Drug reference

Aflibercept

Monoclonal Antibody · Antineoplastic

Also known as Zaltrap

Monoclonal AntibodyAntineoplasticATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Manufacturer advises avoid—toxicity in animal studies. Considerable caution is necessary if a pregnant woman presents with cancer requiring chemotherapy, and specialist advice should always be sought.

FDA category + note

Top interactionssee all 12 →

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Mechanism

Aflibercept is a recombinant fusion protein that acts as a soluble decoy receptor and binds to vascular endothelial growth factors A and B (VEGF-A, VEGF-B) and placental growth factor (PlGF). Aflibercept inhibits the activation of VEGF receptors and the proliferation of endothelial cells, thereby inhibiting the growth of new vessels that supply tumours with oxygen and nutrients.

Indications

In combination with irinotecan, fluorouracil and folinic acid (FOLFIRI) chemotherapy, in metastatic colorectal cancer that is resistant to, or has progressed after, an oxaliplatin-containing regimenwet macular degenerationmetastatic colorectal cancer (in combination with FOLFIRI) resistant to or progressed following an oxaliplatin-containing regimenneovascular (wet) age-related macular degenerationmacular edema following retinal vein occlusiondiabetic retinopathy (in patients with DME)

Dosing

Adult: By intravenous infusion: consult local protocol
Renal adjustment: Caution in severe impairment (no specific information available)
Hepatic adjustment: Manufacturer advises caution in severe impairment (no specific information available)

Pharmacokinetics

Half-life

about 6 days (range, 4–7 days)

Contraindications

Moderate or severe congestive heart failure
Uncontrolled hypertension

Side effects

Common

Appetite decreasedAsthenic conditionsDehydrationDiarrhoeahypertensiondiarrheaeye pain or rednessswellingvision problemsphotosensitivityheadachesconfusionproblems with speech and balance

Serious

Febrile neutropenia
Increased risk of haemorrhage (including fatal events)
Increased risk of hypertension
Increased risk of thromboembolic events
Impaired wound healing
Neutropenic infection
Fistula formation
Neutropenia
Thrombocytopenia
Gastro-intestinal perforation
Proteinuria
Posterior reversible encephalopathy syndrome (presenting as seizures, altered mental status, nausea, vomiting, headache, or visual disturbance)
increased risk of hemorrhage
gastrointestinal perforation
sudden numbness on one side of the body