Eylea HD

Pronunciation: EYE-lee-AH aitch-dee
Generic name: aflibercept ophthalmic
Dosage form: single-dose vial for injection (8 mg)
Drug class: Anti-angiogenic ophthalmic agents

Medically reviewed by Carmen Pope, BPharm. Last updated on Feb 10, 2025.

What is Eylea HD?

Eylea HD injection is used to treat neovascular (wet) age-related macular degeneration (nAMD), diabetic macular edema (DME), and diabetic retinopathy (DR). This medication is administered directly into the eye (intravitreal injection) by an eye care professional.

The key difference with Eylea HD is its higher concentration (8 mg/0.07 mL) compared with standard Eylea (2 mg/0.05 mL). This higher concentration allows for:

• Longer intervals between treatments for many patients
• Similar efficacy to standard Eylea but with potentially fewer injections needed
• The same mechanism of action but with more sustained therapeutic levels in the eye.

See What is the difference between Eylea and Eylea HD? for more information.

Eylea HD (aflibercept) was approved on August 18, 2023. There is no generic or biosimilar available.

How does Eylea HD work?

Eylea HD works as a VEGF (Vascular Endothelial Growth Factor) inhibitor. VEGF is a signal protein produced by multiple cells that stimulates the growth of new blood vessels.

• Eylea HD binds to the VEGF receptor and blocks VEGF-A and PlGF (Placental Growth Factor) - another blood vessel-promoting protein.
• Clinical trials have shown it reduces abnormal blood vessel growth and leakage in the retina.
• This helps manage conditions like nAMD, DME, and DR.

Eylea HD side effects

The most common side effects of Eylea HD are:

• red or watery eyes
• blurred vision
• swelling of the eyelids
• mild eye pain or discomfort after the injection
• cataracts
• increased eye pressure
• floaters
• vitreous detachment (when the gel-like substance inside your eye starts to pull away from the back of the eye)
• scratches or damage to the clear front part of your eye
• bleeding in the front (conjunctival haemorrhage) or back of your eye (retinal hemorrhage).

Clinical trials have also reported a temporary increase in blood pressure following eye injections (see Does Eylea and Eylea HD raise blood pressure?).

Serious side effects and warnings

Eylea HD may cause an increase in the pressure of the fluids inside the eye (intraocular pressure), usually within 60 minutes of an intravitreal injection.

Temporary visual disturbances may occur following an intravitreal injection with Eylea HD. Do not drive or operate machinery until your vision recovers.

Eylea HD may cause an eye condition called endophthalmitis, which is a serious inflammation of the fluids inside the eye. Retinal detachments have also occurred following eye injections and blood clots in the arteries are also possible. Call your doctor at once if you have eye pain or redness, swelling or puffiness around your eyes, sensitivity to light, or sudden vision problems at any time during treatment. 

Eylea HD may cause an allergic reaction. Get emergency medical help if you have any signs of an allergic reaction such as hives, difficulty breathing, or swelling of your eyes, face, lips, tongue, or throat.

Do not receive an eye injection if you have swelling or redness inside your eyes, or any type of infection (bacterial, fungal, viral) in or around your eyes.

Call your doctor at once if you get any of the following symptoms following an Eylea HD injection:

• eye pain or redness, swelling around your eyes

• sudden vision problems

• seeing flashes of light or "floaters" in your vision, seeing halos around lights

• your eyes may be more sensitive to light

• chest pain

• sudden numbness or weakness, especially on one side of the body

• sudden severe headache, confusion, problems with speech or balance.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Related/similar drugs

Before receiving Eylea HD

You should not receive Eylea HD if you are allergic to aflibercept, Eylea, or any inactive ingredients in these eye injections, or if you are allergic to similar medications, such as Yesafili or Opuviz.

Do not receive Eylea HD if:

• your eyes feel swollen
• you have an infection in or around your eyes.

To make sure this medicine is safe for you, tell your doctor if you:

• have had a blood clot or stroke
• have glaucoma or other conditions that increase pressure inside your eyes
• are pregnant or planning to become pregnant
• are breastfeeding.

It is unknown if this medication affects male or female fertility.

Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant while using Eylea HD. You may need to take a pregnancy test before using Eylea HD if you are a female who can get pregnant.

You should use effective birth control to prevent pregnancy before your first dose of this medicine, during treatment and for at least 4 months after your last Eylea HD injection.

Breastfeeding

Do not breastfeed while you are using Eylea.

How is Eylea HD given?

Eylea HD is given as an injection into your eye.

• Your doctor will use a medicine to numb your eye before giving you the injection.
• You will receive this injection in your doctor's office or other clinic setting.

For a short time after your injection, your eyes will be checked regularly to make sure the injection has not caused any side effects.

Dosing information

The usual recommended adult dose of Eylea HD is 8mg (0.07mL) (one injection) into each affected eye.

Initial Eylea HD dosage: 1 injection every 4 weeks (approximately every 28 days +/- 7 days) for the first 3 months.

Maintenance Eylea HD dosage for DR: 1 injection every 8 to 12 weeks (2 to 3 months).

Maintenance Eylea HD dosage for nAMD and DME: 1 injection every 8 to 16 weeks (2 to 4 months).

What happens if I miss a dose?

Call your doctor to reschedule if you miss an appointment for your Eylea HD injection.

What should I avoid?

Eylea HD may cause blurred vision and may impair your reactions or driving skills. Avoid driving or hazardous activity soon after the injection.

What other drugs will affect Eylea HD?

Interactions with Eylea HD are unlikely but you should tell your doctor about all the medicines you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Eylea HD ingredients

Active: aflibercept 114.3 mg/mL solution

Inactive: a buffer containing arginine hydrochloride (0.737 mg), histidine (0.04 mg), L-histidine hydrochloride monohydrate (0.093 mg), polysorbate 20 (0.021 mg), sucrose (3.5 mg) and water for injection with a pH of 5.8.

Eylea HD does not contain an anti-microbial preservative.

The single-dose glass vial is designed to deliver 0.07 mL (70 microliters) of the solution containing 8 mg of aflibercept.

Who makes Eylea HD?

Eylea HD is manufactured by Regeneron Pharmaceuticals, which is based in Tarrytown, New York. Some other notable drugs from Regeneron include:

Dupixent (dupilumab) - for treating severe eczema, asthma, and certain nasal conditions

Libtayo (cemiplimab) - for treating certain types of skin cancer

Praluent (alirocumab) - for lowering cholesterol

REGEN-COV (casirivimab and imdevimab) - a COVID-19 antibody treatment.

Eylea hd Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There are 2 for Eylea HD.

Eylea interchangeable products

Interchangeable biosimilar products can be dispensed by a pharmacist without the intervention of the prescriber of the reference product.

Pharmacy laws for biosimilar prescribing may vary by state.

Eylea biosimilar products

Biosimilar products can only be dispensed in place of the reference product if the healthcare provider specifically prescribes the biosimilar product by name.

Pharmacy laws for biosimilar prescribing may vary by state

Popular FAQ

More FAQ

• What biosimilars have been approved in the United States?

Further information

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