Anti-VEGF and Anti-Ang-2 — Bispecific Monoclonal Antibody Pregnancy: No adequate and well-controlled studies in pregnant women; administration to pregnant monkeys throughout organogenesis increased the incidence of abortions at IV doses 158 times the human Cmax exposure. Based on the mechanism of action of VEGF and Ang-2 inhibitors there is a potential risk to female reproductive capacity and to embryo-fetal development. Should not be used during pregnancy unless the potential benefit to the patient outweighs the potential risk to the fetus (US label §8.1)

Faricimab (Intravitreal)

Brand names: Vabysmo

Faricimab is a bispecific monoclonal antibody given by intravitreal injection for 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 dosing interval individualised on OCT and visual acuity evaluations

NO UK SPC WAS FETCHED — dose taken from the US FDA prescribing information for VABYSMO (faricimab-svoa, Genentech, label date 2026-04-15); verify against the UK SPC. All indications use the same 6 mg (0.05 mL of 120 mg/mL) intravitreal dose; only the schedule differs. nAMD (§2.2): 6 mg every 4 weeks for the first 4 doses, followed by optical coherence tomography and visual acuity evaluations 8 and 12 weeks later to inform whether to give a 6 mg 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 (§2.3), one of two regimens: 1) 6 mg every 4 weeks for at least 4 doses, then, if resolution of oedema based on 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, followed by 6 mg at intervals of every 8 weeks (2 months). Macular oedema following retinal vein occlusion (§2.4): 6 mg every 4 weeks (approximately every 28 ± 7 days, monthly); in clinical studies patients received monthly injections for 6 months. Although additional efficacy was not demonstrated in most patients when dosed every 4 weeks compared with every 8 weeks, some patients may need every-4-week (monthly) dosing after the first 4 doses; patients should be assessed regularly. Supplied as a single-dose prefilled syringe (with a 30-gauge x 1/2-inch extra-thin-wall sterile injection filter needle) or a single-dose vial (with an 18-gauge x 1 1/2-inch 5-micron blunt transfer filter needle); each syringe/vial is for treatment of a SINGLE EYE only. Store at 2 to 8 C, do not freeze, and allow to reach room temperature (20 to 25 C) before administration. Proper aseptic injection technique must always be used. Paediatric (§8.4): safety and efficacy in paediatric patients have not been established. Geriatric (§8.5): no dose adjustment 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 infections
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

Most common (>= 5%): cataract (15% in the DME population) and conjunctival haemorrhage (8%)
Endophthalmitis following intravitreal injection — instruct patients to report suggestive symptoms without delay
Retinal detachment following intravitreal injection
Transient increases in intraocular pressure, seen within 60 minutes of intravitreal injection — monitor IOP and optic nerve head perfusion
Arterial thromboembolic events (potential risk associated with VEGF inhibition)
Retinal vasculitis and/or retinal vascular occlusion
Hypersensitivity reactions

Clinical monograph

How it works

It simultaneously binds and neutralises both vascular endothelial growth factor-A and angiopoietin-2, reducing vascular leakage, neovascularisation and inflammation, and helping stabilise the retinal vasculature.

Prescribing in practice

Intravitreal injection carries a risk of endophthalmitis and intraocular inflammation, so it must be given under aseptic conditions and patients told to report eye pain, redness or worsening vision urgently.
It is contraindicated in active or suspected ocular or periocular infection and active intraocular inflammation.
A transient rise in intraocular pressure can occur after injection, so perfusion of the optic nerve head and pressure should be assessed.

Monitoring

Assess intraocular pressure and optic nerve perfusion around the time of injection and review visual acuity and retinal imaging to guide the treatment interval.

Counselling the patient

Report eye pain, increasing redness, light sensitivity, floaters or any drop in vision without delay, as these can signal infection.
Mild eye irritation or a small bleed on the white of the eye after the injection is common and usually settles.
Attend all follow-up appointments, as injections are given on a planned and sometimes extending schedule.

Evidence & guidelines

The TENAYA, LUCERNE, YOSEMITE and RHINE trials demonstrated non-inferior visual outcomes with faricimab and the potential for extended dosing intervals in wet AMD and diabetic macular oedema.

Reference: NICE TA924; TENAYA/LUCERNE Trials (Lancet 2022); YOSEMITE/RHINE Trials; SPC Vabysmo; 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