{"id":4864,"date":"2020-12-02T10:28:50","date_gmt":"2020-12-02T10:28:50","guid":{"rendered":"https:\/\/zeepedia.com\/?p=4864"},"modified":"2021-08-11T07:33:08","modified_gmt":"2021-08-11T07:33:08","slug":"advate","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/advate\/","title":{"rendered":"ADVATE &#8211; Oktokog alfa uses, dose and side effects"},"content":{"rendered":"\n<p> 250 IU, 500 IU, 1000 IU, 1500 IU&nbsp;powder and solvent for&nbsp;solution&nbsp;for&nbsp;injection.&nbsp;<br>Octocog alfa (&nbsp;recombinant&nbsp;human&nbsp;coagulation factor&nbsp;VIII) <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What ADVATE is and what it is used for<\/h2>\n\n\n\n<p>ADVATE contains the active substance octocog alfa,&nbsp;human&nbsp;coagulation factor&nbsp;VIII produced by&nbsp;recombinant DNA&nbsp;technology.&nbsp;Factor VIII is&nbsp;needed for the blood to form&nbsp;clots&nbsp;and stop bleeding.&nbsp;In patients with&nbsp;hemophilia&nbsp;A (congenital&nbsp;factor VIIIdeficiency&nbsp;), this is absent or does not function normally.<\/p>\n\n\n\n<p>ADVATE is used to treat and prevent bleeding in patients of all ages who have&nbsp;hemophilia&nbsp;A (a hereditary form of&nbsp;hemophilia&nbsp;caused by a&nbsp;factor VIII&nbsp;deficiency&nbsp;).<\/p>\n\n\n\n<p>ADVATE is manufactured without the addition of any&nbsp;human or animal&nbsp;protein throughout the manufacturing process.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2. What you need to know before using ADVATE<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use ADVATE<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>If you are allergic to octocog alfa or any of the other ingredients of this medicine (listed in section 6).<\/li><li>If you are allergic to mouse or hamster protein.<\/li><\/ul>\n\n\n\n<p>If you are not sure, ask your doctor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>Talk to your doctor before using ADVATE.&nbsp;Tell your doctor if you have previously been treated with&nbsp;factor VIII&nbsp;products, especially if you have developed inhibitors, as there may be a greater risk of recurrence.&nbsp;Inhibitors are blocking&nbsp;antibodies&nbsp;to&nbsp;factor VIII, which reduce the effect of ADVATE in preventing or controlling bleeding.&nbsp;The development of inhibitors is a known complication in the treatment of&nbsp;hemophilia. Contact your doctor immediately if your bleeding is not controlled with ADVATE.<br><\/p>\n\n\n\n<p>There is a small risk of you getting an&nbsp;anaphylactic reaction&nbsp;(a severe, sudden&nbsp;allergic reaction&nbsp;) from ADVATE.&nbsp;You should be aware of early signs of allergic reactions such as rash, hives, general&nbsp;itching, swelling of the lips and tongue, difficulty breathing, pressure over the chest, general malaise, and dizziness.&nbsp;These symptoms can be an early symptom of anaphylactic&nbsp;shock, reactions that may also include severe dizziness, unconsciousness, and severe difficulty breathing.<\/p>\n\n\n\n<p>If you experience any of these symptoms, stop the injection\/infusion immediately, and contact your doctor.&nbsp;Severe symptoms, such as difficulty breathing and fainting, require immediate emergency treatment.<\/p>\n\n\n\n<p><em>Patients developing&nbsp;factor VIII&nbsp;inhibitors<\/em><\/p>\n\n\n\n<p>The development of inhibitors (&nbsp;antibodies&nbsp;) is a known complication that may occur during treatment with any&nbsp;factor VIII&nbsp;drug.&nbsp;The inhibitors prevent, especially at high levels, that the treatment works properly.&nbsp;You or your child will be closely monitored for the development of such inhibitors.&nbsp;If you or your child suffer from bleeding that cannot be controlled with ADVATE, tell your doctor immediately.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\n\n\n\n<p>The information on warnings and precautions applies to both adults and children (from 0 to 18 years).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and ADVATE<\/h2>\n\n\n\n<p>Tell your doctor if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p>If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>ADVATE has no effect on the ability to drive and use machines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">ADVATE contains sodium<\/h2>\n\n\n\n<p>This medicine contains 0.45 mmol&nbsp;sodium&nbsp;(10 mg) per&nbsp;vial.&nbsp;This should be considered by patients on a low-salt diet.<\/p>\n\n\n\n<p><strong>Incorrect&nbsp;administration&nbsp;of ADVATE<\/strong><\/p>\n\n\n\n<p>Improper&nbsp;administration&nbsp;(&nbsp;injection&nbsp;into an&nbsp;artery&nbsp;or outside the vein) should be avoided, as mild, short-term reactions at the injection site, such as bruising and&nbsp;erythema, may occur.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to use ADVATE<\/h2>\n\n\n\n<p>Treatment with ADVATE will be initiated by a physician experienced in the management of patients with&nbsp;hemophilia&nbsp;A.<\/p>\n\n\n\n<p>Your doctor will calculate the&nbsp;dose of&nbsp;an ADVATE (in international units or IU) depending on your condition, your weight, and whether it is used to prevent or treat bleeding.&nbsp;How often the treatment is given depends on how well ADVATE works on you.&nbsp;Replacement treatment with ADVATE is usually a lifelong treatment.<\/p>\n\n\n\n<p>Always use this medicine exactly as your doctor has told you.&nbsp;Consult a doctor if you are unsure.<\/p>\n\n\n\n<p><strong>Prevention of bleeding<\/strong><\/p>\n\n\n\n<p>The usual&nbsp;dose&nbsp;is 20 &#8211; 40 IU octocog alfa per kg body weight given every two to three days.&nbsp;In some cases, especially in young patients, more frequent&nbsp;injections&nbsp;or higher&nbsp;doses&nbsp;may be necessary.<\/p>\n\n\n\n<p><strong>Treatment of bleeding<\/strong><\/p>\n\n\n\n<p>The&nbsp;dose of octocog alfa is calculated depending on your body weight and the&nbsp;factor VIII&nbsp;levels to be achieved.&nbsp;The desired&nbsp;factor VIII&nbsp;level depends on the location and severity of the bleeding.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Dose&nbsp;(IU) = body weight (kg) x desired&nbsp;factor VIII&nbsp;increase (% of normal) x 0.5<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>If you have the impression that ADVATE is not working properly, talk to your doctor.<\/p>\n\n\n\n<p>Your doctor will perform appropriate laboratory tests to ensure that you have adequate&nbsp;factor VIII&nbsp;levels.&nbsp;This is especially important if you are having major surgery.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Use in children and adolescents (from 0 to 18 years)<\/h2>\n\n\n\n<p>When it comes to treating bleeding, the&nbsp;dose&nbsp;for children is the same as for adult patients.&nbsp;When it comes to preventing bleeding in children under 6 years of age, a&nbsp;dose&nbsp;of 20 to 50 IU per kg body weight is recommended 3 to 4 times a week.&nbsp;Administration&nbsp;of ADVATE to children (&nbsp;intravenously&nbsp;) does not differ from&nbsp;administration&nbsp;to adults.&nbsp;A central venous access device may be required to enable frequent&nbsp;infusion&nbsp;of&nbsp;factor VIII&nbsp;products.<\/p>\n\n\n\n<p>Due to the reduced injection volume of ADVATE reconstituted in 2 ml, there is even less time to react to&nbsp;hypersensitivity reactions.&nbsp;Therefore, caution is recommended when&nbsp;injecting&nbsp;ADVATE reconstituted in 2 ml, especially for children.<\/p>\n\n\n\n<p><strong>How ADVATE is given<\/strong><\/p>\n\n\n\n<p>ADVATE is usually injected into a vein (&nbsp;intravenously&nbsp;) by your doctor or nurse.&nbsp;You or someone else can also give ADVATE as an&nbsp;injection, but only after the necessary training.&nbsp;Detailed instructions on how to give yourself the medicine can be found at the end of this leaflet.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you use more ADVATE than you should&nbsp;<\/h2>\n\n\n\n<p>Always take ADVATE exactly as your doctor has told you.&nbsp;Consult a doctor if you are unsure.&nbsp;If you inject more ADVATE than recommended, tell your doctor as soon as possible.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to take ADVATE<\/h2>\n\n\n\n<p>Do not inject a double&nbsp;dose&nbsp;to make up for a&nbsp;forgotten&nbsp;dose.