antihemophilic factor recombinant (Rx)

Bleeding episodes

• Mild/moderate hemorrhage
  • Eloctate: 20-30 IU/kg IV to achieve factor VIII level of 40% to 60% of normal for the treatment of joint, superficial muscle/no neurovascular compromise (except iliopsoas), deep laceration and renal, superficial soft tissue, or mucous membrane bleeding; repeat q24-48hr until resolved
  • Advate, Helixate FS, Kogenate FS (initial): 10-20 units/kg IV to achieve factor VIII level of 20-40% of normal for the treatment of early hemarthrosis and minor muscle or oral bleed; may repeat dose q12-24hr x1-3 days if evidence of further bleeding
  • Recombinate, Xyntha: A dose sufficient to achieve factor VIII level of 20-40% of normal for the treatment of early hemarthrosis, muscle bleeding, or oral bleeding episode; may repeat dose q12-24hr x1-3 days if evidence of further bleeding
  • Nuwiq (mild): A dose sufficient to achieve factor VIII activity of 20-40% of normal for superficial muscle or soft tissue and oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Adynovate (mild): 10-20 IU/kg IV to achieve factor VIII activity of 20-40% of normal for superficial muscle or soft tissue and minor oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Kovaltry (mild): A dose sufficient to achieve factor VIII activity of 20-40% of normal for early hemarthrosis, minor muscle bleeding, or oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Afstyla (mild): A dose sufficient to achieve factor VIII activity of 20-40% of normal for early hemarthrosis, minor muscle bleeding, or oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Jivi (mild): 10-20 IU/kg IV to achieve factor VIII activity of 20-40% of normal for early hemarthrosis, superficial muscle or soft tissue and minor oral bleeds; may repeat dose q24-48hr until bleeding episode resolved
• Moderate hemorrhage
  • Advate: 15-30 units/kg IV to achieve factor VIII level of 30-60% of normal for the treatment of moderate bleeding into muscles, bleeding into the oral cavity, definite hemarthroses, and known trauma; may repeat dose q12-24hr x1-3 days if evidence of further bleeding
  • Eloctate: 20-30 IU/kg IV to achieve factor VIII level of 40-60% of normal for the treatment of joint, superficial muscle/no neurovascular compromise (except iliopsoas), deep laceration and renal, superficial soft tissue, or mucous membrane bleeding; repeat q24-48hr until resolved
  • Helixate FS, Kogenate FS (initial): 15-20 units/kg IV to achieve factor VIII level of 30-60% of normal for the treatment of moderate bleeding into muscles, bleeding into the oral cavity, definite hemarthroses, and known trauma; may repeat dose q12-24hr x1-3 days if evidence of further bleeding
  • Recombinate: A dose sufficient to achieve factor VIII level of 30-60% of normal for the treatment of more extensive hemarthrosis, muscle bleeding, or hematoma; repeat q12-24hr x3 days or more
  • Xyntha: A dose sufficient to achieve factor VIII level of 30-60% of normal for the treatment of hemorrhages into muscles, mild head trauma, and hemorrhages into oral cavity; repeat q12-24hr x3-4 days or until adequate local hemostasis is achieved
  • Nuwiq: A dose sufficient to achieve factor VIII activity of 30-60% of normal for hemorrhage into muscles, into oral cavity, hemarthrosis, or known trauma; may repeat dose q12-24hr for at least 3-4 day, until bleeding episode resolved
  • Adynovate: 15-30 IU/kg IV to achieve factor VIII activity of 30-60% of normal for moderate hemorrhage in oral cavity, definite hemarthroses, and known trauma; may repeat dose q12-24hr until bleeding episode resolved
