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Recombinant fusion protein that suppresses neovascularization and decreases vascular permeability.
Indicated for intravitreal injection in forms of macular degeneration and edema and myopic choroidal neovascularization.
After intravitreal administration, plasma concentrations at 1-3 days are low (0 to 0.05 micrograms/mL) and undetectable at 2 weeks. That concentration is between 50 and 500 times lower than necessary to have any systemic effect. In addition, it binds to vascular endothelial growth factor, forming an inert compound that, like other proteins, is degraded by protein catabolism. It does not accumulate after repeated doses every 4 weeks (EMA 2017).
Its very high molecular weight explains the negligible passage to breast milk observed (Juncal 2020), since molecules of more than 800 - 1,000 Da do not pass into breast milk (Hale).
Due to its protein nature, it is inactivated in the gastrointestinal tract, not being absorbed (practically zero oral bioavailability), which makes it difficult or impossible to pass into the infant’s plasma from ingested breast milk, except in premature infants and during the immediate neonatal period in infants, where there may be increased intestinal permeability.