Mynzepli (Aflibercept)

Aflibercept is an anti‑VEGF agent used to manage ocular conditions driven by abnormal vascular growth and leakage.

• Neovascular age‑related macular degeneration: reduces fluid accumulation and can stabilize or improve visual acuity.
• Diabetic macular edema: decreases retinal swelling and helps preserve vision.
• Macular edema secondary to retinal vein occlusion: limits edema and supports visual function.

• Aflibercept is a recombinant fusion protein that combines the extracellular domains of VEGF receptors 1 and 2 with the Fc portion of human IgG1. By binding VEGF‑A, VEGF‑B and placental growth factor with high affinity, it prevents these ligands from activating endothelial VEGF receptors, thereby inhibiting angiogenesis, vascular permeability and the formation of abnormal retinal vessels.

Intravitreal administration of aflibercept may be associated with ocular and systemic adverse reactions.

Common Side Effects

• Conjunctival hemorrhage: minor bleeding on the eye surface.
• Increased intraocular pressure: transient rise after injection.
• Floaters: visual disturbances from vitreous particles.
• Eye pain: mild discomfort at injection site.

Serious or Rare Side Effects

• Endophthalmitis: severe intraocular infection requiring urgent treatment.
• Retinal detachment: separation of retinal layers, a vision‑threatening emergency.
• Vitreous hemorrhage: bleeding into the vitreous cavity.
• Uveitis: inflammation of the uveal tract.

Before using aflibercept intravitreal injections, clinicians should consider several safety and handling precautions.

• Patient assessment: evaluate for active ocular infection or inflammation before injection.
• Anticoagulant therapy: assess bleeding risk and coordinate with managing physician.
• Prior ocular surgery: allow appropriate healing interval before administration.
• Pregnancy and lactation: use only if potential benefit justifies potential risk, as safety data are limited.
• Monitoring: schedule follow‑up examinations to detect intraocular pressure changes or inflammation.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Aflibercept may interact with other agents that affect ocular healing or systemic vascular processes.

Major Interactions (Avoid)

• Intravitreal steroids: combined use may increase risk of elevated intraocular pressure.
• Systemic anti‑VEGF therapies: concurrent use can amplify systemic VEGF inhibition and related adverse events.

Moderate Interactions (Monitor Closely)

• Anticoagulants/antiplatelet drugs: may raise risk of intraocular hemorrhage.
• Ocular hypotensive agents: monitor pressure changes when used together.
• Systemic hypertension medications: watch for blood pressure fluctuations.