How does this medication work? What will it do for me?

Pegaptanib belongs to the class of medications called antivascular endothelial growth factors. It is used to treat "wet," age-related macular degeneration, a condition where blood vessels behind the retina start to grow and leak blood and fluid. This causes damage to the macula (the centre of the retina) and results in central vision loss that can occur quickly. Pegaptanib helps to slow down vision loss and may improve vision by stopping the growth and leakage of new blood vessels in the eye.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

What form(s) does this medication come in?

Macugen is no longer being manufactured for sale in Canada. For brands that may still be available, search under pegaptanib. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

This medication is given by injection into the eye by your doctor (usually an eye doctor) under a local anesthetic.

The usual dose of pegaptanib is 0.3 mg injected into the eye once every 6 weeks. Your doctor may ask you to use antibiotic eye drops for a few days before and after each injection to prevent infection.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive pegaptanib, contact your doctor as soon as possible to reschedule your appointment.

Store this medication in the refrigerator and do not allow it to freeze. It should be protected from light and kept out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to pegaptanib or to any of the ingredients of the medication
  • have or are suspected to have an infection in or around the eye

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dry eye
  • eye discharge
  • eye irritation, itching, or discomfort
  • eyelid swelling, irritation, or inflammation
  • feeling of having something in the eye
  • headache
  • increased blood pressure
  • increased tear production
  • muscle or joint pain
  • nasal discharge
  • reaction at the injection site (e.g., irritation, itching, swelling)
  • temporary blurred vision or vision changes

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • bloodshot eye
  • eye straining
  • clouding of the lens (cataract)
  • excessive eye discharge
  • increased pressure in the eye
  • persistent blurred vision
  • pain or redness in the eye
  • symptoms of an eye infection (e.g., eye discharge, redness, inflammation)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • decreased vision or blindness
  • difficulty moving the eye
  • eye bleeding
  • increased eye discomfort
  • increased sensitivity to light
  • small particles ("floaters") or spots in vision
  • symptoms of a severe allergic reaction (e.g., swelling of face, throat, or tongue; hives; difficulty breathing; rapid pulse; nausea or vomiting)
  • worsening eye redness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Eye problems: Pegaptanib can cause eye problems after injections such as infection of the inside part of the eye; pain, redness, or inflammation; detachment or tear of the retina; or clouding of the lens. Contact your doctor immediately if you experience any of the following:

  • blurred or reduced vision
  • eye pain
  • increased eye discomfort
  • increased sensitivity of the eyes to light
  • an increase in the number of small particles in your vision
  • worsening eye redness

Increased eye pressure: Pegaptanib can increase the pressure in the eye for a short period of time after it is injected. Your doctor will do tests to make sure the pressure in your eye is not elevated persistently after treatment.

Kidney and liver problems: If you have decreased kidney or liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vision problems: Pegaptanib can cause temporary vision problems, which may affect the ability to drive or operate machines. If you experience vision problems, do not drive or operate machines until your vision returns to normal.

Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if pegaptanib passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.