Select a medication above to begin.
Susvimo
ranibizumab intravitreal
Black Box Warnings .
Endophthalmitis
ranibizumab implant associated with up to 3x higher rate of endophthalmitis than monthly ranibizumab intravitreal injections; many events associated with conjunctival retractions or erosions; appropriate conjunctiva management and early detection with surgical repair may reduce risk
Adult Dosing .
Dosage forms: IMPLANT: 2 mg per 0.02 mL
Special Note
- [equivalency or interchangeability info]
- Info: Susvimo solution not interchangeable with other ranibizumab products; do not use other ranibizumab products in Susvimo implant
age-related macular degeneration, neovascular
- [2 mg intravitreal implant q24wk]
- Info: for patients who previously responded to at least 2 VEGF inhibitor intravitreal injections; may give supplemental tx with ranibizumab 0.5 mg intravitreal injection while implant in place; see other ranibizumab products for intravitreal injection use
diabetic macular edema
- [2 mg intravitreal implant q24wk]
- Info: for patients who previously responded to at least 2 VEGF inhibitor intravitreal injections; may give supplemental tx with ranibizumab 0.5 mg intravitreal injection while implant in place; see other ranibizumab products for intravitreal injection use
diabetic retinopathy
- [2 mg intravitreal implant q36wk]
- Info: for patients who previously responded to at least 2 VEGF inhibitor intravitreal injections; may give supplemental tx with ranibizumab 0.5 mg intravitreal injection while implant in place; see other ranibizumab products for intravitreal injection use
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- ocular infection
- periocular infection
- intraocular inflammation, active
- systemic infection, severe
- caution: patients of childbearing potential
- caution: ophthalmic procedure
- caution: MRI, concurrent
Drug Interactions .
Overview
ranibizumab
VEGF directed antibody
- antiplatelet/anticoagulant effects
- thrombogenic effects
Avoid/Use Alternative
- tranexamic acid
- vaccinia immune globulin
Monitor/Modify Tx
- abemaciclib
- abrocitinib
- acalabrutinib
- ado-trastuzumab emtansine
- aflibercept
- alpha-tocopherol (vitamin E)
- alprostadil intravenous
- alteplase
- aminocaproic acid
- anacaulase topical
- anagrelide
- angiotensin II
- anthrax immune globulin
- anti-inhibitor coagulant complex
- antihemophilic factor (factor VIII)/von Willebrand factor complex
- antithrombin
- apixaban
- argatroban
- asciminib
- asparaginase
- aspirin
- atidarsagene autotemcel
- avapritinib
- avatrombopag
- axitinib
- baricitinib
- bazedoxifene
- bevacizumab
- binimetinib
- bivalirudin
- botulism immune globulin
- brolucizumab
- bromelain
- bromfenac ophthalmic
- C1 esterase inhibitor
- cabozantinib
- calaspargase
- cangrelor
- caplacizumab
- carfilzomib
- celecoxib
- chorionic gonadotropin
- cilostazol
- citalopram
- clopidogrel
- clozapine
- coagulation factor IX
- coagulation factor VIIa
- coagulation factor XIII A-subunit
- concizumab
- cytomegalovirus immune globulin
- dabigatran
- dalteparin
- danazol
- danshen
- darbepoetin alfa
- dasatinib
- defibrotide
- deflazacort
- desogestrel (contraceptive)
- desvenlafaxine
- deuruxolitinib
- dexamethasone
- diclofenac
- diclofenac ophthalmic
- diclofenac topical
- dienogest (contraceptive)
- diflunisal
- diosmin
- dipyridamole
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- duloxetine
- edoxaban
- eltrombopag
- encorafenib
- enoxaparin
- epirubicin
- epoetin alfa
- epoprostenol
- eptifibatide
- escitalopram
- estetrol (contraceptive)
- estradiol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- ethinyl estradiol (contraceptive)
- ethinyl estradiol (hormone replacement)
- ethynodiol (contraceptive)
- etodolac
- etonogestrel (contraceptive)
- evening primrose oil
- everolimus
- factor XIII concentrate
- faricimab
- fedratinib
- fenofibrate
- fenofibric acid
- fenoprofen
- fenugreek
- fibrinogen (human)
- fitusiran
- fluoxetine
- flurbiprofen
- flurbiprofen ophthalmic
- fluvoxamine
- follitropin
- fondaparinux
- fruquintinib
- garlic
- gemtuzumab ozogamicin
- ginkgo
- heparin
- hepatitis B immune globulin