  • Kovaltry: A dose sufficient to achieve factor VIII activity of 30-60% of normal for more extensive hemarthrosis, muscle bleeding or hematoma; may repeat dose q12-24hr for at least 3-4 day, until bleeding episode resolved
  • Afstyla: A dose sufficient to achieve factor VIII activity of 30-60% of normal for more extensive hemarthrosis, muscle bleeding or hematoma; may repeat dose q12-24hr for at least 3-4 day, until bleeding episode resolved
  • Jivi: 15-30 IU/kg IV to achieve factor VIII activity of 30-60% of normal for more extensive hemarthrosis, muscle bleeding, or hematoma; may repeat dose q24-48hr until bleeding episode resolved
• Severe hemorrhage
  • Advate: 30-50 units/kg IV to achieve factor VIII plasma level of 60-100% of normal for treatment of significant GI bleeding; intracranial, intra-abdominal, or intrathoracic bleeding; CNS bleeding; bleeding in the retropharyngeal or retroperitoneal spaces; or iliopsoas sheath, factures, and head trauma; repeat q8-24hr until bleeding episode resolved
  • Eloctate: 40-50 IU/kg IV to achieve factor VIII level of 80-100% of normal for the treatment of life or limb threatening hemorrhage, iliopsoas and deep muscle with neurovascular injury, and retroperitoneum, intracranial, or GI bleeding; repeat q12-24hr until bleeding resolved (typically 7-10 days)
  • Helixate FS, Kogenate FS: 40-50 units/kg IV to achieve factor VIII level of 80-100% of normal for the treatment of intracranial, intra-abdominal, or intrathoracic bleeding; GI bleeding; CNS bleeding; bleeding in the retroperitoneal or retropharyngeal spaces or iliopsoas sheath; fractures; and head trauma; repeat with 20-25 units/kg q8-12hr until bleeding episode resolved
  • Recombinate: A dose sufficient to achieve factor VIII level of 60-100% of normal for the treatment of life-threatening bleeding episodes, such as head injury, throat bleeding, or severe abdominal pain; repeat q8-24hr until bleeding episode resolved
  • Xyntha: A dose sufficient to achieve factor VIII level of 60-100% of normal for GI bleeding; intracranial, intra-abdominal, or intrathoracic hemorrhages; and fractures; repeat q8-24hr until bleeding episode resolved
  • Nuwiq: A dose sufficient to achieve factor VIII activity of 60-100% of normal for Intracranial, intraabdominal, GI, or intrathoracic bleeds, central nervous system bleeds, bleeding in retropharyngeal spaces or iliopsoas sheath, eyes/retina, fractures or head trauma; may repeat dose 8-24 hr until bleeding risk resolved
  • Adynovate: 30-50 IU/kg IV to achieve factor VIII activity of 60-100% of normal for severe hemorrhage including GI bleeding, intracranial, intraabdominal or intrathoracic, CNS, bleeding in the retropharyngeal or retroperitoneal spaces or iliopsoas sheath, fractures, head trauma; may repeat dose q8-24hr until bleeding episode resolved
  • Kovaltry: A dose sufficient to achieve factor VIII activity of 60-100% of normal for intracranial, intraabdominal, GI, or intrathoracic bleeds, central nervous system bleeds, bleeding in retropharyngeal spaces or iliopsoas sheath, life or limb threatening hemorrhage; may repeat dose 8-24 hr until bleeding risk resolved
  • Afstyla: A dose sufficient to achieve factor VIII activity of 60-100% of normal for intracranial, intraabdominal, GI, or intrathoracic bleeds, central nervous system bleeds, bleeding in retropharyngeal spaces or iliopsoas sheath, life or limb threatening hemorrhage; may repeat dose 8-24 hr until bleeding risk resolved
  • Jivi: 30-50 IU/kg IV to achieve factor VIII activity of 60-100% of normal for major hemorrhage including GI bleeding, intracranial, intraabdominal or intrathoracic, CNS, bleeding in the retropharyngeal or retroperitoneal spaces or iliopsoas sheath, live- or limb-threatening hemorrhage; may repeat dose q8-24hr until bleeding episode resolved

