South African Haemophilia Foundation (SAHF) Medical and Scientific Advisory Council (MASAC) Treatment Guidelines - Treatment of Bleeding Episodes

Treatment Products

Always refer to the Haemophilia Treatment Centre Physician’s Instructions

Please Note: Patients with Inhibitors require Special Treatment
Plasma-derived Factor VIII Products
Haemophilia A

Plasma-derived Factor VIII Products

Haemosolvate Factor VIII
Haemosolvate Factor VIII

National Bioproducts Institute (NBI):

  • Nandipa Mabusela
  • Tel: 031 714 6700

Virally Inactivated Factor VIII
Virally Inactivated Factor VIII

Western Cape Blood Blood Service (WCBS):

  • Tel: 021 507 6300

Recombinant Factor VIII Products
Haemophilia A

Recombinant Factor VIII Products

Kogenate FS Antihaemophilic Factor
Kogenate FS Antihaemophilic Factor

Bayer:

  • Lynda Woods
  • Tel: 011 921 5054
  • Cell: 082 651 2639
  • Email: lynda.woods@bayer.com

Prothrombin Complex Concentrates (PCC): Factor IX
Haemophilia B

Prothrombin Complex Concentrates (PCC): Factor IX

Haemosolvex Factor IX
Haemosolvex Factor IX

National Bioproducts Institute (NBI):

  • Nandipa Mabusela
  • Tel: 031 714 6700

Recombinant Factor VIIa Products
Haemophilia A with Inhibitors

Recombinant Factor VIIa Products

NovoSeven
NovoSeven

Novo Nordisk:

  • Piletso Maniza
  • Cell: 083 255 8299

Activated Prothrombin Complex Concentrate Products (APCC):
Haemophilia A and B with Inhibitors

Activated Prothrombin Complex Concentrate Products (APCC):

FEIBA
FEIBA

Adcock Ingram Critical Care:

  • Janine Blackensee
  • Tel: 011 494 8496
  • Cell: 076 538 6532

Do not give aspirin:

  • Aspirin impairs platelet function which may compound an existing bleeding disorder.

(see package insert)

15-25 mg/kg/dose po/IV q6 or 8 hr.

  • Antifibrinolytic – prevents clot breakdown.
  • Indicated for mucous membrane bleeding.
  • Contraindicated in haematuria or with concurrent use of Factor IX complex, or activated PCC.

0.3 μg/kg IV in normal saline over 20-30 minutes

0.4 μg/kg SC

  • Moderate or mild haemophilia A and von Willebrand disease.
  • Releases stored Factor VIII and vWF into circulation.
  • Less effective with lower baseline Factor VIII level.
  • Tachyphylaxis may occur with repeat doses.

NB:

  • Beware of fluid retention and syndrome of inappropriate ADH secretion
  • Monitor weight and baseline U+E
  • Restrict fluid as necessary

Following the injections:

Press on area > 5 min.

Apply ice.

Subcutaneous injection is safer.

  • Avoid other intramuscular injections in Haemophilia.