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Emicizumab

Generic Name: emicizumab (EM a SIZ ue mab)
Brand Name: Hemlibra

Medically reviewed: December 5, 2017

What is emicizumab?

Emicizumab is a monoclonal antibody that functions in place of a natural blood-clotting factor that is missing in people with hemophilia A. Emicizumab works as a "bridge" between other clotting factors to replace missing factor VIII.

Emicizumab is for adults and children with hemophilia A and factor VIII inhibitors. Emicizumab is used to help prevent bleeding episodes or make them occur less often.

Emicizumab will not stop a bleeding episode that has already begun.

Emicizumab may also be used for purposes not listed in this medication guide.

Important Information

Emicizumab can cause unwanted blood clots when used together with a bypassing agent such as FEIBA. This can damage small blood vessels in your arms and legs, brain, kidneys, lungs, or other organs.

Tell your doctor if you use a bypassing agent. You will most likely need to stop using it the day before you begin using emicizumab.

If you use emicizumab and a bypassing agent together, call your doctor at once if you have any of these symptoms: weakness, confusion, stomach or back pain, vomiting, decreased urination, chest pain, trouble breathing, coughing up blood, swelling or redness in your arms or legs, eye pain, or vision problems.

Before taking this medicine

You should not use emicizumab if you are allergic to it.

Tell your doctor if you use a bypassing agent such as FEIBA (or "aPCC"; activated prothrombin complex concentrate). Emicizumab can cause unwanted blood clots when used together with aPCC. These blood clots can damage small blood vessels in your arms and legs, brain, kidneys, lungs, or other organs.

You will most likely need to stop using bypassing agents the day before you begin using emicizumab. You may need to limit your dose to more than 100 units/kilogram per 24 hours if your doctor tells you to keep using a bypassing agent during treatment with emicizumab. Follow all instructions carefully.

Follow your doctor's instructions about using emicizumab if you are pregnant. It is not known whether this medicine will harm an unborn baby. Control of bleeding episodes is very important during pregnancy. The benefit of preventing these episodes may outweigh any risks to the baby.

If you are not pregnant, use effective birth control to prevent pregnancy while using this medicine.

It is not known whether emicizumab passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

How is emicizumab given?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Emicizumab is injected under the skin, once per week. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

You will need a syringe and needle to draw emicizumab out of the vial (bottle). You will need a separate needle to inject the medicine into your skin. Use only the type of syringe and needles recommended by your pharmacist to inject emicizumab.

Your care provider will show you the best places on your body to inject emicizumab. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Do not shake the medication bottle. Prepare your dose only when you are ready to give an injection. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

Do not allow a child younger than 7 years old to self-inject this medicine without help from an adult.

Emicizumab can interfere with certain blood-clotting tests. Tell any doctor who treats you that you are using emicizumab.

Store this medicine in the original carton in a refrigerator, do not freeze.

You may store an unopened vial (bottle) at room temperature for a short time. If not used within 7 days, return the vial to the refrigerator.

Once you open and puncture the vial, use the medicine right away. Do not save it for later use. Throw it away after one use, even if there is still medicine left inside.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Then go back to your usual once-weekly schedule and use the next dose on your regular injection day. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using emicizumab?

Avoid injecting this medicine into a mole or into skin that is scarred, bruised, red, tender, hard, or broken.

Emicizumab side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

If you also use a bypassing agent, call your doctor right away if you have any of these side effects:

  • headache, weakness, confusion;

  • feeling light-headed or unusually sick;

  • back pain, little or no urination;

  • stomach pain, vomiting;

  • chest pain, feeling short of breath, coughing up blood;

  • swelling or redness in your arms or legs;

  • eye pain or swelling, vision problems;

  • numbness in your face; or

  • yellowing of your skin or eyes.

Common side effects may include:

  • headache;

  • joint pain; or

  • pain, swelling, burning, or irritation where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Emicizumab dosing information

Usual Adult Dose for Hemophilia A with Inhibitors:

3 mg/kg subcutaneously once a week for the first 4 weeks, followed by 1.5 mg/kg once a week.

Use: Routine prophylaxis to prevent or reduce the frequency of bleeding episodes in patients with hemophilia A (congenital factor VIII deficiency) with factor VIII inhibitors.

Usual Pediatric Dose for Hemophilia A with Inhibitors:

3 mg/kg subcutaneously once a week for the first 4 weeks, followed by 1.5 mg/kg once a week.

Use: Routine prophylaxis to prevent or reduce the frequency of bleeding episodes in pediatric patients with hemophilia A (congenital factor VIII deficiency) with factor VIII inhibitors.

What other drugs will affect emicizumab?

Other drugs may interact with emicizumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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

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