Drug Action
Emicizumab is a monoclonal antibody that bridges activated factor IX and factor X to restore function of missing activated factor VIII, which is needed for haemostasis.
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Drug reference
Emicizumab is a monoclonal antibody that bridges activated factor IX and factor X to restore function of missing activated factor VIII, which is needed for haemostasis.
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Prophylaxis of haemorrhage in haemophilia A (initiated by a specialist) ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 3 mg/kg once weekly for 4 weeks, then maintenance 1.5 mg/kg once weekly, alternatively maintenance 3 mg/kg every 2 weeks, alternatively maintenance 6 mg/kg every 4 weeks
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Concomitant bypassing agent. risk factors for thrombotic microangiopathy CAUTIONS, FURTHER INFORMATION ▶Concomitant bypassing agent Manufacturer advises discontinue bypassing agents the day before starting emicizumab; if a bypassing agent is required—consult product literature.
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Emicizumab is a biological medicine. Biological medicines must be prescribed and dispensed by brand name, see Biological medicines and Biosimilar medicines, under Guidance on prescribing p. 1; manufacturer advises to record the brand name and batch number after each administration.
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▶Common or very common Arthralgia. diarrhoea. fever. headache. myalgia ▶Uncommon Cavernous sinus thrombosis. embolism and thrombosis. skin necrosis. thrombotic microangiopathy
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Manufacturer advises effective contraception during and for 6 months after treatment in women of childbearing potential.
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Manufacturer advises use only if potential benefit outweighs risk—no information available.
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Manufacturer advises avoid—no information available. l EFFECT ON LABORATORY TESTS Manufacturer advises to avoid intrinsic pathway clotting-based laboratory tests or use with caution as results may be misinterpreted—consult product literature.
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Manufacturer advises max. 2 mL per injection site; rotate injection site and avoid skin that is tender, damaged or scarred. Patients or their caregivers may self-administer Hemlibra ® after appropriate training.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection ▶Hemlibra (Roche Products Ltd) A Emicizumab 30 mg per 1 ml Hemlibra 30mg/1ml solution for injection vials | 1 vial P £2,415.30 Emicizumab 150 mg per 1 ml Hemlibra 150mg/1ml solution for injection vials | 1 vial P £12,076.50 Hemlibra 105mg/0.7ml solution for injection vials | 1 vial P £8,453.55 Hemlibra 60mg/0.4ml solution for injection vials | 1 vial P £4,830.60 2.1 Coagulation factor deficiencies BLOOD AND RELATED PRODUCTS › COAGULATION PROTEINS
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Missed doses Manufacturer advises if a dose is missed, the missed dose may be taken up to a day before the next scheduled dose. The next dose should then be taken on the usual scheduled dosing day.
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Initially 3 mg/kg once weekly for 4 weeks, then
First-line fragment. Read the complete Indications and Dose section above.
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