Anti-VEGF-A and Ang-2 monoclonal antibody Pregnancy: No adequate and well-controlled studies in pregnant women. Should not be used during pregnancy unless the potential benefit to the patient outweighs the potential risk to the fetus. Administration to pregnant monkeys throughout organogenesis increased the incidence of abortions at IV doses 158 times human exposure (Cmax) of the maximum recommended human dose; potential risk to female reproductive capacity and to embryo-fetal development based on the mechanism of action of VEGF and Ang-2 inhibitors.

Faricimab (Specialist drug)

Brand names: Vabysmo

Faricimab is a specialist intravitreal bispecific antibody used to treat neovascular (wet) age-related macular degeneration and diabetic macular oedema.

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)

Route: Intravitreal injection (must be administered by a qualified physician)

Frequency: Neovascular (wet) AMD: every 4 weeks (approximately every 28 +/- 7 days, monthly) for the first 4 doses, then interval individualised as below

Source is US prescribing information (VABYSMO, Genentech; label date 2026-04-15) — no UK SPC was retrieved; verify against UK SPC before use. nAMD: after the first 4 monthly doses, optical coherence tomography and visual acuity evaluations at 8 and 12 weeks later inform whether to give a 6 mg intravitreal dose on one of three regimens: 1) Weeks 28 and 44; 2) Weeks 24, 36 and 48; or 3) Weeks 20, 28, 36 and 44. Diabetic macular oedema (DME) — one of two regimens: 1) 6 mg every 4 weeks for at least 4 doses, then, if resolution of oedema by central subfield thickness (CST) on OCT is achieved, the dosing interval may be modified by extensions of up to 4-week increments or reductions of up to 8-week increments based on CST and visual acuity; or 2) 6 mg every 4 weeks for the first 6 doses, then 6 mg every 8 weeks (2 months). Macular oedema following retinal vein occlusion (RVO): 6 mg every 4 weeks (approximately every 28 +/- 7 days, monthly); in clinical studies patients received monthly injections for 6 months. Across indications, although additional efficacy was not demonstrated in most patients with 4-weekly versus 8-weekly dosing, some patients may need every-4-week (monthly) dosing after the first 4 doses; patients should be assessed regularly. Each prefilled syringe or vial is for treatment of a single eye only. Paediatrics: safety and efficacy in paediatric patients have not been established (label section 8.4) — no paediatric dose is stated. Elderly: no dose adjustment is required in patients 65 years and above.

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 infection
Active intraocular inflammation
Known hypersensitivity to faricimab or any of the excipients (may manifest as rash, pruritus, urticaria, erythema or severe intraocular inflammation)

Side effects

Cataract (15%) — most common
Conjunctival haemorrhage (8%)
Endophthalmitis and retinal detachment following intravitreal injection
Transient increase in intraocular pressure (seen within 60 minutes of injection)
Arterial thromboembolic events (potential risk associated with VEGF inhibition); retinal vasculitis and/or retinal vascular occlusion

Clinical monograph

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.

Reference: NICE TA800/TA799; SmPC; 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