Anti-VEGF — Single-chain Antibody Fragment (scFv) Pregnancy: US label §8.1: there are no adequate and well-controlled studies of BEOVU in pregnant women. Based on the anti-VEGF mechanism of action, treatment may pose a risk to human embryo-fetal development; should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus.

Brolucizumab (Intravitreal)

Brand names: Beovu

Intravitreal brolucizumab is a humanised single-chain antibody fragment anti-VEGF agent licensed for the treatment of neovascular (wet) age-related macular degeneration and diabetic macular oedema, given by injection into the vitreous cavity.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 6 mg (0.05 mL of 120 mg/mL solution) per injection

Route: Intravitreal injection (ophthalmic); must be administered by a qualified physician using aseptic technique — one pre-filled syringe or vial treats a single eye

Frequency: Neovascular (wet) age-related macular degeneration: 6 mg monthly (approximately every 25 to 31 days) for the first three doses, followed by 6 mg once every 8 to 12 weeks

US label §2.3 Diabetic macular edema (DME): 6 mg (0.05 mL of 120 mg/mL solution) by intravitreal injection every six weeks (approximately every 39–45 days) for the first five doses, followed by 6 mg once every 8–12 weeks. Available as a 6 mg/0.05 mL single-dose pre-filled syringe or single-dose vial; the dose is set at the 0.05 mL mark on the syringe. Paediatric (§8.4): safety and efficacy in paediatric patients has not been established. Geriatric (§8.5): no dosage regimen adjustment required in patients 65 years and above. SOURCE CAVEAT — no UK SPC (eMC) record was present in the fetched bundle; the dose above is taken from the US BEOVU prescribing information and must be verified against the UK SPC before publication.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Ocular or periocular infections
Active intraocular inflammation
Known hypersensitivity to brolucizumab or any of the excipients (may manifest as rash, pruritus, urticaria, erythema, or severe intraocular inflammation)

Side effects

Vision blurred (most common)
Cataract (most common)
Conjunctival haemorrhage (most common)
Eye pain (most common)
Vitreous floaters (most common)
Serious reactions described in US label §5: endophthalmitis and retinal detachment; retinal vasculitis and/or retinal vascular occlusion; increases in intraocular pressure within 30 minutes of injection; potential risk of arterial thromboembolic events

Clinical monograph

How it works

It binds vascular endothelial growth factor A with high affinity, inhibiting receptor activation and thereby suppressing pathological choroidal neovascularisation, vascular leakage and macular oedema.

Prescribing in practice

Brolucizumab carries a recognised risk of intraocular inflammation, including retinal vasculitis and retinal vascular occlusion that can cause severe sight loss, so any new eye inflammation must prompt urgent review and treatment discontinuation.
It is contraindicated in active or suspected ocular/periocular infection and active intraocular inflammation, and requires strict aseptic injection technique to prevent endophthalmitis.
A transient rise in intraocular pressure may follow injection; monitor optic nerve perfusion and pressure around the procedure.

Monitoring

Monitor intraocular pressure and optic nerve perfusion at injection and review closely for intraocular inflammation, retinal vasculitis or vascular occlusion, with optical coherence tomography and visual acuity at follow-up.

Counselling the patient

Report eye pain, increasing redness, light sensitivity, floaters or any drop in vision urgently after injection.
Attend all monitoring visits, as inflammation can develop in the weeks following treatment.
Mild irritation immediately after injection is common and usually settles.

Evidence & guidelines

The HAWK and HARRIER trials established efficacy in neovascular AMD, but post-marketing safety surveillance prompted MHRA and manufacturer warnings about intraocular inflammation, retinal vasculitis and occlusion.

Reference: MHRA DSU 2020 (Retinal Vasculitis); HAWK/HARRIER Trials (Lancet 2020); SPC Beovu; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways