antihemophilic factor VIII (RECOMBINATE)
Antihemophilic Agent | Blood Modifier Agent
Dosing and Administration
- The dose is calculated based on the patient's weight and desired factor VIII increase: Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
- For minor bleeding episodes, aim for a post-infusion factor VIII level of 20-40% every 12-24 hours until resolved
- For moderate to major bleeding, target a post-infusion level of 30-60% every 12-24 hours for 3-4 days or longer
- For life-threatening bleeding, maintain factor VIII levels at 60-100% every 8-24 hours until resolved
- Administer by slow intravenous injection at a rate not exceeding 5 mL/minute
▶️ For minor surgery or procedures with Recombinate, the recommended dosing is: 60-80% of normal Factor VIII activity level, which typically translates to:
- A single infusion of 30-40 IU/kg body weight
- The prescribing information provides the following guidance:
- For minor surgery, including tooth extraction, aim for a Factor VIII activity level of 60-80% of normal
- A single infusion plus oral antifibrinolytic therapy within one hour is sufficient in approximately 70% of cases
Patient Education
- Teach patients to recognize signs of bleeding and when to seek medical attention
- Emphasize the importance of adhering to prophylaxis regimens if prescribed
- Advise patients to keep a log of infusions and bleeding episodes
Monitoring
- Assess factor VIII levels regularly, especially when initiating therapy or adjusting doses
- Monitor for development of inhibitors, particularly in previously untreated patients
- Watch for signs of allergic reactions, which can occur rarely
Special Considerations
- RECOMBINATE is recombinant and does not contain human plasma, reducing risk of viral transmission
- It can be used for both on-demand treatment and routine prophylaxis
- For minor surgeries, maintain factor VIII levels at 30-60% for at least 1 day post-procedure
- For major surgeries, keep levels at 80-100% for 8-24 hours until wound healing begins
Nursing Considerations
- Verify dosage calculations and reconstitution procedures carefully
- Assess intravenous access sites regularly during infusions
- Educate patients and families on proper administration techniques and safety precautions
- Be prepared to manage potential adverse reactions, including allergic responses
The
BAXJECT II device features a clear plastic spike side and a white spike side. - The clear plastic spike side is inserted into the clear diluent vial, while
- the white spike side is inserted into the powdered vial.
The
BAXJECT II device features a clear plastic spike side and a white spike side. - The clear plastic spike side is inserted into the clear diluent vial, while
- the white spike side is inserted into the powdered vial.⤵️
Note the illustration below, where the vial containing the reconstituted solution is flipped to be on top when drawing the RECOMBINATE solution into the syringe.
References:
- https://www.shirecontent.com/PI/PDFs/RECOMBINATE_USA_ENG.pdf — package insert
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