Mynzepli (Aflibercept)

Mynzepli (aflibercept) targets vascular endothelial growth factor pathways that drive abnormal retinal neovascularization and fluid leakage.

• Neovascular age‑related macular degeneration: reduces disease activity and improves visual acuity.
• Diabetic macular edema: decreases retinal swelling and stabilizes vision.
• Macular edema secondary to retinal vein occlusion: resolves fluid accumulation and enhances visual outcomes.
• Myopic choroidal neovascularization: inhibits new vessel growth and helps preserve sight.

• Aflibercept is a recombinant fusion protein that combines portions of the extracellular domains of VEGF receptors 1 and 2 with the Fc region of human IgG1. By binding VEGF‑A, VEGF‑B and placental growth factor with high affinity, it prevents these ligands from activating VEGF receptors on endothelial cells, thereby suppressing pathological angiogenesis and vascular permeability in the retina.

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

Common Side Effects

• Eye pain: mild discomfort or soreness at the injection site lasting a few hours.
• Conjunctival hemorrhage: small bleed on the eye surface that usually resolves without treatment.
• Floaters: transient visual specks that may appear after the injection and fade over days.
• Increased intraocular pressure: temporary rise measured at follow‑up visits, often managed with medication.

Serious or Rare Side Effects

• Endophthalmitis: severe intraocular infection that can cause vision loss if not treated promptly.
• Retinal detachment: separation of retinal layers, a vision‑threatening emergency requiring surgical repair.
• Vitreous hemorrhage: bleeding into the vitreous cavity, which may impair vision and need intervention.
• Uveitis: inflammation of the uveal tract that can lead to pain, redness and visual disturbance.

Prior to intravitreal administration of Mynzepli, clinicians should observe several safety considerations.

• Infection risk: ensure aseptic technique and assess for active ocular infection before injection.
• Intraocular pressure: monitor pressure before and after the procedure, especially in glaucoma patients.
• Anticoagulant therapy: evaluate bleeding risk in patients receiving systemic anticoagulants.
• Ocular comorbidities: consider pre‑existing retinal or vitreous conditions that may affect outcomes.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Aflibercept administered intravitreally has limited systemic drug interactions, but certain agents may influence safety or efficacy.

Major Interactions (Avoid)

• Systemic anti‑VEGF therapy: concurrent use may increase risk of systemic vascular events.
• Intravitreal corticosteroids: combined use may heighten intraocular pressure and infection risk.

Moderate Interactions (Monitor Closely)

• Anticoagulants or antiplatelet drugs: may exacerbate intraocular bleeding.
• Recent ocular surgery: could affect wound healing and infection susceptibility.
• Systemic chemotherapy: may alter immune response and infection risk.
• Systemic hypertension: monitor as VEGF inhibition can affect vascular tone.