Vabysmo (Faricimab): Uses, Injection Schedule, Side Effects and Risks

Vabysmo (faricimab) is an eye injection for wet macular degeneration and two causes of macular swelling. It is the first eye drug that blocks two disease pathways at once, which lets many people go up to four months between injections.

• What it treats: neovascular (wet) age-related macular degeneration (AMD), diabetic macular edema (DME), and macular edema after retinal vein occlusion (RVO).
• How it works: it blocks both VEGF-A, which drives leaky new blood vessels, and angiopoietin-2 (Ang-2), which makes vessels unstable and inflamed.
• How often: monthly loading injections at first, then, depending on the condition and how your eye responds, as far apart as every 16 weeks for wet AMD and DME.
• Most common side effects: cataract (15% in trials) and a red patch on the white of the eye from the injection (conjunctival hemorrhage, 8%).
• Rare but serious risks: eye infection (endophthalmitis), retinal detachment, a rise in eye pressure, intraocular inflammation and retinal vasculitis, which can threaten sight.

This is general information, not medical advice. Vabysmo is given only by a retina specialist. If your eye becomes painful, red, light-sensitive or your vision changes after an injection, contact your eye doctor the same day.

Vabysmo at a glance

	Details
Generic name	Faricimab-svoa
Drug class	Bispecific antibody: VEGF-A and Ang-2 inhibitor
Made by	Genentech (Roche)
First US approval	January 2022 (wet AMD and DME); October 2023 (RVO)
How it’s given	Intravitreal injection (into the eye) by a retina specialist
Dose	6 mg (0.05 mL) per injection, from a vial or a prefilled syringe
Common side effects	Cataract, conjunctival hemorrhage
Do not use if	Infection in or around the eye, active inflammation inside the eye, allergy to faricimab

What is Vabysmo used for?

Vabysmo is approved for three conditions that damage the macula, the small central part of the retina responsible for sharp, detailed vision such as reading and recognising faces.

• Wet (neovascular) age-related macular degeneration: abnormal blood vessels grow under the retina and leak fluid and blood. Without treatment, central vision can be lost within months.
• Diabetic macular edema: long-term high blood sugar damages small retinal vessels, which leak fluid into the macula and blur vision. It is a leading cause of vision loss in working-age adults.
• Macular edema following retinal vein occlusion: a blocked vein in the retina (a branch vein or the central vein) backs up blood and causes swelling in the macula.

In all three, a protein called vascular endothelial growth factor (VEGF) plays a central role. Anti-VEGF injections such as ranibizumab (Lucentis), aflibercept (Eylea) and bevacizumab (Avastin, used off-label) transformed treatment, but they often need injections every 4 to 8 weeks for years. Vabysmo was designed to stretch that interval.

How Vabysmo works

Faricimab is a bispecific antibody, one molecule with two different binding arms:

• One arm blocks VEGF-A, the main signal that makes abnormal vessels grow and leak.
• The other arm blocks angiopoietin-2 (Ang-2). Ang-2 rises in diseased eyes and destabilises blood vessels, making them leakier and more inflamed and more sensitive to VEGF.

By blocking Ang-2 as well, faricimab is thought to help vessels stay stable for longer, which is why many people can safely extend the time between injections. It is currently the only FDA-approved eye injection that targets both pathways.

How Vabysmo is given

Each dose is 6 mg in 0.05 mL, injected into the gel inside the eye (the vitreous) in an outpatient clinic. The procedure takes a few minutes:

• your eye is numbed with drops or gel
• the skin around the eye and the eye surface are cleaned with antiseptic (usually povidone-iodine)
• a small device holds your eyelids open
• the injection is given through the white of the eye with a very fine needle
• your eye pressure may be checked afterwards

Most people feel pressure rather than pain. Since July 2024, Vabysmo has also been available in a prefilled syringe, which simplifies preparation for the clinic.

Dosing schedules

Condition	Start	After loading
Wet AMD	6 mg every 4 weeks for the first 4 doses	Then every 8, 12 or 16 weeks based on your eye’s response, or another schedule your specialist chooses
Diabetic macular edema	6 mg every 4 weeks for at least 4 doses	Then the interval is extended or shortened in steps of up to 4 weeks, up to every 16 weeks, based on response
Macular edema after RVO	6 mg every 4 weeks	Typically for 6 months; later intervals set by your specialist

Retina specialists commonly use a “treat-and-extend” approach: if the macula stays dry, the gap to the next injection is lengthened; if fluid returns, it is shortened. Regular eye exams and optical coherence tomography (OCT) scans guide each decision.

How well does Vabysmo work?

Faricimab was tested against aflibercept 2 mg, a standard anti-VEGF treatment, in large phase 3 trials:

• TENAYA and LUCERNE (wet AMD): vision gains with faricimab were non-inferior to aflibercept given every 8 weeks. By the end of the first year, about 45% of people on faricimab were on every-16-week dosing and nearly 80% on every 12 weeks or longer.
• YOSEMITE and RHINE (DME): vision gains matched aflibercept, and faricimab dried the macula well. By the end of the first year, more than half of people in the treat-and-extend arm were on every-16-week dosing.
• BALATON and COMINO (RVO): in branch and central vein occlusion, faricimab given monthly for 6 months produced vision gains similar to aflibercept.

In short, faricimab gives similar vision results to aflibercept with fewer injections for many patients. Fewer clinic visits matters a great deal to older adults who rely on others for transport, and to working-age people with diabetes.

