Active Ingredient: Bevacizumab
Bevacizumab is indicated in adults for treatment of neovascular (wet) age-related macular degeneration (nAMD).
For this indication, competent medicine agencies globally authorize below treatments:
For:
Intravitreal, 1.25 milligrams bevacizumab, once every 4 weeks.
The recommended dose is 1.25 mg administered by intravitreal injection every 4 weeks (monthly).
Treatment is initiated with one injection per month until maximum visual acuity is achieved and/or there are no signs of disease activity, i.e., no change in visual acuity or in other signs and symptoms of the disease under continued treatment. The kinetics of bevacizumab gamma efficacy indicate that three or more consecutive monthly injections may be needed initially. Thereafter, the healthcare professional may individualise treatment intervals based on disease activity as assessed by visual acuity and/or anatomical parameters.
Monitoring and treatment intervals should then be determined by the healthcare professional and should be based on disease activity, including clinical examination, functional testing or imaging techniques (e.g. optical coherence tomography or fluorescein angiography).
If visual and anatomical outcomes indicate that the patient is not benefiting from continued treatment, the medicinal product should be discontinued. Treatment should also be withheld if clinically indicated.
The intravitreal injection procedure should be carried out under aseptic conditions, which includes the use of surgical hand disinfection, sterile gloves, a sterile drape and a sterile eyelid speculum (or equivalent). Sterile paracentesis equipment should be available as a precautionary measure. The patient’s medical history for hypersensitivity reactions should be carefully evaluated prior to performing the intravitreal procedure. Adequate anaesthesia and a broad-spectrum topical microbicide to disinfect the periocular skin, eyelid and ocular surface should be administered prior to the injection.
The injection needle should be inserted 3.5-4.0 mm posterior to the limbus into the vitreous cavity, avoiding the horizontal meridian and aiming towards the centre of the globe. The injection volume of 0.05 mL is then delivered slowly; a different scleral site should be used for subsequent injections.
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