Faricimab (Specialist drug)

How it works

It binds and inhibits both vascular endothelial growth factor A and angiopoietin-2, reducing abnormal vascular leakage, neovascularisation and retinal oedema.

Prescribing in practice

• It must be given as an intravitreal injection by a trained ophthalmologist under aseptic conditions, with patients told to report symptoms of endophthalmitis or retinal detachment immediately.
• It is contraindicated in active or suspected ocular or periocular infection and in active intraocular inflammation, and may cause a transient rise in intraocular pressure after injection.
• Intraocular inflammation, including rare retinal vasculitis, has been reported and should prompt assessment.

Monitoring

Assess intraocular pressure and perfusion around injection and monitor for signs of infection or intraocular inflammation.

Counselling the patient

• Seek urgent ophthalmic care if you develop eye pain, increasing redness, reduced vision, floaters or light sensitivity.
• Multiple injections over time are usually needed, with the interval adjusted to your response.
• Attend all review appointments so treatment can be tailored.

Evidence & guidelines

Faricimab is supported by phase 3 randomised trials in wet age-related macular degeneration and diabetic macular oedema and by NICE technology appraisal guidance.