Perioperative management

• Minor surgery
  • Advate: 30-50 units/kg IV as a single IV bolus infusion beginning within 1 hr of the operation to achieve factor VIII level of 60-100% of normal for minor surgery, including tooth extraction; may repeat dosage q12-24hr as needed to control bleeding (for dental procedures, adjunctive therapy may be considered)
  • Eloctate: 25-40 units/kg IV to achieve factor VIII level of 50-80% of normal for minor surgery, including tooth extraction; may repeat dosage q24hr for at least 1 day until healing is achieved
  • Helixate FS, Kogenate FS: 15-30 units/kg IV to achieve factor VIII level of 30-60% of normal for minor surgery, including tooth extraction; may repeat dosage q12-24hr until bleeding is resolved
  • Recombinate: 60-80 units/kg IV to achieve adequate factor VIII level for minor surgery, including tooth extraction; a single infusion plus oral antifibrinolytic therapy within 1 hr is sufficient in ~70% of cases
  • Xyntha: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal q12-24hr for 3-4 days or until adequate local hemostasis is achieved; for tooth extraction, a single infusion plus oral antifibrinolytic therapy within 1 hr may be sufficient
  • Nuwiq: An IV dose sufficient to achieve Factor VIII activity within 80-100% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
  • Kovaltry: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
  • Afstyla: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
  • Jivi: 15-30 IU/kg IV to achieve factor VIII level of 30-60% of normal for minor surgery (eg, tooth extraction); may repeat dosage q24hr for at least 1 day until healing is achieved
• Major surgery
  • Advate: 40-60 units/kg IV preoperatively to achieve factor VIII level of 80-120% of normal pre- and postoperatively for major surgery, including intracranial, intra-abdominal, or intrathoracic surgery, and joint replacement surgery; repeat q8-24hr, depending on the desired level of factor VIII and state of wound healing
  • Eloctate: 40-60 units/kg IV preoperatively to achieve factor VIII level of 80-120% of normal pre- and postoperatively for major surgery, including intracranial, intra-abdominal, and joint replacement surgery; repeat dose of 40-50 units/kg after 8-24hr and then q24hr until adequate wound healing, then continue therapy for at least 7 days to maintain a Factor VIII activity within the target range
  • Helixate FS, Kogenate FS: 50 units/kg IV preoperatively to achieve factor VIII level of 100% of normal perioperatively for major surgery, including tonsillectomy, inguinal herniotomy, synovectomy, total knee replacement, craniotomy, osteosynthesis, trauma; repeat dose q6-12hr to maintain a Factor VIII activity within the target range until healing is complete
  • Recombinate: 80-100 units/kg IV preoperatively and postoperatively for major surgery; repeat dose q8-24hr depending on the state of healing
  • Xyntha: An IV dose sufficient to achieve Factor VIII activity within 60-100% of normal q8-24hr until threat is resolved, or in the case of surgery, until adequate local hemostasis and wound healing are achieved
  • Nuwiq: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal pre- and postoperatively for major surgery including intracranial, intraabdominal, or joint replacement therapy; may repeat q8-24hr until adequate wound healing, then continue therapy for at least another 7 days to maintain a Factor VIII activity of 30-60% (IU/dL)
  • Kovaltry: An IV dose sufficient to achieve Factor VIII activity within 80-100% of normal pre- and postoperatively for major surgery including intracranial, intraabdominal, intrathoracic, or joint replacement therapy; may repeat q8-24hr until adequate wound healing, then continue therapy for at least another 7 days to maintain a Factor VIII activity of 30-60% (IU/dL)
  • Afstyla: An IV dose sufficient to achieve Factor VIII activity within 80-100% of normal pre- and postoperatively for major surgery including intracranial, intraabdominal, intrathoracic, or joint replacement therapy; may repeat q8-24hr until adequate wound healing, then continue therapy for at least another 7 days to maintain a Factor VIII activity of 30-60% (IU/dL)
  • Jivi: 40-50 IU/kg IV to achieve factor VIII level of 80-100% of normal for major surgery (eg, intracranial, intra-abdominal, or joint replacement); may repeat dosage q12-24hr for at least 1 day until adequate wound healing complete, then continue therapy for at least another 7 days to maintain Factor VIII activity of 30-60% (IU/dL)

Routine prophylaxis dose

• NovoEight: 20-50 IU/kg IV 3x/week, OR 20-4 IU/kg IV every other day
• Kogenate FS: 25 IU/kg IV 3x/week
• Advate: 20-50 IU/kg IV every other day, OR every 3rd day dosing targeted to maintain FVIII trough levels ≥1%
• Eloctate: 50 IU/kg IV q4days; adjust based on patient response (range: 24-65 IU/kg at 3-5 day intervals)
• Nuwiq: 30-40 IU/kg IV every other day
• Adynovate: 40-50 IU/kg IV 2x/week; adjust dose based on clinical response
• Kovaltry (adults and adolescents): 20-40 IU/kg IV 2-3 x/week
• Afstyla (adults and adolescents): 20-50 IU/kg IV 2-3 times per week
• Jivi: 30-40 IU/kg IV 2x/week; based on bleeding episodes, may adjust to 45-60 IU/kg q5days; may further individually adjust to less or more frequent dosing

Subsequent dosing

• May repeat q4-12hr
• Titrate dose and frequency of administration based on factor VIII recovery levels and individual clinical response
• Maintain the factor VIII activity within the target range; plasma levels of factor VIII should not exceed 200% of normal or 200 units/dL

FVIII level required

• Minor/moderate, superficial muscle, no neurovascular compromise, and joint: 50-100 U/dL
• Major, moderate to severe IM bleeding, retroperitoneal, GI, intracranial:
• -Acute major bleed: 100-200 U/dL
• -After acute major bleed controlled (if required): 50-100 U/dL

Limitations of use

• Safety and efficacy not established in patients with a baseline antiporcine factor VIII inhibitor titer >20 BU
• Not indicated for the treatment of congenital hemophilia A or von Willebrand disease

