Cimerli is a brand-name prescription medication. It’s FDA-approved to treat the following eye conditions in adults:

All of these conditions involve changes in your macula or retina. (The macula is an area in the center of the retina. The retina is a thin layer of tissue that covers the back of your eye.) For more details about these conditions and how Cimerli is used to treat them, see the “Cimerli uses” section below.

Drug details

The active ingredient in Cimerli is ranibizumab-eqrn. The reason “-eqrn” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.

Cimerli belongs to a drug class called vascular endothelial growth factor inhibitors.

Cimerli is given as an injection into the eye by a healthcare professional.

The drug comes as a solution in a single-dose vial. Cimerli comes in two strengths:

  • 0.5 milligrams (mg) in 0.05 milliliters (mL) of solution
  • 0.3 mg/0.05 mL

FDA approval

The Food and Drug Administration (FDA) approved Cimerli in August 2022.

Effectiveness

For information about the effectiveness of Cimerli, see the “Cimerli uses” section below.

Cimerli contains ranibizumab-eqrn as its active ingredient. Cimerli is a biosimilar version of ranibizumab (Lucentis).

A biosimilar is a drug that’s similar to a brand-name biologic medication (the reference drug). Cimerli is a biologic drug, which is also called a biologic.

Biologic drugs are made from living cells, so it isn’t possible to copy these drugs exactly. In contrast, a generic refers to drugs made from chemicals. And a generic is an exact copy of the active drug in a brand-name medication.

Biosimilars are considered to be just as safe and effective as their reference drug. And like generics, biosimilars tend to cost less than brand-name medications.

Specifically, the Food and Drug Administration (FDA) describes Cimerli as “interchangeable” with Lucentis (the reference drug) for all its approved uses. This means that clinical data has proven Cimerli to be just as safe and effective as Lucentis.

You may have noticed the suffix “-eqrn” at the end of Cimerli’s active ingredient name. This suffix is specific to the active ingredient in Cimerli and distinguishes it from other drugs, including:

  • ranibizumab (Lucentis), the reference drug
  • ranibizumab-nuna (Byooviz), a biosimilar

If you’re interested in a medication that’s similar to Cimerli, talk with your doctor. They can tell you more about similar drugs that can be used to treat your condition.

As with all medications, the cost of Cimerli can vary. The actual price you’ll pay depends on factors such as your insurance plan. The cost also depends on the price your healthcare professional charges for administering the drug. (Cimerli is an injection that’s given by a healthcare professional.)

Before approving coverage for Cimerli, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Cimerli, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Cimerli, or if you need help understanding your insurance coverage, help is available.

Programs called Cimerli Co-Pay Savings Program and Patient Assistance Program are available for Cimerli. For more information and to find out whether you’re eligible for support, call 844-483-3692 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

Biosimilar form

Cimerli contains ranibizumab-eqrn as its active ingredient. Cimerli is a biosimilar version of ranibizumab (Lucentis).

A biosimilar is a drug that’s similar to a brand-name biologic medication (the reference drug). Cimerli is a biologic drug, which is also called a biologic.

Biologic drugs are made from living cells, so it isn’t possible to copy these drugs exactly. In contrast, a generic refers to drugs made from chemicals. And a generic is an exact copy of the active drug in a brand-name medication.

Biosimilars are considered to be just as safe and effective as their reference drug. And like generics, biosimilars tend to cost less than brand-name medications.

The Cimerli dosage your doctor prescribes depends on several factors. These include the type and severity of the condition being treated with Cimerli.

The following information describes dosages that are commonly used or recommended. However, your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Cimerli is given as an injection into the eye by a healthcare professional.

The drug comes as a solution in a single-dose vial. Cimerli comes in two strengths:

  • 0.5 milligrams (mg) in 0.05 milliliters (mL) of solution
  • 0.3 mg/0.05 mL

Dosage for wet age-related macular degeneration

For wet age-related macular degeneration (AMD), the typical dosage is one injection of 0.5 mg/0.05 mL once per month (about every 28 days).

Besides monthly dosing, your doctor may recommend a less frequent dosing schedule for Cimerli, such as:

  • one dose per month for 3 months, then less frequent dosing based on the results of your vision exams
  • one dose per month for 4 months, then one dose every 3 months

However, compared with once-monthly dosing, these dosing schedules may not be as effective for maintaining your visual acuity (the sharpness of your vision). Your ophthalmologist (eye specialist) will help determine the dosing schedule that’s best for you.

