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(peg-apt-i-nib) ,


(trade name)


Therapeutic: ocular agents
Pharmacologic: vascular endothelial growth factor antagonists
Pregnancy Category: B


Neovascular (wet) age-related macular degeneration.


Acts as an antagonist of vascular endothelial growth factor (VEGF). VEGF may be responsible for the formation of incompetent, leaky blood vessels associated with macular degeneration.

Therapeutic effects

Decreased rate of loss of visual acuity.


Absorption: Slowly absorbed into systemic circulation after intravitreous administration.
Distribution: Unknown.
Metabolism and Excretion: Metabolized by exo- and endonucleases.
Half-life: 10 days (plasma).

Time/action profile

Intravitrealunknownunknown6 wk


Contraindicated in: Ocular/periocular infections.
Use Cautiously in: Obstetric: Use only if maternal benefit outweighs fetal risk; Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Ear, Eye, Nose, Throat

  • cataract
  • blurred vision
  • conjunctival bleeding
  • irritation/pain
  • ↑ intraocular pressure
  • ocular inflammation
  • infection (rare)
  • retinal detachment (rare)
  • traumatic cataract formation (rare)


  • Anaphylaxis
  • angioedema


Drug-Drug interaction

None known.


Intravitreal (Adults) 0.3 mg every 6 wk.


Solution for intraviteous injection: 0.3 mg/mL in 1-mL single use glass syringes

Nursing implications

Nursing assessment

  • Assess eye for signs of infection frequently during week following injection.
  • Check perfusion of optic nerve head immediately after injection, use tonometry to measure intraocular pressure within 30 min following the injection, and biomicroscopy between 2 and 7 days following injection. Increases in intraocular pressure have been seen within 30 min of injection.

Potential Nursing Diagnoses

Disturbed sensory perception (Indications)


  • Do not administer solutions that are discolored or contain particulate matter. Attach threaded plastic threader rod to the rubber stopper inside barrel of syringe. Do not pull back on plunger.
    • Adequate analgesia and a broad-spectrum antibiotic should be given prior to injection.
  • Intravitreal: For ophthalmic intravitreal injection only.

Patient/Family Teaching

  • Advise patient to notify ophthalmologist immediately if eye becomes red, sensitive to light, painful, or develops a change in vision.

Evaluation/Desired Outcomes

  • Slowing of vision loss.


a miscellaneous ophthalmic agent that binds to vascular endothelial growth factor, thereby inhibiting angiogenesis.
indications This drug is used in the treatment of neovascular age-related macular degeneration. It may be used alone or with photodynamic therapy.
contraindications Ocular or periocular infections and known hypersensitivity to this drug prohibit its use.
adverse effects Adverse effects of this drug include retinal detachment and traumatic cataract. Common side effects include anterior chamber inflammation, blurred vision, conjunctival hemorrhage, corneal edema, cataract, eye discharge, eye pain, increased intraocular pressure, punctuate keratitis, reduced visual acuity, vitreous floaters, vitreous opacities, blepharitis, conjunctivitis, and photophobia.


An anti-vascular endothelial growth factor agent that has been found helpful in the treatment of neovascular age-related macular degeneration. A brand name is Macugen.
References in periodicals archive ?
From 2005 to 2009, intravitreal injection volume then increased dramatically due to the approval and use of pegaptanib, ranibizumab, and bevacizumab (Ramulu et al.
6,7) The main anti-VEGF agents used in the treatment of DME are ranibizumab, bevacizumab, pegaptanib sodium, and aflibercept.
Four VEGF-binding agents are currently used for ocular diseases: pegaptanib, bevacizumab (off-label), ranibizumab and aflibercept.
Pegaptanib sodium/Macugen (Eyetech Pharmaceuticals/Pfizer) is an RNA aptamer directed against vascular endothelial growth factor (VEGF)-165, which is primarily responsible for pathological ocular neovascularization and vascular permeability.
Researchers found that participants treated with any of the three anti-VEGF agents--ranibizumab (Lucentis), bevacizumab (Avastin), and pegaptanib (Macugen)--more often had improved vision, less often lost vision, and were less likely to be legally blind after one year than those treated with control treatments.
One aptamer drug, Pegaptanib, has already gotten FDA approval, and Shumbera believes diagnostic applications arent far behind.
There are three agents in this class: aflibercept (Eylea), pegaptanib (Macugen), and ranibizumab (Lucentis).
Therefore, vascular endothelial growth factor (VEGF) as the most important regulator of angiogenic network has been considered as a key target for current treatment of wet AMD, and several VEGF inhibitors such as bevacizumab, pegaptanib, or ranibizumab have demonstrated promising therapeutic benefits in clinical context [4].
In the UK, the first prominent approved anti-VEGF drug was pegaptanib (Macugen), which has now been replaced by the more effective anti-VEGF agents ranibizumab (Lucentis) and aflibercept (VEGF-trap, Eylea) (14) although pegaptanib is still available for about 9,000[pounds sterling] for a two-year course.
A prefix "Peg" indicates "pegylation" (polyethylene glycol complex) as in pegaptanib, peginterferons.
The FDA has approved two drugs for the treatment of wet AMD that can be injected directly into the eye (called anti- VEGF therapy)--ranibizumab (Lucentis) and pegaptanib sodium (Macugen).