&nbsp;Take the next&nbsp;dose&nbsp;as planned and continue according to your doctor&#8217;s prescription.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop taking ADVATE<\/h2>\n\n\n\n<p>Do not stop using ADVATE without consulting your doctor<\/p>\n\n\n\n<p>If you have any further questions on the use of this product, ask your doctor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4. Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause&nbsp;side effects, although not everybody gets them.<\/p>\n\n\n\n<p><strong>If severe, sudden allergic (anaphylactic) reactions<\/strong>&nbsp;occur,&nbsp;<strong>discontinue&nbsp;injection immediately.&nbsp;<\/strong>You must&nbsp;<strong>contact your doctor immediately<\/strong>&nbsp;if you get any of the following early signs of allergic reactions:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>rash,&nbsp;hives, general&nbsp;itching,<\/li><li>swelling of the lips and tongue,<\/li><li>difficulty breathing, wheezing, pressure over the chest,<\/li><li>general malaise,<\/li><li>dizziness, unconsciousness.<\/li><\/ul>\n\n\n\n<p><br>Severe symptoms, such as difficulty breathing and fainting, require immediate emergency treatment.<\/p>\n\n\n\n<p>In children who have not been&nbsp;previously&nbsp;treated with&nbsp;factor VIII&nbsp;drugs, it is very common for inhibitory&nbsp;antibodies to&nbsp;develop (see section 2) (affects more than 1 user in 10).&nbsp;However, for patients who have previously been treated with&nbsp;factor VIII(treatment for more than 150 days), the risk is less and the complication is less common (occurs in less than 1 in 100 users).&nbsp;If you or your child develop&nbsp;antibodies, the medicines may stop working properly and you or your child may suffer from persistent bleeding.&nbsp;If this happens, consult a doctor immediately.<\/p>\n\n\n\n<p><strong>A very common&nbsp;side effect&nbsp;is<\/strong>&nbsp;(occurring in more than 1 in 10)<\/p>\n\n\n\n<p>Factors&nbsp;VIII&nbsp;inhibitors&nbsp;(in children not&nbsp;previously&nbsp;treated with&nbsp;factor VIII&nbsp;medicines).<\/p>\n\n\n\n<p><strong>Common&nbsp;adverse&nbsp;s<\/strong>&nbsp;(affects up to 1 in 10)<\/p>\n\n\n\n<p>Headache and fever.<\/p>\n\n\n\n<p><strong>Less common&nbsp;side effects&nbsp;are<\/strong>&nbsp;(affects up to 1 in 100)<\/p>\n\n\n\n<p>Inhibitors of&nbsp;factor VIII&nbsp;(in patients who have been treated with&nbsp;factor VIII&nbsp;-previously (treatment for more than 150 days)), dizziness,&nbsp;influenza, fainting, abnormal heart rhythm, red itchy lumps on the skin, chest discomfort, bruising at the injection site, reaction to the injection site,&nbsp;itching, increased sweating, unusual taste in the mouth, swelling,&nbsp;migraine, memory problems, chills, diarrhea, nausea, vomiting, shortness of breath, sore throat,&nbsp;infection&nbsp;of the lymph vessels, pallor, eye inflammation,&nbsp;eczema, profuse sweating, swollen legs, feet decreased proportion of&nbsp;red blood cells in the blood, increased number of a certain type of white blood cells&nbsp;(&nbsp;monocytes&nbsp;) and pain in the upper abdomen or lower chest.<\/p>\n\n\n\n<p><em>In connection with surgery<\/em><\/p>\n\n\n\n<p>catheter-related&nbsp;infection, decreased red blood cell count, swelling of&nbsp;extremities joints, prolonged bleeding after&nbsp;drainage&nbsp;removal, decreased&nbsp;factor VIII&nbsp;level, and postoperative bruising.<\/p>\n\n\n\n<p><em>In connection with the device for central venous access<\/em><\/p>\n\n\n\n<p>Catheter-related&nbsp;infection, systemic&nbsp;infection,&nbsp;and local blood clot at the catheter site.<\/p>\n\n\n\n<p><strong>Adverse reactions&nbsp;with an unknown frequency<\/strong>&nbsp;(cannot be calculated from the available data).<\/p>\n\n\n\n<p>Potentially life-threatening reactions (&nbsp;anaphylaxis&nbsp;) and other allergic reactions (hypersensitivity), general symptoms (fatigue, weakness).