Ranibizumab
Intravitreal anti-VEGF agents
Intravitreal anti-VEGF agents
An antibody fragment injected into the eye that binds VEGF-A and slows the leaky vessels of wet macular degeneration and diabetic macular oedema.
Quick facts
- Group
- Intravitreal anti-VEGF agents
- Target
- VEGF-A (vascular endothelial growth factor A)
- Used for
- Wet age-related macular degeneration
- Key effects
- Feeling of something in the eye · Headache
- Monitor
- Intraocular pressure after the injection
- ATC
- S01LA04
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows human VEGF bound to an affinity-matured antibody fragment, the kind of anti-VEGF Fab that ranibizumab is.
Ranibizumab is a humanised antibody Fab fragment, derived from bevacizumab with its Fc part removed and its binding site affinity-matured. It binds all active forms of VEGF-A and stops them from activating VEGF receptors on retinal endothelial cells. Fewer new vessels grow and less fluid leaks into the macula.
- Ranibizumab is injected into the vitreous
- Its Fab binding site grabs VEGF-A
- VEGF receptors on retinal vessels stay off
- Less neovascularisation and macular oedema
Indications
- Wet age-related macular degeneration Age-related macular degeneration →
- Diabetic macular oedema and diabetic retinopathy Diabetic retinopathy →
- Macular oedema after retinal vein occlusion Central retinal vein occlusion →
- Myopic choroidal neovascularisation
Adverse effects
Common
- Feeling of something in the eye, dry or itchy eye, watery eye
- Headache
- Cold-like symptoms: sneezing, runny nose, sore throat
Contraindications
- Active infection in or around the eye
- Active intraocular inflammation
- Hypersensitivity to ranibizumab or any component
Key interactions
- Other anti-VEGF agents in the same eye
- Same target and added injection risk; not combined
What is monitored
- Intraocular pressure after the injection
- Signs of infection or a retinal problem in the following days
- History of stroke or heart attack before starting
Administration and safety
- Intravitreal injection by an eye specialist, with aseptic technique.
- Antibiotic eye drops may be ordered for a few days after each injection.
- Biosimilars and a long-acting eye implant also exist; the exact product ordered is checked.
- Someone else should drive the patient home.
Pregnancy and breastfeeding
Use in pregnancy needs a clear benefit and a discussion with the eye specialist; a pregnancy during treatment is reported to the treating team.
Nursing care
- Ask about eye infection, eye inflammation, and past stroke or heart attack.
- Check vision and arrange the pressure check after the injection.
- Teach the eye warning signs (pain, redness, discharge, floaters, flashes, vision loss) and to report them the same day.
- Teach stroke warning signs: sudden weakness, numbness or trouble speaking.
Pharmacokinetics
- Absorption
- Given into the vitreous; small fragment without Fc, acts locally and little reaches the blood
Test yourself
Think of the answer, then tap the question to see it.
What is ranibizumab structurally?
A humanised Fab fragment derived from bevacizumab, affinity-matured, without the Fc part.
Which history should be asked about because of systemic risk?
Previous stroke or heart attack (arterial thromboembolic events).
Which retinal diseases are treated with ranibizumab?
Wet age-related macular degeneration (also diabetic macular oedema, retinal vein occlusion, myopic neovascularisation).
Connections
← Back to the class: Intravitreal anti-VEGF agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Ranibizumab Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); RCSB PDB - 1CZ8: VASCULAR ENDOTHELIAL GROWTH FACTOR IN COMPLEX WITH AN AFFINITY MATURED ANTIBODY (RCSB Protein Data Bank, 2026).
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Representative model, for educational purposes only.