NZBlood logo 
 

How to administer Clotting Factor Concentrates - Quick Guide

Presentation

  • Factor VIII & VWF (Biostate®)
    • (500 or 1000 IU + 5 or 10 mL water for injection)
  • Prothrombinex®-VF
  • Antithrombin III (Thrombotrol®-VF)
    • (1000 IU powder + 20 mL water for injection)
  • Factor VIII inhibitor bypassing fraction (FEIBA)
    • This is ordered for specific patients. Please contact Blood Bank to arrange.
  • Fibrinogen concentrate (RiaSTAP) 1g fibrinogen in 50 mL
    • This is ordered for specific patients. Please contact Blood Bank to arrange.
  • For Factor XIII, Protein C, and fibrinogen support, please see Section 29 medicines.
  • Recombinant Factors VIIa, VIII and IX are pharmaceutical products and are not blood donor derived. Please see here for more information about them.
Biostate
Thrombotrol-VF FEIBA RiaSTAP

ABO Compatibility

  • Compatibility is not relevant for manufactured (fractionated) plasma product transfusion

Storage and Infusion

  • Infuse as soon as the bottles have reached room temperature. If any delay store at 2-8°C in an appropriately monitored refrigerator or return to Blood Bank.
  • Multiple vials of the same product may be pooled together.
  • Give the dose IV slowly at 3mL/min (Riastap: 5mL/min)
  • For multiple vials a syringe infusion pump recommended. Ensure the syringe pump can deliver at 3mL/min (180 mL/hour). For Riastap: 5mL/min (300mL/hour).
  • An inline blood filter is not needed.
  • See the Mix2Vial page for instructions on spiking the bottle
  • Please see the Product Alert from CSL Behring regarding changed storage conditions for RiaSTAP (was room temperature, now refrigerated), as well as the new presentation which includes 50mL water for injection (WFI).

Precautions

  • Read manufacturer's instructions carefully
  • Always observe for turbidity, floating material and sediment
  • Syringe infusion pumps may be used and are recommended for large doses
  • Specific information about the administration of each product is given in the manufacturer's product information
  • Do not store reconstituted coagulation factors in a fridge
  • Please see the Product Alerts from CSL Behring regarding changed storage conditions for RiaSTAP (was room temperature, now refrigerated), as well as the new presentation which includes 50mL water for injection (WFI)

Rate

  • Coagulation factors should be infused at 180mL/hour (3mL/min). For Riastap the maximum rate is 300mL/hour (5mL/min).
  • Coagulation factors should be administered directly after reconstitution and completed within 3 hours.

Dose

  • Factor VIII& VWF (Biostate®), Antithrombin III (Thrombotrol®-VF), Prothrombinex®-VF (in Haemophilia B)
    • Refer to a Haematologist
    • Note: Biostate® contains both FVIII and VWF in a 1:2 ratio, and is approved for use in both haemophilia A and von Willebrand disease. Each order for Biostate® should specify the "active entity" of the ordered dose. For example:
      • "Biostate - 1000 IU of VWF"
      • "Biostate - 1500 IU of FVIII"
      • Any order for Biostate® that does not specify the "active entity" of the ordered dose should be clarified before the order is requested from Blood Bank or administered to the patient.
    • See also Haemophilia NZ National Treatment Guidelines (March '05)
  • see Prothrombinex®-VF for reversal of warfarin
  • Fibrinogen (RiaSTAP): the dose per kg bodyweight is:
    • where the fibrinogen level is known, the dose is the desired increment divided by 1.7
    • where the fibrinogen level is unknown, the dose is 70mg/kg

Monitoring

  • Recipients should remain under observation for 20 minutes following administration in case they experience an immediate adverse event requiring treatment.

DO NOT

  • DO NOT add medications to blood products.
  • DO NOT add reconstituted factors to other infusion fluids (including saline and blood). Saline may be used to flush a line but factors are not stable suspended in other fluids.

More Info

Top