The dose is calculated based on the patient's weight and desired factor VIII increase: Dose (IU) = Weight (kg) x Desired factor VIII rise (% normal or IU/dL) x 0.5
For minor bleeding episodes, aim for a post-infusion factor VIII level of 20-40% every 12-24 hours until resolved
For moderate to major bleeding, target a post-infusion level of 30-60% every 12-24 hours for 3-4 days or longer
For life-threatening bleeding, maintain factor VIII levels at 60-100% every 8-24 hours until resolved
Administer by slow intravenous injection at a rate not exceeding 5 mL/minute
▶️ For minor surgery or procedures with Recombinate, the recommended dosing is: 60-80% of normal Factor VIII activity level, which typically translates to:
A single infusion of 30-40 IU/kg body weight
The prescribing information provides the following guidance:
For minor surgery, including tooth extraction, aim for a Factor VIII activity level of 60-80% of normal
A single infusion plus oral antifibrinolytic therapy within one hour is sufficient in approximately 70% of cases
Patient Education
Teach patients to recognize signs of bleeding and when to seek medical attention
Emphasize the importance of adhering to prophylaxis regimens if prescribed
Advise patients to keep a log of infusions and bleeding episodes
Monitoring
Assess factor VIII levels regularly, especially when initiating therapy or adjusting doses
Monitor for development of inhibitors, particularly in previously untreated patients
Watch for signs of allergic reactions, which can occur rarely
Special Considerations
RECOMBINATE is recombinant and does not contain human plasma, reducing risk of viral transmission
It can be used for both on-demand treatment and routine prophylaxis
For minor surgeries, maintain factor VIII levels at 30-60% for at least 1 day post-procedure
For major surgeries, keep levels at 80-100% for 8-24 hours until wound healing begins
Nursing Considerations
Verify dosage calculations and reconstitution procedures carefully
Assess intravenous access sites regularly during infusions
Educate patients and families on proper administration techniques and safety precautions
Be prepared to manage potential adverse reactions, including allergic responses
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The BAXJECT II device features a clear plastic spike side and a white spike side.
The clear plastic spike side is inserted into the clear diluent vial, while
the white spike side is inserted into the powdered vial.
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The BAXJECT II device features a clear plastic spike side and a white spike side. The clear plastic spike side is inserted into the cleardiluent vial, while the white spike side is inserted into the powdered vial.⤵️
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Note the illustration below, where the vial containing the reconstituted solution is flipped to be on top when drawing the RECOMBINATE solution into the syringe.