Vabysmo side effects

Common side effects

In clinical trials, the most common side effects (in 5% or more of people) were:

• cataract (15%): clouding of the lens, which becomes more common in anyone receiving repeated eye injections over time, and with age and diabetes
• conjunctival hemorrhage (8%): a bright red patch on the white of the eye where the needle went in; it looks alarming but is harmless and fades over 1 to 2 weeks

Other effects that can follow any eye injection include floaters (vitreous floaters), eye pain or a gritty feeling, a temporary rise in eye pressure and short-lived blurring.

Serious side effects

• Endophthalmitis: an infection inside the eye, a rare but sight-threatening complication of any intravitreal injection. Signs include worsening pain, redness, light sensitivity and decreasing vision, usually within a few days.
• Retinal detachment or tear: the retina pulls away from the back of the eye. Warning signs are a sudden shower of floaters, flashes of light or a curtain over part of your vision.
• Raised eye pressure: pressure often rises briefly within an hour of the injection. Sustained rises are monitored, especially in people with glaucoma.
• Intraocular inflammation (uveitis, vitritis): inflammation inside the eye, reported in a small percentage of patients.
• Retinal vasculitis and retinal vascular occlusion: inflammation or blockage of the retinal blood vessels, usually alongside intraocular inflammation. This was added to the US label in October 2023 based on post-marketing reports. It is rare, but it can cause permanent vision loss, and the label says to stop Vabysmo in people who develop it.
• Arterial thromboembolic events: heart attacks and strokes are a theoretical risk with all anti-VEGF drugs because tiny amounts enter the bloodstream. Rates in the faricimab trials were low and similar to aflibercept.

When to call your eye doctor urgently

Call the same day, or go to emergency care, if after an injection you notice:

• eye pain that gets worse rather than better
• increasing redness, especially with discharge
• sensitivity to light
• a new shower of floaters, flashes or a shadow in your vision
• any drop in vision

Who should not get Vabysmo

• people with an active infection in or around the eye
• people with active inflammation inside the eye
• people allergic to faricimab or any ingredient

Tell your specialist if you have glaucoma, have had a stroke or heart attack, are pregnant or breastfeeding, or are planning pregnancy. Anti-VEGF drugs may affect a developing baby, so the label advises women who could become pregnant to use effective contraception during treatment and for at least 3 months after the last injection.

Vabysmo vs Eylea vs Lucentis

	Vabysmo (faricimab)	Eylea (aflibercept 2 mg)	Eylea HD (aflibercept 8 mg)	Lucentis (ranibizumab)
Targets	VEGF-A and Ang-2	VEGF-A, VEGF-B, PlGF	VEGF-A, VEGF-B, PlGF	VEGF-A
Longest label interval (wet AMD)	Every 16 weeks	Every 12 weeks in some patients	Every 16 weeks after loading	Every 4 weeks (less often in practice)
Biosimilars available	No	Yes	No	Yes

The best choice depends on your condition, how your eye responds, insurance rules (some insurers require a cheaper drug first, a policy called step therapy) and the clinic’s experience. Switching between drugs is common if one stops controlling fluid well.

Practical tips for injection days

• Bring a driver. Your vision may be blurred from dilating drops and the procedure.
• Use artificial tears if your eye feels gritty afterwards, but avoid rubbing it.
• Don’t swim or wear eye makeup for a few days, to lower infection risk.
• Keep every follow-up appointment, even if your vision feels fine. Fluid can return before you notice symptoms.
• Check each eye separately at home with an Amsler grid, if your doctor recommends it, and report new distortion.
• If you have diabetes, good blood sugar, blood pressure and cholesterol control still matter. Injections treat the swelling, not the underlying disease.

Frequently asked questions

What is Vabysmo used for?

Vabysmo (faricimab) treats wet age-related macular degeneration, diabetic macular edema and macular edema after retinal vein occlusion. It is injected into the eye by a retina specialist.

How often do you need Vabysmo injections?

Usually monthly at first, then, for wet AMD and diabetic macular edema, as far apart as every 16 weeks if the eye stays dry. For retinal vein occlusion, injections are typically monthly for 6 months.

What are the most common side effects of Vabysmo?

Cataract (15% in trials) and a red patch on the white of the eye from the injection (8%). Floaters, eye discomfort and a short rise in eye pressure can also occur.

What is retinal vasculitis with Vabysmo?

Inflammation, sometimes with blockage, of the retinal blood vessels, usually alongside inflammation inside the eye. It is rare but can cause permanent vision loss. Report any vision change after an injection right away.

Is Vabysmo better than Eylea?

In trials, vision results with faricimab were similar to aflibercept 2 mg, but many patients could go longer between injections. Eylea has cheaper biosimilars, and a high-dose version (Eylea HD) also allows long intervals.

Does a Vabysmo injection hurt?

Most people feel pressure rather than pain because the eye is numbed first. The eye may feel gritty or sore for a day or two.

Can I drive after a Vabysmo injection?

It is best not to. Your vision may be blurred from dilating drops and the procedure, so arrange for someone to take you home.

References

• FDA. VABYSMO (faricimab-svoa) prescribing information, revised 4/2026
• DailyMed. VABYSMO (faricimab) injection label
• European Medicines Agency. Vabysmo product information
• Heier JS, et al. Efficacy, durability, and safety of intravitreal faricimab up to every 16 weeks for neovascular AMD (TENAYA and LUCERNE). Lancet. 2022;399:729-740
• Wykoff CC, et al. Efficacy, durability, and safety of intravitreal faricimab with extended dosing up to every 16 weeks in diabetic macular oedema (YOSEMITE and RHINE). Lancet. 2022;399:741-755
• Genentech. VABYSMO patient information