Antihemophilic Factor Dosage

Medically reviewed by Drugs.com. Last updated on Aug 15, 2023.

Usual Adult Dose for Hemophilia A

ADVATE(R), HEXILATE FS(R), JIVI(R), KOGENATE FS(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
Expected factor VIII rise (% of normal): 2 x IU administered / weight (kg)

Control of Bleeding Episodes:
Minor bleeding (early hemarthrosis, minor muscle or oral bleeds): 10 to 20 IU/kg intravenously until bleeding is resolved; repeat for evidence of further bleeding

• Factor VIII level required = 20 to 40% of normal

Moderate bleeding (hemorrhage into muscles/oral cavity, hemarthrosis, known trauma): 15 to 30 IU/kg intravenously every 12 to 24 hours until bleeding is resolved.

• Factor VIII level required = 30 to 60% of normal

Major bleeding (gastrointestinal, intracranial, intraabdominal, intrathoracic, central nervous system, retropharyngeal, retroperitoneal, or iliopsoas sheath bleeds, fractures, head trauma):

• Initial dose: 40 to 50 IU/kg intravenously
• Repeat dose: 20 to 25 IU/kg intravenously every 8 to 12 hours until bleeding is resolved.
• Factor VIII level required = 80 to 100% of normal

Surgery:
Minor surgery (including tooth extraction): 15 to 30 IU/kg intravenously every 12 to 24 hours until bleeding is resolved.

• Factor VIII level required = 30 to 60% of normal

Major surgery (e.g. tonsillectomy, inguinal herniotomy, synovectomy, craniotomy, osteosynthesis, trauma, joint replacement):

• Prior to surgery: 50 IU/kg intravenously to achieve 100% factor VIII activity; continue dosing every 6 to 12 hours to keep factor VIII activity in desired range until healing is complete

Routine Prophylaxis: 25 IU/kg three times a week

AFSTYLA(R), HEMOFIL M(R), NOVOEIGHT(R), NUWIQ(R), RECOMBINATE(R), XYNTHA(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
Expected factor VIII rise (% of normal): 2 x IU administered / weight (kg)

Control and Prevention of Bleeding Episodes:
Minor bleeding (superficial muscle, soft-tissue, or oral): dose to post-infusion factor VIII level of 20 to 40% every 12 to 24 hours for at least one day, until bleeding is resolved

Moderate to major bleeding (hemorrhage into muscles/oral cavity, hemarthrosis, known trauma): dose to post-infusion factor VIII level of 30 to 60% every 12 to 24 hours for 3 to 4 days or longer until bleeding is resolved.

Life-threatening bleeding (hemorrhage into muscles/oral cavity, hemarthrosis, known trauma): dose to post-infusion factor VIII level of 60 to 100% every 8 to 24 hours until bleeding is resolved.

Surgery:
Minor surgery (including tooth extraction): dose to post-infusion factor VIII level of 30 to 60% every 24 hours, for at least 1 days until healing is achieved.
Major surgery (intracranial, intraabdominal, joint replacement): dose to post-infusion factor VIII level of 80 to 100% every 8 to 24 hours until wound healing, the continue therapy at least 7 more days maintaining factor VIII level of 30 to 60%.

Routine Prophylaxis: 30 to 40 IU/kg every other day

ELOCTATE(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
Expected factor VIII rise (% of normal): 2 x IU administered / weight (kg)

Control of Bleeding Episodes:
Minor to moderate bleeding (joint, superficial muscle without neurovascular compromise except iliopsoas, deep laceration, renal, superficial soft tissue, mucous membranes): 20 to 30 IU/kg intravenously every 24 to 48 hours until bleeding is resolved.