<\/p>\n\n\n\n<p><strong>Additional&nbsp;side effects&nbsp;are in children<\/strong><\/p>\n\n\n\n<p>In addition to the development of inhibitors in&nbsp;pediatric patients&nbsp;not previously treated, as well as catheter-related complications, no age-specific differences in&nbsp;adverse reactions were&nbsp;observed&nbsp;during clinical trials.<\/p>\n\n\n\n<p><em>Reporting of side effects<\/em><\/p>\n\n\n\n<p>If you get any side effects, talk to your doctor, pharmacist, or nurse.&nbsp;This includes any possible side effects not listed in this leaflet.&nbsp;You can also report side effects directly to the Medical Products Agency,&nbsp;www.lakemedelsverket.se.&nbsp;By reporting side effects, you can help increase drug safety information.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">5. How to store ADVATE<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the label after EXP.&nbsp;The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>Store in a refrigerator (2 \u00b0 C &#8211; 8 \u00b0 C).&nbsp;Do not freeze.<\/p>\n\n\n\n<p>During the shelf life, the powder vial can be stored at room temperature (at a maximum of 25 \u00b0 C) for up to 6 months.&nbsp;The expiry date for the medicine is then the end of this 6-month period or the expiry date which is printed on the bottle, whichever is the earlier.&nbsp;Note the end date of the 6-month period on the outer carton.&nbsp;Once the medicine has been stored at room temperature, it must not be put back in the refrigerator.<\/p>\n\n\n\n<p>Keep the vial in the outer carton.&nbsp;Sensitive to light.<\/p>\n\n\n\n<p>This product is for single use only.&nbsp;Dispose of the unused product appropriately.<\/p>\n\n\n\n<p>Use the product immediately when the powder is completely dissolved.<\/p>\n\n\n\n<p>Do not store the product in the refrigerator after&nbsp;preparation.<\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">6. Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substance is octocog alfa (&nbsp;human&nbsp;coagulation factor&nbsp;VIII produced by&nbsp;recombinant DNA&nbsp;technology).&nbsp;Each&nbsp;vial&nbsp;of powder nominally contains 250, 500, 1000, or 1500 IU octocog alfa.<\/li><li>The other ingredients are mannitol, sodium chloride, histidine, trehalose, calcium chloride, <a href=\"https:\/\/zeepedia.com\/medical\/medicines\/tribonate\/\">trometamol<\/a>, polysorbate 80, and glutathione (reduced).<\/li><\/ul>\n\n\n\n<p><em>Vial&nbsp;with liquid:<\/em>&nbsp;2 ml sterile water for injections<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and the contents of the pack<\/h2>\n\n\n\n<p>ADVATE is a white to off-white powder.&nbsp;After&nbsp;reconstitution, the solution is clear, colorless, and free of foreign particles.&nbsp;Each pack also contains a preparation aid (BAXJECT II).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n<p><strong>Marketing Authorisation Holder<\/strong><\/p>\n\n\n\n<p>Takeda Manufacturing Austria AG<\/p>\n\n\n\n<p>Industriestrasse 67<\/p>\n\n\n\n<p>A \u2011 1221 Vienna<\/p>\n\n\n\n<p>Tel: +800 66838470<\/p>\n\n\n\n<p>Email: medinfoEMEA@shire.com<br><\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Baxalta Belgium Manufacturing SA<\/p>\n\n\n\n<p>Boulevard Ren\u00e9 Branquart 80<\/p>\n\n\n\n<p>B \u2011 7860 Lessines<\/p>\n\n\n\n<p>Belgium<br><\/p>\n\n\n\n<p>This leaflet was last modified on 04\/2020<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other sources of information<\/h2>\n\n\n\n<p>Further information on this medicine is available on the European Medicines Agency web site:&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Instructions for preparation and administration<\/h2>\n\n\n\n<p>Aseptic technique is necessary during the&nbsp;preparation&nbsp;of the solution and during administration.<\/p>\n\n\n\n<p>Use only the sterile water for injections and the reconstitution aid provided with each package ADVATE.&nbsp;ADVATE must not be mixed with other medicines or solutions.<\/p>\n\n\n\n<p>It is strongly recommended to note the name and batch number of the product each time ADVATE is administered to a patient.<\/p>\n\n\n\n<p><strong>Instructions for&nbsp;preparation<\/strong><br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do not use this medicine after the expiry date which is stated on the label and carton.