Monitor for signs and symptoms of hypersensitivity reactions (angioedema, chest-tightness, dyspnea, hypotension, wheezing, urticaria, pruritus). If symptoms occur, discontinue administration and provide symptomatic treatment.
Lab Test Considerations:
Perform one-stage clotting assay to confirm that adequate factor VIII levels have been achieved and maintained. Monitor factor VIII activity 30 minutes and 3 hours after initial dose. Monitor factor VIII activity 30 minutes after subsequent doses. For superficial muscle bleeding with no neurovascular compromise, and joint bleeding, Factor VIII of 50–100 units/dL or % of normal are required. For moderate to severe intramuscular bleeding, retroperitoneal, gastrointestinal, or intracranial bleeding, use 100–200 units/dL or % normal to treat an acute bleed. Administer 50–100 units/dL or % of normal after acute bleed if more is required.
Monitor development of inhibitory antibodies with Nijmegen Bethesda inhibitor assay if expected plasma factor VIII activity levels are not attained or if bleeding is not controlled with the expected dose. Use Bethesda Units (BU) to report inhibitor levels.
IV Push: Reconstitute by bringing solution to room temperature. Follow manufacturer's instructions for reconstitution. Inject all diluent from syringe into vial; gently swirl without removing syringe until completely dissolved. Use within 3 hrs of reconstitution if stored at room temperature. Solution is clear and colorless; do not administer solutions that are discolored or contain particulate matter. Once all vials are reconstituted, connect large syringe to vial adapter and withdraw all solution. Repeat until total volume to be administered is reached. Discard unused reconstituted solution.
Hemostasis in patients with acquired Hemophilia A. If the plasma factor VIII level fails to increase as expected, or if bleeding is not controlled after OBIZUR administration, suspect the presence of an anti-porcine factor VIII antibody. If such inhibitory antibodies to anti-porcine factor VIII are suspected and there is a lack of clinical response, consider other therapeutic options.