Octocog alfa

Thông tin thuốc gốc
Chỉ định và Liều dùng
Treatment and prophylaxis of haemorrhagic episodes in patients with haemophilia A
Adult: Treatment: Dosage is individualised based on the severity of deficiency, location and extent of bleeding, and patient's clinical condition. Generally, admin of factor VIII 1 IU/kg will increase circulating factor VIII levels by approx 2 IU/dL. Recommendation: Minor bleeding: 10-20 IU/kg 12-24 hrly for approx 1-3 days. Moderate bleeding: 15-30 IU/kg 12-24 hrly for approx ≥3 days. Major bleeding: 30-50 IU/kg 8-24 hrly until bleeding resolves. Minor surgery: 30-50 IU/kg as a single dose w/in 1 hr of the procedure; repeat after 12-24 hr as needed. Major surgery: 40-60 IU/kg pre-op, repeated 8-24 hrly depending on state of wound healing. Prophylaxis: 20-40 IU/kg 3-4 times wkly. Doses are given via infusion over ≤5 min at max rate of 10 mL/min.
Child: Treatment: Same as adult dose. Patients <6 yr may require more frequent admin: 8-24 hrly (minor/moderate bleeding); 6-12 hrly (major bleeding); 6-24 hrly (major surgery). Prophylaxis: <6 yr 20-50 IU/kg 3-4 times wkly; ≥6 yr Same as adult dose.
Chống chỉ định
Hypersensitivity to mouse or hamster protein.
Thận trọng
Childn. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Hypersensitivity reactions (e.g. anaphylaxis), inhibitory antibodies formation, catheter-related complications (e.g. bacteraemia, local infections, catheter-site thrombosis).
Nervous: Dizziness, headache, lightheadedness, asthenia, fatigue, malaise, depersonalisation, somnolence, restlessness, falling.
CV: Chest discomfort or tightness, increased/decreased BP.
GI: Diarrhoea, constipation, vomiting, dry mouth, unpleasant taste.
Resp: Nasopharyngitis, cough, rhinitis, dyspnoea, cough, nasal congestion, wheezing, epistaxis.
Musculoskeletal: Arthralgia, limb pain or injury, joint swelling.
Otic: Earache, ear infection.
Dermatologic: Facial flushing or swelling, rash, pruritus, urticaria.
Immunologic: Flu-like symptoms.
Others: Fever, chills, generalised discomfort, cold feet, inj site reactions (e.g. burning, erythema).
Chỉ số theo dõi
Monitor BP and heart rate before and during admin, plasma factor VIII activity before and during treatment; inhibitor occurrence, Hb, haematocrit, signs of bleeding, and hypersensitivity reactions.
Tác dụng
Mechanism of Action: Octocog alfa (coagulation factor VIII, recombinant) is a glycoprotein that is biologically equivalent to the factor VIII glycoprotein found in human plasma. It binds to endogenous von Willebrand Factor in the patient's circulation. Activated factor VIII activates factor X, as co-factor for activated factor IX. Activated factor X converts prothrombin to thrombin, which then converts fibrinogen to fibrin, forming a stable clot.
Absorption: Time to peak plasma concentration: Approx 10-15 min, up to 1-2 hr.
Distribution: Circulates in plasma bound to von Willebrand factor; w/ minimal extravascular distribution (approx 14%).
Excretion: Terminal elimination half-life: 12 hr.
Bảo quản
Store between 2-8°C. Do not freeze.
Any unused portions should be disposed of in accordance w/ local requirements.
Phân loại MIMS
Thuốc cầm máu
Tài liệu tham khảo
Advate (Baxalta US Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/05/2017.

Anon. Antihemophilic Factor (Recombinant). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 08/05/2017.

Anon. Antihemophilic Factor (Recombinant). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/05/2017.

Buckingham R (ed). Factor VIII. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/05/2017.

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