Dosage for macular edema following retinal vein occlusion

For macular edema following retinal vein occlusion, the typical dosage is one injection of 0.5 mg/0.05 mL once per month (about every 28 days).

Dosage for diabetic macular edema

For diabetic macular edema, the typical dosage is one injection of 0.3 mg/0.05 mL once per month (about every 28 days).

Dosage for diabetic retinopathy

For diabetic retinopathy, the typical dosage is one injection of 0.3 mg/0.05 mL once per month (about every 28 days).

Dosage for myopic choroidal neovascularization

For myopic choroidal neovascularization, the typical dosage is one injection of 0.5 mg/0.05 mL once per month (about every 28 days) for up to 3 months.

In some cases, you may need to repeat this treatment. Your doctor will help determine the number of doses that’s right for you.

What if I miss a dose?

If you miss an appointment to have your Cimerli injection, call your ophthalmologist as soon as possible to reschedule.

To help make sure that you don’t miss a dose, be sure to note your appointment on your calendar. You could also download a reminder app on your phone.

Will I need treatment with this drug long term?

It depends on the reason your doctor prescribed Cimerli.

For myopic choroidal neovascularization, Cimerli is typically a short-term treatment. For the drug’s other uses, Cimerli is meant to be a long-term treatment. (These other uses include wet AMD, macular edema following retinal vein occlusion, diabetic macular edema, and diabetic retinopathy.)

Your doctor will help determine the length of treatment that’s right for you.

Cimerli can cause mild or serious side effects. The following lists contain some of the key side effects that may occur during treatment with Cimerli. These lists do not include all possible side effects.

For more information about the possible side effects of Cimerli, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Cimerli, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Cimerli. To learn about other mild side effects, talk with your doctor or pharmacist, or view Cimerli’s prescribing information.

Mild side effects of Cimerli can include:

  • a red spot on the surface of your eye caused by bleeding from a minor blood vessel
  • eye pain
  • seeing floaters (squiggly lines or moving spots in your vision)
  • eye irritation
  • feeling as though something is in your eye
  • dry eye
  • watery eyes
  • nasopharyngitis (inflammation of the nasal passages and throat)
  • mild allergic reaction*

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Cimerli, see “Allergic reaction” below.

Serious side effects

Serious side effects from Cimerli are rare. However, they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Endophthalmitis (infection inside the eyeball). Symptoms can include:
    • eye pain
    • eyelid swelling
    • decreased vision
    • eye redness
  • Retinal detachment (separation of the retina from the back of your eye). Symptoms can include:
    • seeing flashes of light in your peripheral vision
    • seeing more floaters than is typical for you
    • shadowy vision
  • A temporary increase in intraocular pressure (pressure in your eye). This doesn’t typically cause symptoms. Your doctor will measure your intraocular pressure at each Cimerli injection appointment.
  • Increased risk of blood clots in arteries, which may cause a stroke, heart attack, or blood vessel problems. Stroke and heart attack symptoms may include:
    • chest pain
    • pain in your left arm
    • confusion
  • Severe allergic reaction.*

* For details about allergic reaction and Cimerli, see “Allergic reaction” below.

ALLERGIC REACTION

As with most drugs, some people can have an allergic reaction after taking Cimerli. Allergic reactions rarely occurred in Cimerli’s clinical trials.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare. However, it is possible. Symptoms of a severe allergic reaction can include:

  • swelling in your eye
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Cimerli, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

The Food and Drug Administration (FDA) approves prescription drugs such as Cimerli to treat certain conditions.

Cimerli is FDA-approved to treat the following eye conditions in adults:

All of these conditions involve changes in your macula or retina. The macula is an area in the center of the retina, and the retina is a thin layer of tissue that covers the back of your eye.

For more details about how Cimerli is used to treat these conditions, continue reading just below. You can also refer to our eye health hub to learn more about vision health.

Cimerli for wet AMD

Cimerli is FDA-approved to treat wet AMD in adults. The condition may also be referred to as neovascular (a medical term that means new blood vessels) or exudative (a medical term for “leaky”) macular degeneration.

Wet AMD explained

Wet AMD occurs when new, leaky blood vessels grow under the macula. These blood vessels grow very quickly. The fluid builds up and causes the macula to swell, leading to a sudden onset of symptoms.