Bleeding episodes, FVIII level required

• Mild hemorrhage: 20-40 IU/dL peak (700-1400 IU for 70 kg); begin infusions q12-24hr x 1-3 days until resolved
• Moderate hemorrhage: 30-60 IU/dL peak (1050-2100 IU for 70 kg); repeat infusions q12-24hr x 3 days or more until resolved
• Severe/life-threatening hemorrhage: 60-100 IU/dL peak (2100-3500 IU for 70 kg); repeat infusions q8-24hr until resolved

Bleeding episodes (Eloctate)

• Mild/moderate hemorrhage: 20-30 IU/kg IV; repeat q24-48hr (age <6 yr give q12-24hr) until resolved; 40-60 IU/dL FVIII level required
• Severe hemorrhage: 40-50 IU/kg IV; repeat q12-24hr (age <6 yr give q8-24hr) until resolved (~7-10 days); 80-100 IU/dL FVIII level required

Bleeding episodes (Nuwiq)

• Aged 2-17 years
  • Mild hemorrhage: A dose sufficient to achieve factor VIII activity of 20-40% of normal for superficial muscle or soft tissue and oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Moderate hemorrhage: A dose sufficient to achieve factor VIII activity of 30-60% of normal for hemorrhage into muscles, into oral cavity, hemarthrosis, or known trauma; may repeat dose q12-24hr for at least 3-4 day, until bleeding episode resolved
  • Severe hemorrhage: A dose sufficient to achieve factor VIII activity of 60-100% of normal for Intracranial, intraabdominal, GI, or intrathoracic bleeds, central nervous system bleeds, bleeding in retropharyngeal spaces or iliopsoas sheath, eyes/retina, fractures or head trauma; may repeat dose 8-24 hr until bleeding risk resolved

Bleeding episodes (Adynovate)

• Children (<12 years) have demonstrated higher clearance, a shorter half-life, and lower incremental recovery of factor VIII compared to adults; dose adjustment or more frequent dosing based on per kg body weight may be needed in this population
• Mild hemorrhage: 10-20 IU/kg to achieve factor VIII activity of 20-40% of normal for superficial muscle or soft tissue and minor oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
• Moderate hemorrhage: 15-30 IU/kg to achieve factor VIII activity of 30-60% of normal for moderate hemorrhage in oral cavity, definite hemarthroses, and known trauma; may repeat dose q12-24hr until bleeding episode resolved
• Severe hemorrhage: 30-50 IU/kg to achieve factor VIII activity of 60-100% of normal for severe hemorrhage including GI bleeding, intracranial, intraabdominal or intrathoracic, CNS, bleeding in the retropharyngeal or retroperitoneal spaces or iliopsoas sheath, fractures, head trauma; may repeat dose q8-24hr until bleeding episode resolved

Bleeding episodes (Kovaltry)

• Aged ≤12 years
  • Mild hemorrhage: A dose sufficient to achieve factor VIII activity of 20-40% of normal for early hemarthrosis, minor muscle bleeding, or oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Moderate hemorrhage: A dose sufficient to achieve factor VIII activity of 30-60% of normal for more extensive hemarthrosis, muscle bleeding or hematoma; may repeat dose q12-24hr for at least 3-4 day, until bleeding episode resolved
  • Severe hemorrhage: A dose sufficient to achieve factor VIII activity of 60-100% of normal for intracranial, intraabdominal, GI, or intrathoracic bleeds, central nervous system bleeds, bleeding in retropharyngeal spaces or iliopsoas sheath, life or limb threatening hemorrhage; may repeat dose 8-24 hr until bleeding risk resolved

Bleeding episodes (Afstyla)

• All ages
  • Mild hemorrhage: A dose sufficient to achieve factor VIII activity of 20-40% of normBal for early hemarthrosis, minor muscle bleeding, or oral bleeds; may repeat dose q12-24hr for at least 1 day, until bleeding episode resolved
  • Moderate hemorrhage: A dose sufficient to achieve factor VIII activity of 30-60% of normal for more extensive hemarthrosis, muscle bleeding or hematoma; may repeat dose q12-24hr for at least 3-4 day, until bleeding episode resolved
  • Severe hemorrhage: A dose sufficient to achieve factor VIII activity of 60-100% of normal for intracranial, intraabdominal, GI, or intrathoracic bleeds, central nervous system bleeds, bleeding in retropharyngeal spaces or iliopsoas sheath, life or limb threatening hemorrhage; may repeat dose 8-24 hr until bleeding risk resolved

Bleeding episodes (Jivi)

