Anti-Haemophilia Factor
Synonym :
Factor VIII
Mechanism :
Recombinant human coagulation Factor VIIIa is intended for promoting hemostasis by activating the extrinsic pathway of the coagulation cascade.
Indication :
Contraindications :
Coagulation Factor VIIIa (Recombinant) should not be administered to patients with known hypersensitivity to it or any of its components. Plasma level of factor VIII should be monitored during treatment.
Dosing :
The dose for factor VIII must be calculated and adjusted according to the needs of the individual patient. The required dosage may be estimated using the following formula as a guide:
Number of factor VIII units required = Body weight (kg) x desired increase (international units) in factor VIII x 0.5 (% of normal).
Minor haemorrhage:
15 IU/kg loading dose to achieve FVIII C plasma level ~30% of normal; followed by administration of half of loading dose once daily or into 12 hourly doses for 1-2 days if a second infusion necessary.
Moderate haemorrhage:
25 IU/kg loading dose to achieve FVIII: C plasma level ~50% of normal; followed by administration of FVIII: C 15 IU/kg IV every 8-12 hours for 1-2 days to maintain plasma levels of FVIII: C at 30% of normal; Dose repeated daily or every 12 hours for up to 7 days or until adequate would healing achieved.
Severe haemorrhage/major surgery:
40-50 IU/kg loading dose followed by administration of FVIII: C 20-25 IU/kg IV every 8-12 hourly to maintain plasma levels of FVIII: C at 80-100% of normal for 7 days; continue dose once daily or every 12 hourly for up to 7 days to maintain FVIII: C levels at 30% to 50% normal.
Minor surgery:
(Desired factor VIII level = 30-60%) 15-40 IU/kg; dose is dependent upon the procedure, dose can be repeated every 12-24 hours as and when needed.
Major Surgery:
(Desired factor VIII level = 80-100%) 40-50 IU/kg; repeat dose every 8-24 hours.
Always administer at 2 mL/min, with maximum rate of 10 mL/min. Watch for tachycardia.
Adverse Effect :
Factor VIII inhibitor disorder, pyrexia, hemorrhage, injection site reaction, arthralgia, headache, hypertension, hypotension, taste disturbances, nausea, vomiting, pain, edema and rash.
Interaction :
Prothrombin: Simultaneous use of activated prothrombin complex concentrates, or prothrombin complex concentrates should be avoided.
Hepatic Dose :
No dosage adjustments are recommended.