Prophylaxis schedule for indications other than cardiovascular diseases in elderly persons with severe hemophilia
| Indication . | Dosage . | Duration . |
|---|---|---|
| Frequent bleeding, ie, ≥ 2×/mo | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | 1 y, then stop and restart if bleeding frequency increases again |
| Rehabilitation after severe bleeding, for severe arthropathy or after orthopedic surgery | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | During the whole period of rehabilitation |
| Medications increasing the underlying bleeding tendency | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | During the medication period |
| Platelet count < 30 000/μL | Daily 10 U/kg FVIII; every other day 20 U/kg FIX | Until platelet count > 30 000/μL |
| Major surgery (especially orthopedic surgery) in patients without inhibitors | ||
| Day of surgery | FVIII or IX 50 U/kg, followed by bolus injections 2×/d 25 U/kg, or continuous infusion with 3-4 U/kg/h aiming at trough levels > 60 U/dL, followed by prophylaxis aiming at trough levels of 25 U/dL | 1 wk, trough > 60 U/dL, followed by 1 wk, trough > 25 U/dL |
| Postsurgical prophylaxis | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | 1-2 wk, depending on the type of surgery |
| Major surgery (especially orthopedic surgery) in patients with inhibitors | Day of surgery, rFVIIa 100 μg/kg every 2 h for 24-48 h, then every 3 h until day 5, then every 4 h until days 7-10, then every 6 h until days 14-21 | ≥ 2-3 wk, depending on the type of surgery |
| Indication . | Dosage . | Duration . |
|---|---|---|
| Frequent bleeding, ie, ≥ 2×/mo | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | 1 y, then stop and restart if bleeding frequency increases again |
| Rehabilitation after severe bleeding, for severe arthropathy or after orthopedic surgery | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | During the whole period of rehabilitation |
| Medications increasing the underlying bleeding tendency | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | During the medication period |
| Platelet count < 30 000/μL | Daily 10 U/kg FVIII; every other day 20 U/kg FIX | Until platelet count > 30 000/μL |
| Major surgery (especially orthopedic surgery) in patients without inhibitors | ||
| Day of surgery | FVIII or IX 50 U/kg, followed by bolus injections 2×/d 25 U/kg, or continuous infusion with 3-4 U/kg/h aiming at trough levels > 60 U/dL, followed by prophylaxis aiming at trough levels of 25 U/dL | 1 wk, trough > 60 U/dL, followed by 1 wk, trough > 25 U/dL |
| Postsurgical prophylaxis | 3×/wk 15 U/kg FVIII; 2×/wk 30 U/kg FIX | 1-2 wk, depending on the type of surgery |
| Major surgery (especially orthopedic surgery) in patients with inhibitors | Day of surgery, rFVIIa 100 μg/kg every 2 h for 24-48 h, then every 3 h until day 5, then every 4 h until days 7-10, then every 6 h until days 14-21 | ≥ 2-3 wk, depending on the type of surgery |