The following text comes from www.HemophiliaEmergencyCare.com. To determine specific factor dosages for a given patient, go to the web site and click on 'Get Factor Dosage Orders'.

Factor

Dosage

Each bottle of factor concentrate is labeled with the activity expressed as International Units (IU, example: 287 IU). The dosage to be administered is based on the patient's body weight in kilograms (kg)*.

The ENTIRE contents of all the vials reconstituted for an infusion should be used, even if it exceeds the calculated dosage. A larger dose will only prolong the period of normal coagulation. Due to its expense, factor concentrate should never be discarded!

Some patients are instructed to bring unmixed factor concentrate with them to the ED to minimize treatment delay and cost. Occasionally, patients will bring prepared factor concentrate after unsuccessful home venipuncture attempts. Please assist with venipuncture and allow the patient or family to infuse the prepared factor concentrate if less than 3 hours have elapsed since reconstitution.

The half-life of factor VIII (8) is 8-12 hours; the half-life of factor IX (9) is 18-24 hours.

Factor reconstitution

Mixing instructions and the rate of administration are found on the drug insert. Document the lot number(s), expiration date(s), factor concentrate trade name and total number of units infused. Patients may request the box top for their records.

Factor types

Recombinant: Refers to genetically engineered Factor VIII (8) or IX (9) concentrates which are not derived from plasma.

High purity / Monoclonal - plasma product: Factor VIII (8) or IX (9) concentrates of high specific activity and purity of the specific clotting factor achieved through the use of an affinity column matrix.

Intermediate purity - plasma product: Refers to Factor VIII (8) concentrate with lower specific activity. Some contain von Willebrand factor and are used to treat von Willebrand Disease.

Factor IX (9) prothrombin complex concentrates (PCCs) - plasma product: Also contains some other clotting factors and small amounts of activated coagulation factors. Used to treat Hemophilia B and some patients with Factor VIII or IX inhibitors. When used to treat Factor VIII (8) inhibitor, the dose is 75 IU/kg for all situations. If a patient brings PCC product to the ED, verify whether his diagnosis if Factor IX deficiency or Factor VIII inhibitors as the dosage is different.

Activated prothrombin complex concentrates - plasma product: Prothrombin complex concentrates purposely "activated" so they contain some Factor IX (9), Factor X (10), etc. in the active form for use with Factor VIII (8) inhibitor patients only. The brands are Autoplex and FEIBA.