• Factor VIII level required = 40 to 60% of normal

Major bleeding (life/limb threatening hemorrhage, iliopsoas and deep muscle with neurovascular injury, retroperitoneal, intracranial, gastrointestinal): 40 to 50 IU/kg intravenously every 12 to 24 hours until bleeding is resolved (approximately 7 to 10 days)

• Factor VIII level required = 80 to 100% of normal

Surgery:
Minor surgery (including tooth extraction): 25 to 40 IU/kg intravenously; repeat every 24 hours if needed for a duration of at least 1 day until healing is achieved.
Major surgery (intracranial, intraabdominal, joint replacement):

• Prior to surgery: 40 to 60 IU/kg intravenously once prior to surgery
• After surgery: 40 to 50 IU/kg intravenously 8 to 24 hours after surgery, then every 24 for until adequate wound healing, then continue at least 7 days while maintaining factor VIII within target range.
• Factor VIII level required prior to and after surgery= 80 to 120% of normal

Routine Prophylaxis:

• Initial dose: 50 IU/kg every 4 days
• Maintenance dose: 25 to 65 IU/kg every 3 to 5 days
• Adjust frequency based on bleeding episodes.

ESPEROCT(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5

Control of Bleeding Episodes:
Minor bleeding (early hemarthrosis, minor muscle or oral bleeds): 40 IU/kg intravenously; one dose should be sufficient

Moderate bleeding (more extensive hemarthrosis, muscle bleeding, hematoma): 40 IU/kg intravenously; may give one additional dose after 24 hours

Major bleeding (life or limb threatening, gastrointestinal, intracranial, intraabdominal, intrathoracic, fractures): 40 IU/kg intravenously; may repeat approximately every 24 hours

Surgery:
Minor surgery (including tooth extraction): 50 IU/kg intravenously; may repeat after 24 hours if needed
Major surgery (intracranial, intraabdominal, intrathoracic, joint replacement): 50 IU/kg intravenously; may repeat approximately every 24 hours for the first week, then approximately every 48 hours until wound healing has occurred.

Routine Prophylaxis:

• Initial dose: 50 IU/kg every 4 days
• Adjust frequency based on bleeding episodes.

KOATE(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5

Control and Prevention of Bleeding Episodes:
Minor bleeding (large bruises, significant cuts/scrapes, uncomplicated joint hemorrhage): 15 IU/kg intravenously every 12 hours (twice daily) until hemorrhage stops and healing achieved (1 to 2 days)

• Factor VIII level required = 30% of normal

Moderate bleeding (nose/mouth/gum bleeds, dental extractions, hematuria): 25 IU/kg intravenously every 12 hours (twice daily) until healing achieved (average of 2 to 7 days)

• Factor VIII level required = 50% of normal

Major bleeding (joint hemorrhage, muscle hemorrhage, major trauma, hematuria, intracranial/intraperitoneal bleeding):
Initial dose: 40 to 50 IU/kg intravenously every 12 hours (twice daily)
Maintenance dose: 25 until healing achieved (up to 10 days)

• Intracranial hemorrhage may require prophylaxis for up to 6 months.
• Factor VIII level required = 80 to 100% of normal

Surgery:
Prior to surgery: 40 to 50 IU/kg intravenously once prior to surgery
After surgery: 40 to 50 IU/kg intravenously for 7 to 10 days or until healing achieved

• Factor VIII level required prior to surgery= 80 to 100% of normal
• Factor VIII level required after surgery= 60 to 100% of normal

Comments:

• Base dose and frequency on clinical response.

OBIZUR(R):
Minor to Moderate Bleeding (superficial muscle without neurovascular compromise, joint): 200 units/kg intravenously every 4 to 12 hours

• Adjust frequency based on clinical response and factor VIII levels
• Factor VIII level required = 50 to 100% of normal

Major Bleeding (moderate to severe intramuscular, retroperitoneal, gastrointestinal, intracranial): 200 units/kg intravenously every 4 to 12 hours

• Adjust frequency based on clinical response and factor VIII levels
• Factor VIII level required = 100 to 200% of normal for acute bleeds; 50 to 100% after bleed is controlled

Comments:

• For treatment of bleeding episodes in acquired hemophilia A
• Safety and efficacy have not been established in patients with baseline anti-porcine factor VIII inhibitor titer over 20 BU.
• Not for treatment of congenital hemophilia A or von Willebrand disease
• Base dose, dose frequency, and treatment duration on bleeding severity, factor VIII levels, and clinical condition.