Symptoms of wet AMD typically start in one eye and eventually affect both eyes. Symptoms may include:

  • blurred vision
  • trouble seeing in dim light
  • wavy or distorted vision when you look straight ahead
  • faded-looking colors

Without the correct treatment, wet AMD may lead to central vision loss (inability to see objects straight ahead). Wet AMD does not affect your peripheral vision (your ability to see objects off to the sides).

Wet AMD is a progressive condition, meaning that it typically gets worse with time. Treatments such as Cimerli are available to help slow the progression of wet AMD.

Effectiveness for wet AMD

In clinical trials, Cimerli was shown to be an effective treatment for wet AMD. For details on how the drug performed in these trials, see Cimerli’s prescribing information.

Cimerli is a vascular endothelial growth factor inhibitor (anti-VEGF) drug that’s given as an intravitreal injection.* The American Academy of Ophthalmology recommends intravitreal injection of an anti-VEGF drug as the first-choice treatment option for wet AMD.

* An intravitreal injection is an injection given into the eye by a healthcare professional.

Cimerli for macular edema following retinal vein occlusion

Cimerli is FDA-approved to treat macular edema after retinal vein occlusion in adults. A retinal vein occlusion may also be referred to as an “eye stroke.”

Macular edema following retinal vein occlusion explained

Macular edema may occur after a retinal vein occlusion. A retinal vein occlusion involves the blocking of a blood vessel in the eye by a blood clot or narrowing of the blood vessel over time. The blockage or narrowing may cause blood or fluid to enter the retina, leading to swelling of the macula.

Symptoms of macular edema after retinal vein occlusion typically affect one eye. Symptoms may include:

  • a sudden change or loss of vision in one eye
  • vision getting worse over time

Without the correct treatment, macular edema after retinal vein occlusion may lead to permanent vision loss in the affected eye. Treatments such as Cimerli are available to help reduce the swelling in the macula.

Effectiveness for macular edema following retinal vein occlusion

In clinical trials, Cimerli was shown to be an effective treatment for macular edema following retinal vein occlusion. For details on how the drug performed in these trials, see Cimerli’s prescribing information.

Cimerli is a vascular endothelial growth factor inhibitor (anti-VEGF) drug that’s given as an intravitreal injection.* The American Academy of Ophthalmology recommends intravitreal injection of an anti-VEGF drug as the first-choice treatment option for macular edema resulting from retinal vein occlusion.

* An intravitreal injection is an injection given into the eye by a healthcare professional.

Cimerli for diabetic macular edema

Cimerli is FDA-approved to treat diabetic macular edema (DME) in adults.

DME explained

With DME, a high level of blood sugar damages the blood vessels of the eye. This damage causes the blood vessels to become leaky. As fluid leaks out into the macula, the macula starts to swell. As the swelling increases, symptoms may begin.

Symptoms may include:

  • blurred or wavy central vision (ability to see objects straight ahead)
  • trouble reading
  • colors appearing faded

Without the correct treatment, DME may lead to reduced vision or blindness. Several treatment options are available to help maintain a healthy blood sugar level. And medications such as Cimerli are available to help manage the symptoms of DME.

Effectiveness for DME

In clinical trials, Cimerli was shown to be an effective treatment for DME. For details on how the drug performed in these trials, see Cimerli’s prescribing information.

Cimerli is a vascular endothelial growth factor inhibitor (anti-VEGF) drug that’s given as an intravitreal injection.* The American Academy of Ophthalmology recommends intravitreal injection of an anti-VEGF drug as the first-choice treatment option for DME.

* An intravitreal injection is an injection given into the eye by a healthcare professional.

Cimerli for diabetic retinopathy

Cimerli is FDA-approved to treat an eye condition called diabetic retinopathy in adults.

Diabetic retinopathy explained

Diabetic retinopathy is a complication of diabetes. Over time, blood vessels in the eye become damaged when exposed to a high level of sugar in the blood.

Symptoms of diabetic retinopathy will likely affect both eyes, although not always with the same severity. Symptoms may include:

  • blurred vision
  • floaters (squiggly lines or moving spots in your vision)
  • streaks or patches blocking the field of vision
  • reduced night vision
  • a sudden, total loss of vision

Without treatment, diabetic retinopathy may lead to a detached retina (when the retina pulls away from the back of your eye) and vision loss.

Diabetic retinopathy is a progressive condition, meaning that it typically gets worse with time. Treatments such as Cimerli are available to help slow the progression and reduce the risk of complications.

Effectiveness for diabetic retinopathy

In clinical trials, Cimerli was shown to be an effective treatment for diabetic retinopathy. For details on how the drug performed in these trials, see Cimerli’s prescribing information.

