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Q. Mansoor, S. Agrawal, S. Morgan; Quantitative Estimation of Ranibizumab Dose Delivered in the Treatment of Choroidal Neovascular Membranes. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2371.
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To estimate the dose of Ranibizumab given by intravitreal injection using syringe and separate needle as supplied by Novartis for use in the United Kingdom.
0.05ml solution of Ranibizumab contains 0.5 mg Ranibizumab. A total of 100 measurement values were taken by filling 1 ml syringe (BD Plastipak, Becton Dickinson S.A. Madrid Spain) with distilled water using 18G 1 ½" BD Blunt Fill Needle-Filter. Air was expelled from syringe and 30G ½" BD Microlance 3 needle was placed on syringe. Fluid was expelled until plunger is advanced to 0.05ml mark. The fluid was instilled directly over plastic tray on GR-120 Analytical Balance (A&D Company Limited, Tokyo) and the mass reading was noted.
The mass of water delivered using this standard technique had a mean of 55.86mg (range 37.10mg to 66.10mg), standard deviation 3.99mg, P= 0.02.
The recommended dose of Ranibizumab for the treatment of wet macular degeneration is 0.5 mg, injected into the eye once a month.The above results demonstrate the variability of dosages given to patients using this standard method of delivering intravitreal Ranibizumab. Results suggest that we routinely deliver doses 12% greater than planned. Higher doses of Ranibizumab have been linked previously with increased risk of adverse events.
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