Usual Pediatric Dose for Hemophilia A

ADVATE(R), HEXILATE FS(R), Kogenate FS(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
Expected factor VIII rise (% of normal): 2 x IU administered / weight (kg)

Control of Bleeding Episodes:
Minor bleeding (early hemarthrosis, minor muscle or oral bleeds): 10 to 20 IU/kg intravenously until bleeding is resolved; repeat for evidence of further bleeding

• Factor VIII level required = 20 to 40% of normal

Moderate bleeding (hemorrhage into muscles/oral cavity, hemarthrosis, known trauma): 15 to 30 IU/kg intravenously every 12 to 24 hours until bleeding is resolved.

• Factor VIII level required = 30 to 60% of normal

Major bleeding (gastrointestinal, intracranial, intraabdominal, intrathoracic, central nervous system, retropharyngeal, retroperitoneal, or iliopsoas sheath bleeds, fractures, head trauma):

• Initial dose: 40 to 50 IU/kg intravenously
• Repeat dose: 20 to 25 IU/kg intravenously every 8 to 12 hours until bleeding is resolved.
• Factor VIII level required = 80 to 100% of normal

Surgery:
Minor surgery (including tooth extraction): 15 to 30 IU/kg intravenously every 12 to 24 hours until bleeding is resolved.

• Factor VIII level required = 30 to 60% of normal

Major surgery (e.g. tonsillectomy, inguinal herniotomy, synovectomy, craniotomy, osteosynthesis, trauma, joint replacement):

• Prior to surgery: 50 IU/kg intravenously to achieve 100% factor VIII activity; continue dosing every 6 to 12 hours to keep factor VIII activity in desired range until healing is complete

Routine Prophylaxis: 25 IU/kg every other day

AFSTYLA(R), HEMOFIL M(R), NOVOEIGHT(R), NUWIQ(R), RECOMBINATE(R), XYNTHA(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
Expected factor VIII rise (% of normal): 2 x IU administered / weight (kg)

Control and Prevention of Bleeding Episodes:
Minor bleeding (superficial muscle, soft-tissue, or oral): dose to post-infusion factor VIII level of 20 to 40% every 12 to 24 hours for at least one day, until bleeding is resolved

Moderate to major bleeding (hemorrhage into muscles/oral cavity, hemarthrosis, known trauma): dose to post-infusion factor VIII level of 30 to 60% every 12 to 24 hours for 3 to 4 days or longer until bleeding is resolved.

Life-threatening bleeding (hemorrhage into muscles/oral cavity, hemarthrosis, known trauma): dose to post-infusion factor VIII level of 60 to 100% every 8 to 24 hours until bleeding is resolved.

Surgery:
Minor surgery (including tooth extraction): dose to post-infusion factor VIII level of 30 to 60% every 24 hours, for at least 1 days until healing is achieved.
Major surgery (intracranial, intraabdominal, joint replacement): dose to post-infusion factor VIII level of 80 to 100% every 8 to 24 hours until wound healing, the continue therapy at least 7 more days maintaining factor VIII level of 30 to 60%.

Routine Prophylaxis:
12 years and older: 30 to 40 IU/kg every other day
Under 12 years: 30 to 50 IU/kg every other day or three times per week

ELOCTATE(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
Expected factor VIII rise (% of normal): 2 x IU administered / weight (kg)

Control of Bleeding Episodes:
Minor to moderate bleeding (joint, superficial muscle without neurovascular compromise except iliopsoas, deep laceration, renal, superficial soft tissue, mucous membranes): 20 to 30 IU/kg intravenously every 24 to 48 hours until bleeding is resolved.