Cimerli is a vascular endothelial growth factor inhibitor (anti-VEGF) drug that’s given as an intravitreal injection.* The American Academy of Ophthalmology recommends intravitreal injection of an anti-VEGF drug as the first-choice treatment option for diabetic retinopathy.

* An intravitreal injection is an injection given into the eye by a healthcare professional.

Cimerli for myopic choroidal neovascularization

Cimerli is FDA-approved to treat an eye condition called myopic choroidal neovascularization (mCNV) in adults.

mCNV explained

Myopia is an extreme form of nearsightedness. A possible complication of myopia is mCNV, which is the formation of new, defective blood vessels in the eye. These blood vessels grow very quickly and tend to leak fluid or blood.

Symptoms of mCNV may occur in either one or both eyes. Symptoms may include:

  • blurred vision
  • wavy or distorted vision when you look straight ahead
  • blind spots in the center of your field of vision

mCNV is a progressive condition, meaning that it typically gets worse with time. Without the correct treatment, mCNV may lead to vision loss. Treatments such as Cimerli are available to help slow the progression of mCNV.

Effectiveness for mCNV

In clinical trials, Cimerli was shown to be an effective treatment for mCNV. For details on how the drug performed in these trials, see Cimerli’s prescribing information.

Cimerli is a vascular endothelial growth factor inhibitor (anti-VEGF) drug that’s given as an intravitreal injection.* The American Academy of Ophthalmology recommends intravitreal injection of an anti-VEGF drug as the first-choice treatment option for mCNV.

* An intravitreal injection is an injection given into the eye by a healthcare professional.

Cimerli and children

It’s not known whether Cimerli is safe or effective in children. The drug isn’t approved for use in children.

There are no known interactions between Cimerli and alcohol.

If you drink alcohol, ask your doctor how much is safe to drink while you’re receiving treatment with Cimerli.

Cimerli is not known to interact with other medications, herbs, supplements, or foods.

However, this doesn’t mean that interactions won’t be recognized in the future. For example, new drugs could become available that interact with Cimerli.

Before starting Cimerli treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Your ophthalmologist (eye specialist) will give you Cimerli as an injection into your eye. You’ll receive Cimerli at your ophthalmologist’s office.

Before you receive your injection, your ophthalmologist will check your intraocular pressure (the pressure inside your eye). They will also administer medications to prepare your eye for the injection. This typically includes a local anesthetic to numb your eye and an antimicrobial drug to help prevent infection. Then your ophthalmologist will inject Cimerli into your eye using a very thin needle.

Cimerli may cause temporary increases in intraocular pressure, among other side effects. After the injection, your ophthalmologist will monitor you for side effects. This includes rechecking the pressure in your eye 30 minutes after the injection. They may also use special equipment to check the blood flow in your eye.

Your ophthalmologist will tell you how often you’ll receive doses of Cimerli. The typical dosing schedule is one injection once per month (about every 28 days). They’ll also determine whether short-term or long-term treatment is right for your condition.

Cimerli contains the active ingredient ranibizumab-eqrn. It belongs to a drug class called vascular endothelial growth factor (VEGF) inhibitors, also known as anti-VEGFs.

VEGF is a protein that stimulates the growth of new blood vessels. With certain eye conditions, these new blood vessels are defective and leaky. As blood and fluid leak out of these defective blood vessels, certain areas in your eyeball begin to swell. These include the retina (a thin layer of tissue that covers the back of your eye) and specifically the macula (an area in the center of the retina).

This swelling causes damage to your retina and macula, leading to vision problems. Without treatment, vision loss may occur.

Anti-VEGF drugs, including Cimerli, work by blocking the VEGF protein. These drugs help to stop the growth of new, leaky blood vessels with the goal of reducing the fluid buildup and swelling in your eye. Anti-VEGF drugs also help to improve or preserve eyesight in people with certain eye conditions.

How long does it take to work?

Cimerli starts working from the first dose. Some people have decreased swelling inside their eye within 7 days to a few months after starting Cimerli treatment. It may take 3 to 4 doses before you notice better vision.

However, you may not notice any improvement in your vision. This doesn’t mean the drug isn’t working. Cimerli is used to help slow the progression of certain eye conditions. This means it can help prevent your vision from getting worse.

Your ophthalmologist (eye specialist) will do eye exams regularly to check how well Cimerli is working for your condition.

