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Antihemophilic Factor/Von Willebrand Factor Dosage

Medically reviewed by Drugs.com. Last updated on Feb 28, 2023.

Usual Adult Dose for Hemophilia A

ALPHANATE(R):
Minor Hemorrhage (large bruises, significant cuts or scrapes, uncomplicated joint hemorrhage):
15 international units factor VIII (FVIII)/kg IV every 12 hours to achieve FVIII plasma level of 30% of normal, until hemorrhage stops and healing has been achieved (1 to 2 days)

Moderate Hemorrhage (nose, mouth, and gum bleeds; dental extractions; hematuria):
25 international units FVIII/kg IV every 12 hours to achieve FVIII plasma level of 50% of normal, until healing has been achieved (2 to 7 days, on average)

Major Hemorrhage (joint hemorrhage, muscle hemorrhage, major trauma, hematuria, intracranial and intraperitoneal bleeding):


Surgery:

HUMATE-P(R):
Minor Hemorrhage (early joint or muscle bleed or severe epistaxis):
15 international units FVIII/kg IV to achieve FVIII plasma level of approximately 30% of normal; one infusion may be sufficient. If needed, half of the initial dose may be given once or twice a day for 1 to 2 days.

Moderate Hemorrhage (advanced joint or muscle bleed; neck, tongue, or pharyngeal hematoma without airway compromise; tooth extraction; severe abdominal pain):

Life-Threatening Hemorrhage (major surgery; gastrointestinal bleeding; neck, tongue, or pharyngeal hematoma with potential for airway compromise; intracranial, intraabdominal, or intrathoracic bleeding; fractures):

Usual Adult Dose for von Willebrand's Disease

TREATMENT OF BLEEDING EPISODES IN VON WILLEBRAND DISEASE (VWD):

HUMATE-P(R):
Type 1, Mild VWD (baseline von Willebrand factor:ristocetin cofactor activity [VWF:RCo] typically greater than 30%):
Minor hemorrhage (if desmopressin is inappropriate) or major hemorrhage (e.g., severe or refractory epistaxis, gastrointestinal [GI] bleeding, central nervous system [CNS] trauma, traumatic hemorrhage):


Type 1, Moderate or Severe VWD (baseline VWF:RCo typically less than 30%):
Minor hemorrhage (e.g., epistaxis, oral bleeding, menorrhagia): 40 to 50 international units VWF:RCo/kg IV (1 or 2 doses)
Major hemorrhage (e.g., severe or refractory epistaxis, GI bleeding, CNS trauma, hemarthrosis, traumatic hemorrhage):

Types 2 (all variants) and 3 VWD:
Minor hemorrhage (clinical indications above): 40 to 50 international units VWF:RCo/kg IV (1 or 2 doses).
Major hemorrhage (clinical indications above):

WILATE(R):
Minor Hemorrhage:
Loading dose: 20 to 40 international units VWF:RCo/kg IV
Maintenance dose: 20 to 30 international units VWF:RCo/kg IV every 12 to 24 hours for up to 3 days, keeping VWF:RCo and FVIII troughs greater than 30%
Comments: In VWD type 3 patients, especially those with GI bleeding, higher doses may be required.

Major Hemorrhage:
Loading dose: 40 to 60 international units VWF:RCo/kg IV
Maintenance dose: 20 to 40 international units VWF:RCo/kg IV every 12 to 24 hours for 5 to 7 days, keeping VWF:RCo and FVIII troughs greater than 50%
Comments: In VWD type 3 patients, especially those with GI bleeding, higher doses may be required.

PREVENTION OF EXCESSIVE BLEEDING DURING AND AFTER SURGERY IN VWD:

ALPHANATE(R):
Minor and Major Surgery/Bleeding (except type 3 VWD patients undergoing major surgery):
Preoperative dose: 60 international units VWF:RCo/kg IV

Maintenance dose:

Comments:

HUMATE-P(R):
Emergency Surgery:
Loading dose: 50 to 60 international units VWF:RCo/kg IV to achieve VWF:RCo of 100 international units/dL and FVIII:C of 80 to 100 international units/dL

Comments: Closely monitor trough coagulation factor levels.

Nonemergency Surgery:
Loading dose calculation (to be administered 1 to 2 hours before surgery): (Target peak VWF:RCo - baseline VWF:RCo) x body weight (kg) / in vivo recovery (IVR) = international units VWF:RCo required. If IVR is not available, assume an IVR of 2 international units/dL per international unit/kg of VWF:RCo administered.

IVR calculation:
1. Measure baseline VWF:RCo.
2. Infuse a calculated dose of VWF:RCo at time 0.
3. At time + 30 minutes, measure VWF:RCo. IVR = (VWF:RCo at time + 30 min - VWF:RCo at baseline) / calculated dose (international units/kg).