• Factor VIII level required = 40 to 60% of normal

Major bleeding (life/limb threatening hemorrhage, iliopsoas and deep muscle with neurovascular injury, retroperitoneal, intracranial, gastrointestinal): 40 to 50 IU/kg intravenously every 12 to 24 hours until bleeding is resolved (approximately 7 to 10 days)

• Under 6 years: Repeat dose every 8 to 24 hours until bleeding is resolved.
• Factor VIII level required = 80 to 100% of normal

Surgery:
Minor surgery (including tooth extraction): 25 to 40 IU/kg intravenously; repeat every 24 hours if needed for a duration of at least 1 day until healing is achieved.
Major surgery (intracranial, intraabdominal, joint replacement):

• Prior to surgery: 40 to 60 IU/kg intravenously once prior to surgery
• After surgery: 40 to 50 IU/kg intravenously 8 to 24 hours after surgery (6 to 24 hours in patients under 6 years), then every 24 for until adequate wound healing, then continue at least 7 days while maintaining factor VIII within target range.
• Factor VIII level required prior to and after surgery= 80 to 120% of normal

Routine Prophylaxis:

• 6 years and older, initial dose: 50 IU/kg every 4 days
• Under 6 years, initial dose: 50 IU/kg twice a week
• Maintenance dose (all ages): 25 to 65 IU/kg every 3 to 5 days
• More frequent or higher doses (up to 80 IU/kg) may be required.
• Adjust frequency based on bleeding episodes.

ESPEROCT(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5

Control of Bleeding Episodes:
Minor bleeding (early hemarthrosis, minor muscle or oral bleeds):

• 12 years and older: 40 IU/kg intravenously; one dose should be sufficient
• Under 12 years: 65 IU/kg intravenously; one dose should be sufficient

Moderate bleeding (more extensive hemarthrosis, muscle bleeding, hematoma):

• 12 years and older: 40 IU/kg intravenously; may give one additional dose after 24 hours
• Under 12 years: 65 IU/kg intravenously; may give one additional dose after 24 hours

Major bleeding (life or limb threatening, gastrointestinal, intracranial, intraabdominal, intrathoracic, fractures):

• 12 years and older: 40 IU/kg intravenously; may repeat approximately every 24 hours
• Under 12 years: 65 IU/kg intravenously; may repeat approximately every 24 hours

Surgery:
Minor surgery (including tooth extraction): 50 IU/kg intravenously; may repeat after 24 hours if needed
Major surgery (intracranial, intraabdominal, intrathoracic, joint replacement):

• 12 years and older: 50 IU/kg intravenously; may repeat approximately every 24 hours for the first week, then approximately every 48 hours until wound healing has occurred.
• Under 12 years: 65 IU/kg intravenously; may repeat approximately every 24 hours for the first week, then approximately every 48 hours until wound healing has occurred.

Routine Prophylaxis:

• 12 years and older, initial dose: 50 IU/kg every 4 days
• Under 12 years: 65 IU/kg twice a week
• Adjust frequency based on bleeding episodes.

KOATE(R):
Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5

Control and Prevention of Bleeding Episodes:
Minor bleeding (large bruises, significant cuts/scrapes, uncomplicated joint hemorrhage): 15 IU/kg intravenously every 12 hours (twice daily) until hemorrhage stops and healing achieved (1 to 2 days)

• Factor VIII level required = 30% of normal

Moderate bleeding (nose/mouth/gum bleeds, dental extractions, hematuria): 25 IU/kg intravenously every 12 hours (twice daily) until healing achieved (average of 2 to 7 days)

• Factor VIII level required = 50% of normal

Major bleeding (joint hemorrhage, muscle hemorrhage, major trauma, hematuria, intracranial/intraperitoneal bleeding):
Initial dose: 40 to 50 IU/kg intravenously every 12 hours (twice daily)
Maintenance dose: 25 until healing achieved (up to 10 days)

• Intracranial hemorrhage may require prophylaxis for up to 6 months.
• Factor VIII level required = 80 to 100% of normal

Surgery:
Prior to surgery: 40 to 50 IU/kg intravenously once prior to surgery
After surgery: 40 to 50 IU/kg intravenously for 7 to 10 days or until healing achieved

• Factor VIII level required prior to surgery= 80 to 100% of normal
• Factor VIII level required after surgery= 60 to 100% of normal

Comments:

• Base dose and frequency on clinical response.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to any of the ingredients

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Further information

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

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