It’s unknown whether it’s safe to receive Cimerli treatment during pregnancy. The drug hasn’t been clinically trialed in pregnant people.

In animal studies, abnormal bone development occurred in fetuses when the drug was given at very high doses to pregnant animals. However, animal studies don’t always indicate what may happen in humans.

Cimerli typically isn’t used during pregnancy unless you and your doctor determine that the benefits outweigh the risks.

If you’re pregnant or planning to become pregnant, tell your ophthalmologist (eye specialist) before starting Cimerli treatment. They’ll discuss the available treatment options with you.

Cimerli and fertility

Cimerli may affect fertility. However, this isn’t known for sure.

If you plan to have children, talk with your ophthalmologist before you start receiving Cimerli. They’ll help determine the right treatment for your condition.

It’s not known whether Cimerli is safe to receive during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re receiving Cimerli.

For more information about receiving Cimerli during pregnancy, see the “Cimerli and pregnancy” section above.

It’s not known whether Cimerli is safe to receive while breastfeeding. This drug’s use while breastfeeding hasn’t been clinically trialed.

If you’re breastfeeding or planning to breastfeed, tell your doctor before starting Cimerli. They can discuss the best treatment plan for your eye condition and also recommend healthy ways to feed your child.

Here are answers to some frequently asked questions about Cimerli.

Does Cimerli cause long-term side effects?

It’s not common. Most of Cimerli’s potential side effects are temporary. These temporary side effects can include eye pain or irritation.

In rare cases, Cimerli may cause serious side effects that affect long-term health. For example, Cimerli treatment may increase the risk of blood clots in arteries. Blood clots can cause serious health problems such as heart attack and stroke.

If you have questions about long-term side effects with Cimerli, talk with your doctor.

Will Cimerli cure macular degeneration?

No, it won’t. Cimerli is used to treat wet age-related macular degeneration (AMD), among other eye conditions. However, it’s not a cure. Instead, Cimerli works to reduce the symptoms and slow the progression of these conditions.

Cimerli belongs to a drug class called vascular endothelial growth factor (VEGF) inhibitors, also known as anti-VEGFs. VEGF is a protein that stimulates the growth of new blood vessels. With certain eye conditions, these new blood vessels are defective and leaky.

Anti-VEGF drugs, including Cimerli, work by blocking the VEGF protein. These drugs help to stop the growth of new, leaky blood vessels with the goal of reducing fluid buildup and swelling in your eye. Anti-VEGF drugs also help to improve or preserve eyesight in people with wet AMD and other specific eye conditions.

If you have questions about Cimerli for wet AMD or other eye conditions, talk with your doctor.

Can Cimerli make my vision worse?

No, Cimerli is used to improve your vision or help prevent your vision from getting worse. If your vision is getting worse during treatment with Cimerli, this may be caused by your eye condition.

After receiving a dose of Cimerli, you may experience mild side effects. Common examples include eye pain or irritation, floaters in your vision, and red spots on the surface of your eye caused by bleeding from a minor blood vessel. However, these side effects are typically temporary and shouldn’t affect your vision.

Your ophthalmologist (eye specialist) will do eye exams regularly throughout your Cimerli treatment to monitor for changes in your vision.

If you have questions about your vision and treatment with Cimerli, talk with your doctor.

This drug comes with several precautions. These are known as drug-condition interactions.

Before taking Cimerli, talk with your doctor about your health history. Cimerli may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Infection of the eye or eye area. In rare cases, Cimerli may cause endophthalmitis (infection inside the eyeball). If you already have an infection in your eye or eye area, you may be at higher risk of this side effect. Before receiving Cimerli, tell your doctor about any eye symptoms that may be a sign of infection, such as eye itching or redness. Doctors typically won’t give Cimerli if you have an infection in your eye or around your eye (called a periocular infection). Instead, they will likely recommend treatment for the infection. Once the infection is managed, you may be able to receive Cimerli.
  • Allergic reaction. If you’ve had an allergic reaction to Lucentis, Cimerli, or any of its ingredients, your doctor will likely not prescribe Cimerli. Ask your doctor what other medications may be better options for you.
  • Pregnancy. It’s not known whether Cimerli is safe during pregnancy. For more information, see the “Cimerli and pregnancy” section above.
  • Breastfeeding. It’s not known whether Cimerli is safe while breastfeeding. For more information, see the “Cimerli and breastfeeding” section above.

Note: For more information about the potential negative effects of Cimerli, see the “Cimerli side effects” section above.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.