When Eylea Isn't Available, What Are Your Options?

If you've been told your retina specialist is out of Eylea — or that your next injection needs to be rescheduled — your first reaction might be worry. That's completely understandable. Eylea (Aflibercept) is a critical treatment for conditions that can threaten your vision, and any delay feels risky.

But here's the reassuring news: Eylea is not the only anti-VEGF medication available. Several proven alternatives treat the same eye conditions, and your retina specialist can help you find the right one. In this guide, we'll explain what Eylea does, how it works, and walk you through the best alternatives available in 2026.

What Is Eylea?

Eylea is the brand name for Aflibercept, a biologic medication made by Regeneron Pharmaceuticals. It's FDA-approved to treat:

• Wet age-related macular degeneration (wet AMD)
• Diabetic macular edema (DME)
• Diabetic retinopathy (DR)
• Macular edema following retinal vein occlusion (RVO)
• Retinopathy of prematurity (ROP)

Eylea has been one of the most widely used eye injection treatments in the world since its FDA approval in 2011. For a complete overview, see our guide on what Eylea is and how it's used.

How Does Eylea Work?

Eylea belongs to a class of drugs called VEGF inhibitors. VEGF stands for vascular endothelial growth factor — a protein your body produces that signals blood vessels to grow. In certain eye conditions, your body produces too much VEGF, leading to:

• Abnormal blood vessel growth under or within the retina
• Fluid leakage that causes swelling (edema)
• Damage to the macula — the part of the retina responsible for sharp, central vision

Eylea works as a "VEGF trap." It's a fusion protein that binds to VEGF-A, VEGF-B, and placental growth factor (PlGF), preventing them from activating their receptors. This slows or stops abnormal vessel growth and reduces swelling, helping preserve your vision.

Eylea is administered as an intravitreal injection — a tiny needle delivers the medication directly into the vitreous (the gel-like substance inside your eye). This is done in your doctor's office and typically takes only a few minutes. For more on how it works, visit our article on Eylea's mechanism of action.

Alternatives to Eylea

The following medications work through similar mechanisms and are used to treat the same or overlapping conditions. Your retina specialist will help determine which is best for your specific situation.

1. Vabysmo (Faricimab-svoa)

Vabysmo is one of the newest anti-VEGF treatments, FDA-approved in 2022 for wet AMD and diabetic macular edema. What makes Vabysmo unique is that it's a bispecific antibody — it targets both VEGF-A and a second protein called angiopoietin-2 (Ang-2). By blocking two pathways instead of one, Vabysmo may provide more durable effects.

Key facts about Vabysmo:

• Can be given every 8 to 16 weeks after initial monthly loading doses
• Clinical trials showed it was as effective as Eylea for wet AMD and DME
• Manufactured by Genentech/Roche
• Cash price is comparable to Eylea (around $1,800 to $2,200 per injection)

Vabysmo has become a popular first-line alternative to Eylea, especially for patients who want longer intervals between injections.

2. Lucentis (Ranibizumab)

Lucentis was one of the first anti-VEGF treatments specifically designed for eye use. It was FDA-approved in 2006 for wet AMD and has since been approved for DME, RVO, and other conditions.

Key facts about Lucentis:

• Targets VEGF-A specifically
• Typically given monthly (every 4 weeks), though some patients can extend to every 8 to 12 weeks
• Manufactured by Genentech/Roche
• Biosimilar versions (like Cimerli and Byooviz) are now available, which may cost less
• Cash price for brand-name Lucentis: approximately $1,800 to $2,000 per injection

Lucentis has a long track record of safety and efficacy. The availability of biosimilars makes it an increasingly accessible option.

3. Avastin (Bevacizumab) — Off-Label Use

Avastin is technically an anti-cancer drug, but it has been widely used off-label for eye conditions since the mid-2000s. It works by binding to VEGF-A, similar to Eylea and Lucentis.

Key facts about Avastin:

• Not FDA-approved for eye conditions (used off-label)
• Must be compounded into smaller doses by a specialty pharmacy for intravitreal injection
• Significantly cheaper: approximately $50 to $100 per injection
• Large clinical trials (CATT, IVAN) showed comparable efficacy to Lucentis for wet AMD
• Manufactured by Genentech/Roche (as a cancer drug)

Avastin is the most affordable anti-VEGF option and is widely used, especially when cost or insurance coverage is a concern. However, because it requires compounding, there are slightly different safety considerations. Your doctor can explain the risks and benefits.

4. Beovu (Brolucizumab-dbll)

Beovu is a newer anti-VEGF treatment FDA-approved for wet AMD in 2019 and for DME in 2022. It's a small, single-chain antibody fragment that can penetrate tissue effectively.

Key facts about Beovu:

• Can be given every 8 to 12 weeks after loading doses
• Manufactured by Novartis
• Some post-marketing reports of intraocular inflammation and retinal vasculitis, which has made some doctors more cautious about prescribing it
• Cash price: approximately $1,800 to $1,900 per injection

Beovu remains an option for patients who don't respond well to other anti-VEGF drugs or who need extended dosing intervals, but your doctor will carefully weigh the benefits against the inflammation risk.

How to Decide Which Alternative Is Right for You

Choosing an alternative to Eylea isn't something you should do on your own. Your retina specialist will consider:

• Your specific diagnosis — Not all alternatives are approved for every condition Eylea treats.
• Your treatment history — How you've responded to Eylea and other medications.
• Dosing schedule — Some alternatives allow for longer intervals between injections.
• Cost and insurance — Your plan may cover some options better than others. Avastin is dramatically cheaper if cost is a major factor.
• Safety profile — Each medication has slightly different side effect risks.

If you're unsure where to start, ask your doctor: "If Eylea isn't available, what would you recommend for my condition, and why?"

Can You Still Get Eylea?

Yes — Eylea is still being manufactured and distributed. The issue is intermittent supply constraints, not a full discontinuation. If you prefer to stay on Eylea, check availability using Medfinder or read our tips on how to find Eylea in stock near you.

Final Thoughts

Not being able to get Eylea is stressful, but you're not without options. Vabysmo, Lucentis, Avastin, and Beovu are all proven treatments that can protect your vision while Eylea supply stabilizes. The most important thing is to not skip treatment. Talk to your retina specialist about the best alternative for your situation, and use Medfinder to stay on top of availability.