- ibrutinib
- ibuprofen
- ibuprofen lysine
- icosapent ethyl
- imatinib
- immune globulin
- indomethacin
- iodixanol
- iohexol
- iomeprol
- iopamidol
- iopromide
- iothalamate meglumine
- ioversol
- ketoprofen
- ketorolac
- ketorolac ophthalmic
- lazertinib
- lenalidomide
- lenvatinib
- levomilnacipran
- levonorgestrel (contraceptive)
- levonorgestrel (hormone replacement)
- lifileucel
- luspatercept
- lusutrombopag
- meclofenamate
- medroxyprogesterone (contraceptive)
- medroxyprogesterone (hormone replacement)
- mefenamic acid
- megestrol
- meloxicam
- menotropins
- methoxy polyethylene glycol-epoetin beta
- methyl salicylate topical
- methyltestosterone
- milnacipran
- mitotane
- momelotinib
- nabumetone
- naproxen
- nattokinase
- necitumumab
- nepafenac ophthalmic
- niacin (vitamin B3)
- nilotinib
- nintedanib
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norethindrone (hormone replacement)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- nusinersen
- obinutuzumab
- olaparib
- omega-3-acid
- ospemifene
- oxaliplatin
- oxaprozin
- pacritinib
- paroxetine
- pazopanib
- pegaspargase
- penicillin G
- pentosan polysulfate sodium
- pentoxifylline
- piperacillin
- piroxicam
- pirtobrutinib
- plasminogen, human
- pomalidomide
- ponatinib
- porfimer
- pralsetinib
- prasugrel
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- prothrombin complex concentrate (human)
- raloxifene
- ramucirumab
- regorafenib
- remibrutinib
- resveratrol
- reteplase
- revakinagene taroretcel
- Rho(D) immune globulin
- ritlecitinib
- rivaroxaban
- romiplostim
- ruxolitinib
- ruxolitinib topical
- salsalate
- saw palmetto
- segesterone (contraceptive)
- selpercatinib
- selumetinib
- sepiapterin
- sertraline
- sipuleucel-T
- sirolimus albumin-bound
- sodium tetradecyl sulfate
- sorafenib
- sotatercept
- sulindac
- sunitinib
- tamoxifen
- temsirolimus
- tenecteplase
- testosterone
- thalidomide
- ticagrelor
- tipranavir
- tirofiban
- tisotumab vedotin
- tivozanib
- tofacitinib
- tolmetin
- toremifene
- tovorafenib
- trametinib
- trazodone
- treprostinil
- tretinoin
- upadacitinib
- vadadustat
- valoctocogene roxaparvovec
- valproic acid
- vamorolone
- vandetanib
- varicella zoster immune globulin
- venlafaxine
- vilazodone
- vinpocetine
- von Willebrand factor
- vorapaxar
- vorinostat
- vortioxetine
- warfarin
- willow bark
- zanubrutinib
- ziv-aflibercept
- zopapogene imadenovec
Adverse Reactions .
Serious Reactions
- endophthalmitis
- retinal detachment, rhegmatogenous
- vitreous hemorrhage
- conjunctival erosion
- conjunctival retraction
- conjunctival bleb
- corneal abrasion
- corneal edema
- iritis
- ocular hypotony
Common Reactions
- conjunctival hemorrhage
- conjunctival hyperemia
- iritis
- ocular pain
- vitreous floaters
- conjunctival bleb
- foreign body sensation
- ocular hypotony
- vitreous detachment
- vitreous hemorrhage
- cataracts
- conjunctival edema
- corneal disorder
- corneal abrasion
- corneal edema
- visual acuity decr, postop transient
- intraocular inflammation, postop
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available, though risk of fetal harm not expected based on minimal systemic absorption; possible risk of fetal harm based on drug's mechanism of action
Individuals of Reproductive Potential
avoid pregnancy by using effective contraception during tx and for at least 12mo after D/C in patients of childbearing potential
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on minimal systemic absorption in breastfeeding patients and drug properties
Pharmacology .
Metabolism: for ranibizumab: unknown; CYP450: unknown; Info: minimal systemic absorption, systemic concentration 90,000-fold lower than vitreal concentration
Excretion: for ranibizumab: unknown; Half-life: 15wk (aqueous humor), 29wk (serum)
Subclass: Antineoplastics, Ophthalmic ; Macular Diseases ; VEGF Inhibitors, Ophthalmic
Mechanism of Action
for ranibizumab: binds and inhibits vascular endothelial growth factor A, decreasing neovascularization, vascular permeability, and endothelial cell proliferation (monoclonal antibody)
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.