[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Intravitreal anti-VEGF agents](https://durgical.com/en/pharmacology/classes/intravitreal-anti-vegf-agents/) › Ranibizumab

# 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.

Updated Nov 1, 2026

## Quick facts

**Group**
[Intravitreal anti-VEGF agents](https://durgical.com/en/pharmacology/classes/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.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**VEGF-A (vascular endothelial growth factor A)**Ranibizumab

ⓘ The figure shows human VEGF bound to an affinity-matured antibody fragment, the kind of anti-VEGF Fab that ranibizumab is.

**Target in 3D:** VEGF-A (vascular endothelial growth factor A). PDB structure 1CZ8 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1CZ8) · Drag to rotate · pinch to zoom

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 →](https://durgical.com/en/conditions/age-related-macular-degeneration/)
- Diabetic macular oedema and diabetic retinopathy [Diabetic retinopathy →](https://durgical.com/en/conditions/diabetic-retinopathy/)
- Macular oedema after retinal vein occlusion [Central retinal vein occlusion →](https://durgical.com/en/conditions/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

### Serious (rare, important)

- Endophthalmitis: worsening pain, redness, discharge, falling vision
- New floaters or flashing lights, which need urgent eye review
- Bleeding in or around the eye; raised eye pressure
- Arterial thromboembolic events such as stroke or heart attack

## 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

## Memory aid

«RANI = Retina's Anti-VEGF, No Fc, Intravitreal»: a small Fab that stays in the eye.

## 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).

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/ranibizumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 2

- [Aflibercept](https://durgical.com/en/pharmacology/aflibercept/)
- [Bevacizumab](https://durgical.com/en/pharmacology/bevacizumab/)

## Related conditions 3

- [Age-related macular degeneration](https://durgical.com/en/conditions/age-related-macular-degeneration/)
- [Diabetic retinopathy](https://durgical.com/en/conditions/diabetic-retinopathy/)
- [Central retinal vein occlusion](https://durgical.com/en/conditions/central-retinal-vein-occlusion/)

[← Back to the class: Intravitreal anti-VEGF agents](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a607044.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=S01LA04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [RCSB PDB - 1CZ8: VASCULAR ENDOTHELIAL GROWTH FACTOR IN COMPLEX WITH AN AFFINITY MATURED ANTIBODY](https://www.rcsb.org/structure/1CZ8) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/ranibizumab/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/ranibizumab/