<\/li><li><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20110112000127#\" rel=\"noopener\"><\/a>Do not use BAXJECT II if sterile protection or packaging is damaged or shows any signs of injury.&nbsp;This is indicated by the symbol:<\/li><li>The solution must not be placed in the refrigerator after&nbsp;preparation.<\/li><\/ul>\n\n\n\n<ol class=\"wp-block-list\"><li>If the product is still stored in a refrigerator: remove both ADVATE powder and liquid vials from the refrigerator and allow them to reach room temperature (between 15 \u00b0 C and 25 \u00b0 C).<\/li><li>Wash your hands thoroughly with soap and warm water<\/li><li>Remove the caps from the powder and liquid vials.<\/li><li>Clean the plugs with injection dryers.&nbsp;Place the bottles on a flat, clean surface.<\/li><li>Open the packaging of the BAXJECT II by pulling off the paper cover without touching the inside (Fig. A).&nbsp;Do not remove BAXJECT II from its packaging.&nbsp;Do not use BAXJECT II if sterile protection or packaging is damaged or shows any signs of injury.<\/li><li>Turn the package over and push the transparent plastic tip through the rubber stopper of the water bottle.&nbsp;Grasp the edges of the package and pull the package away from the BAXJECT II (Fig. B).&nbsp;Do not remove the blue cap from the BAXJECT II.<\/li><li>Only sterilized water for injections and the reconstitution aid provided in the package should be used for&nbsp;reconstitution.&nbsp;Turn the entire system with BAXJECT II attached to the water bottle so that the water bottle ends up on top.&nbsp;Push the white plastic tip through the rubber stopper of the ADVATE powder bottle.&nbsp;The water will be sucked into the ADVATE powder bottle by vacuum (Fig. C).<\/li><li>Carefully rotate the bottle until all the powder is dissolved.&nbsp;Make sure that the ADVATE powder is completely dissolved, otherwise not all the reconstituted solution can pass through the filter.&nbsp;The product dissolves quickly (usually in less than 1 minute).&nbsp;After&nbsp;reconstitution, the solution should be clear, colorless, and free of foreign particles.<\/li><\/ol>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20110112000127#\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.fass.se\/imaging\/resources\/a3f65b78-db15-41c1-b438-a300f1d07d1d\" alt=\"Pictures for Preparation with BAXJECT II\"\/><\/a><\/figure>\n\n\n\n<p><strong>Instructions for&nbsp;injection<\/strong><\/p>\n\n\n\n<p>For&nbsp;administration, a&nbsp;syringe&nbsp;with a Luer cap is required.<\/p>\n\n\n\n<p><em>Important information:<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do not try to inject the solution yourself unless you have been trained by your doctor or nurse to do so.<\/li><li>Inspect the reconstituted solution for&nbsp;particulate matter&nbsp;and discoloration prior to&nbsp;administration&nbsp;(the solution should be clear, colorless, and free of foreign particles).&nbsp;<br>Do not use ADVATE if the solution is not completely clear or not completely dissolved.<\/li><\/ul>\n\n\n\n<ol class=\"wp-block-list\"><li>Remove the blue cap from the BAXJECT II.&nbsp;<strong>Do not draw air into the syringe.&nbsp;<\/strong>Connect the syringe to BAXJECT II (Fig. D).<\/li><li>Turn the system over (so that the bottle of the reconstituted solution is on top).&nbsp;Pull the reconstituted solution into the syringe by slowly pulling out the plunger (Fig. E).<\/li><li>Remove the syringe.<\/li><li>Connect a &#8220;butterfly&#8221; needle to the syringe and inject the reconstituted solution into a vein.&nbsp;The solution should be administered slowly, at a rate determined according to the patient&#8217;s condition, and should not exceed 10 ml per minute.&nbsp;(See section 4 \u201cPossible side effects\u201d.)<\/li><li>Dispose of the unused product appropriately.