Loading dose peak targets:

Maintenance dose: Half the initial loading dose IV generally every 8 or 12 hours (patients with shorter half-lives may require every 6 hours); subsequent dosing should be based on VWF:RCo and FVIII levels

Comments:

Usual Pediatric Dose for Hemophilia A

ALPHANATE(R):
Minor Hemorrhage (large bruises, significant cuts or scrapes, uncomplicated joint hemorrhage):
15 international units factor VIII (FVIII)/kg IV every 12 hours to achieve FVIII plasma level of 30% of normal, until hemorrhage stops and healing has been achieved (1 to 2 days)

Moderate Hemorrhage (nose, mouth, and gum bleeds; dental extractions; hematuria):
25 international units FVIII/kg IV every 12 hours to achieve FVIII plasma level of 50% of normal, until healing has been achieved (2 to 7 days, on average)

Major Hemorrhage (joint hemorrhage, muscle hemorrhage, major trauma, hematuria, intracranial and intraperitoneal bleeding):


Surgery:

Usual Pediatric Dose for von Willebrand's Disease

TREATMENT OF BLEEDING EPISODES IN VON WILLEBRAND DISEASE (VWD):

HUMATE-P(R):
Type 1, Mild VWD (baseline von Willebrand factor:ristocetin cofactor activity [VWF:RCo] typically greater than 30%):
Minor hemorrhage (if desmopressin is inappropriate) or major hemorrhage (e.g., severe or refractory epistaxis, gastrointestinal [GI] bleeding, central nervous system [CNS] trauma, traumatic hemorrhage):


Type 1, Moderate or Severe VWD (baseline VWF:RCo typically less than 30%):
Minor hemorrhage (e.g., epistaxis, oral bleeding, menorrhagia): 40 to 50 international units VWF:RCo/kg IV (1 or 2 doses)
Major hemorrhage (e.g., severe or refractory epistaxis, GI bleeding, CNS trauma, hemarthrosis, traumatic hemorrhage):

Types 2 (all variants) and 3 VWD:
Minor hemorrhage (clinical indications above): 40 to 50 international units VWF:RCo/kg IV (1 or 2 doses).
Major hemorrhage (clinical indications above):

WILATE(R):
Minor Hemorrhage:
Loading dose: 20 to 40 international units VWF:RCo/kg IV
Maintenance dose: 20 to 30 international units VWF:RCo/kg IV every 12 to 24 hours for up to 3 days, keeping VWF:RCo and FVIII troughs greater than 30%
Comments: In VWD type 3 patients, especially those with GI bleeding, higher doses may be required.

Major Hemorrhage:
Loading dose: 40 to 60 international units VWF:RCo/kg IV
Maintenance dose: 20 to 40 international units VWF:RCo/kg IV every 12 to 24 hours for 5 to 7 days, keeping VWF:RCo and FVIII troughs greater than 50%
Comments: In VWD type 3 patients, especially those with GI bleeding, higher doses may be required.

PREVENTION OF EXCESSIVE BLEEDING DURING AND AFTER SURGERY IN VWD:

ALPHANATE(R):
Minor and Major Surgery/Bleeding (except type 3 VWD patients undergoing major surgery):
Preoperative dose: 75 international units VWF:RCo/kg IV

Maintenance dose:

Comments:

HUMATE-P(R):
Emergency Surgery:
Loading dose: 50 to 60 international units VWF:RCo/kg IV to achieve VWF:RCo of 100 international units/dL and FVIII:C of 80 to 100 international units/dL

Comments: Closely monitor trough coagulation factor levels.

Nonemergency Surgery:
Loading dose calculation (to be administered 1 to 2 hours before surgery): (Target peak VWF:RCo - baseline VWF:RCo) x body weight (kg) / in vivo recovery (IVR) = international units VWF:RCo required. If IVR is not available, assume an IVR of 2 international units/dL per international unit/kg of VWF:RCo administered.

IVR calculation:
1. Measure baseline VWF:RCo.
2. Infuse a calculated dose of VWF:RCo at time 0.
3. At time + 30 minutes, measure VWF:RCo. IVR = (VWF:RCo at time + 30 min - VWF:RCo at baseline) / calculated dose (international units/kg).

Loading dose peak targets:

Maintenance dose: Half the initial loading dose IV generally every 8 or 12 hours (patients with shorter half-lives may require every 6 hours); subsequent dosing should be based on VWF:RCo and FVIII levels

Comments:

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Safety and efficacy of Humate-P(R) have not been established in hemophilia A patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice: The manufacturer product information should be consulted.

Storage requirements: The manufacturer product information should be consulted.

Reconstitution/preparation techniques: The manufacturer product information should be consulted.

IV compatibility:


General:

Monitoring: The manufacturer product information should be consulted.

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.