On-demand treatment & control of bleeding episodes; perioperative management; routine prophylaxis to reduce the frequency of bleeding episodes in adults & childn w/ hemophilia A (congenital factor VIII deficiency).
IVIndividualized dosage. Early hemarthrosis, minor muscle/oral bleeds 20-40 IU/dL 12-24 hrly for at least 1 day. Moderate (bleeding into muscles/oral cavity, mild head trauma 30-60 IU/dL 12-24 hrly for 3-4 days. GI, intracranial, intra-abdominal or intrathoracic bleeding, fractures 60-100 IU/dL 8-24 hrly. Minor surgery 30-60 IU/dL every 12-24 hr for 3-4 days. Tooth extraction 30-60 IU/dL single infusion + oral antifibrinolytic therapy w/in 1 hr. Routine prophylaxis Adult & adolescents ≥12 yr 30 IU/kg 3x wkly. Childn <12 yr Initially, 25 IU/kg every other day.
Discontinue treatment if hypersensitivity symptoms occur. Hypersensitivity to non-human mammalian proteins eg, hamster proteins. Not indicated in patients w/ von Willebrand's disease. Monitor patients for development of factor VIII inhibitors. Perform an assay that measures the presence of factor VIII inhibitor conc if expected levels are not attained or if bleeding is not controlled. Pregnancy & lactation.
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