<\/li><\/ol>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20110112000127#\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.fass.se\/imaging\/resources\/a292e081-db2f-4265-9dd9-db0df563ea42\" alt=\"Pictures for Preparation with BAXJECT II\"\/><\/a><\/figure>\n\n\n\n<p><strong>The following information is intended for medical professionals only:<\/strong><br><\/p>\n\n\n\n<p><em>Treatment if necessary<\/em><\/p>\n\n\n\n<p>In the event of the following hemorrhagic events, the&nbsp;factor VIII&nbsp;activity should not be less than the given plasma activity level (in% of normal or IU \/ dl) during the corresponding period.&nbsp;The following table can be used as a dosing guide for bleeding episodes and surgeries.<br><\/p>\n\n\n\n<p>The dose&nbsp;and interval of&nbsp;administration&nbsp;should be adjusted according to the clinical effect of the individual case.&nbsp;In special circumstances (eg in the presence of a low titer inhibitor) higher&nbsp;doses&nbsp;than those calculated according to the formula may be required.<br><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Degree of bleeding \/ type of&nbsp;<\/strong><strong>surgery<\/strong><\/td><td><strong>Required&nbsp;factor VIIIlevel&nbsp;<br>(% or&nbsp;<\/strong><strong>IU \/ dl)<\/strong><\/td><td><strong>Dose interval (hours) \/&nbsp;<\/strong><strong>duration of treatment (days)<\/strong><\/td><\/tr><tr><td><strong>Bleeding<\/strong><br>Early home osteoarthritis, muscle bleeding, or mouth bleeding.<\/td><td><br>20 &#8211; 40<\/td><td><br>Repeat&nbsp;injection&nbsp;once&nbsp;every 12-24 hours (8-24 hours for patients younger than 6 years) for at least 1 day until the bleeding episode (pain experienced) has ceased or healing has been achieved.<\/td><\/tr><tr><td>More extensive osteoarthritis, muscle bleeding or hematoma.<\/td><td>30 &#8211; 60<\/td><td>Repeat&nbsp;injection&nbsp;once&nbsp;every 12-24 hours (8-24 hours for patients younger than 6 years) for 3-4 days or longer until pain relief and acute movement restriction are lifted.<\/td><\/tr><tr><td>Life-threatening bleeding.<\/td><td>60 &#8211; 100<\/td><td>Repeat&nbsp;injection&nbsp;once&nbsp;every 8-24 hours (6-12 hours for patients younger than 6 years) until the critical condition is overcome.<\/td><\/tr><tr><td><strong>Surgery<\/strong><br><em>Less<\/em>Including tooth extraction.<\/td><td><br>30 &#8211; 60<\/td><td><br>Every 24 hours (12-24 hours for patients younger than 6 years) for at least 1 day, until healing is achieved.<\/td><\/tr><tr><td><em>Major<\/em><\/td><td>80 &#8211; 100(pre- and postoperatively)<\/td><td>Repeat&nbsp;injection&nbsp;once&nbsp;every 8-24 hours (6-24 hours for patients younger than 6 years) until wound healing occurs, then continue treatment for at least another 7 days to maintain a&nbsp;factor VIIIactivity of 30-60% (IU \/ dl)&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>ADVATE contains the active substance octocog alfa, human coagulation factor VIII produced by recombinant DNA technology. Factor VIII is needed for the blood to form clots and stop bleeding. In patients with hemophilia A (congenital factor VIIIdeficiency ), this is absent or does not function normally.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2201,2200],"tags":[11504,11508,11502,11498,11501,11509,11503,11507,11505,11499,11500],"class_list":["post-4864","post","type-post","status-publish","format-standard","hentry","category-a","category-medicines","tag-advate","tag-benefits-of-advate","tag-benefits-of-oktokog-alfa","tag-oktokog-alfa","tag-oktokog-alfa-powder","tag-side-effects-of-advate","tag-side-effects-of-oktokog-alfa","tag-what-advate-is-used-for","tag-what-is-advate","tag-what-is-oktokog-alfa","tag-what-oktokog-alfa-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/4864","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=4864"}],"version-history":[{"count":6,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/4864\/revisions"}],"predecessor-version":[{"id":13059,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/4864\/revisions\/13059"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=4864"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=4864"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=4864"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}