis and Cimerli biosimilar only
