Last update: Feb. 7, 2021

Aflibercept, Ophtalmic use

Decreased level of risk

New scientific evidences have driven the Apilam staff to update the level of risk associated to this product.
Former level of risk, which was Low Risk, is now set to Very Low Risk.

Level of risk reviewed on Feb. 7, 2021

Very Low Risk for breastfeeding

Safe. Compatible.
Minimal risk for breastfeeding and infant.

A recombinant fusion protein that suppresses neovascularization and decreases vascular permeability.
Used to treat forms of macular degeneration and edema and myopic choroidal neovascularization via intravitreal injection.

Following intravitreal administration, plasma concentrations at 1-3 days are low (0 to 0.05 microngram/mL) and undetectable at 2 weeks. This concentration is between 50 and 500 times lower than necessary to have some systemic effect. In addition, it binds to the vascular endothelial growth factor forming an inert complex 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, so its oral bioavailability is practically nil, except in premature babies and the immediate neonatal period when there may be greater intestinal permeability.


Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.


Aflibercept, Ophtalmic use belongs to this group or family:


Main tradenames from several countries containing Aflibercept, Ophtalmic use in its composition:


Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 115.000 daltons
VD 0,09 l/Kg
T1/2 120 -144 hours
Theoretical Dose 0,0016 mg/Kg/d
Relative Dose 0,49 %


  1. Juncal VR, Paracha Q, Bamakrid M, Francisconi CLM, Farah J, Kherani A, Muni RH. Ranibizumab and Aflibercept Levels in Breast Milk after Intravitreal Injection. Ophthalmology. 2020 Feb;127(2):278-280. Abstract
  2. EMA. Aflibercept. Ficha técnica. 2017 Full text (in our servers)
  3. EMA. Aflibercept. Drug Summary. 2017 Full text (in our servers)

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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2006 from United States of America

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