• <12 years: Safety and efficacy not established
• There is a higher rate of hypersensitivity in children aged <12 years owing to immune response to PEG
• ≥12 years
  • Mild hemorrhage: 10-20 IU/kg IV to achieve factor VIII activity of 20-40% of normal for early hemarthrosis, superficial muscle or soft tissue and minor oral bleeds; may repeat dose q24-48hr until bleeding episode resolved
  • Moderate hemorrhage: 15-30 IU/kg IV to achieve factor VIII activity of 30-60% of normal for more extensive hemarthrosis, muscle bleeding, or hematoma; may repeat dose q24-48hr until bleeding episode resolved
  • Severe hemorrhage: 30-50 IU/kg IV to achieve factor VIII activity of 60-100% of normal for major hemorrhage including GI bleeding, intracranial, intraabdominal or intrathoracic, CNS, bleeding in the retropharyngeal or retroperitoneal spaces or iliopsoas sheath, live- or limb-threatening hemorrhage; may repeat dose q8-24hr until bleeding episode resolved

Perioperative management, FVIII level required

• Minor surgery: Target of 60-100 IU/dL peak (2100-3500 IU for 70 kg); single bolus within 1 hr of operation; additional dosing q12-24hr PRN for bleeding
• Major surgery: Target of 80-100 IU/dL peak (2800-4200 IU for 70 kg) preop and postop; repeat infusion q6-12hr PRN for wound healing

Perioperative management (Eloctate)

• Minor surgery: 25-40 IU/kg IV; repeat q24hr (age <6 yr q12-24hr) for at least 1 day until healing is achieved; 50-80 IU/dL FVIII level required
• Major surgery: 40-60 IU/kg IV preop; repeat 40-50 IU/kg after 8-24 hr (age <6 yr q6-24hr), and then qDay until adequate wound healing, then continue for at least 7 days; 80-120 IU/dL FVIII level required

Perioperative management (Nuwiq)

• Aged 2-17 years
  • Minor surgery: An IV dose sufficient to achieve Factor VIII activity within 80-100% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
  • Major surgery: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal pre- and postoperatively for major surgery including intracranial, intraabdominal, or joint replacement therapy; may repeat q8-24hr until adequate wound healing, then continue therapy for at least another 7 days to maintain a Factor VIII activity of 30-60% (IU/dL)

Perioperative management (Adynovate)

• Children (<12 years) have demonstrated higher clearance, a shorter half-life, and lower incremental recovery of factor VIII compared to adults; dose adjustment or more frequent dosing based on per kg body weight may be needed in this population
• Minor surgery: An IV dose of 30-50 IU/kg sufficient to achieve Factor VIII activity within 60-100% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
• Major surgery: An IV dose of 40-60 IU/kg sufficient to achieve Factor VIII activity within 80-120% of normal pre- and postoperatively within 1 hr before operation for major surgery including intracranial, intraabdominal, or joint replacement therapy; may repeat q8-24hr (q6-24 hr for children <12 yr) until adequate wound healing

Perioperative management (Kovaltry)

• Aged ≤12 years
  • Minor surgery: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
  • Major surgery: An IV dose sufficient to achieve Factor VIII activity within 80-100% of normal pre- and postoperatively for major surgery including intracranial, intraabdominal, intrathoracic, or joint replacement therapy; may repeat q8-24hr until adequate wound healing, then continue therapy for at least another 7 days to maintain a Factor VIII activity of 30-60% (IU/dL)

Perioperative management (Afstyla)

• Any age
  • Minor surgery: An IV dose sufficient to achieve Factor VIII activity within 30-60% of normal pre- and postoperatively; may repeat q24hr for least 1 day until healing is achieved
  • Major surgery: An IV dose sufficient to achieve Factor VIII activity within 80-100% of normal pre- and postoperatively for major surgery including intracranial, intraabdominal, intrathoracic, or joint replacement therapy; may repeat q8-24hr until adequate wound healing, then continue therapy for at least another 7 days to maintain a Factor VIII activity of 30-60% (IU/dL)

Perioperative management (Jivi)

• <12 years: Safety and effiacy not established
• There is a higher rate of hypersensitivity in children aged <12 years owing to immune response to PEG
• ≥12 years
  • Minor surgery: 15-30 IU/kg IV to achieve factor VIII level of 30-60% of normal for minor surgery (eg, tooth extraction); may repeat dosage q24hr for at least 1 day until healing is achieved
  • Major surgery: 40-50 IU/kg IV to achieve factor VIII level of 80-100% of normal for major surgery (eg, intracranial, intra-abdominal, or joint replacement); may repeat dosage q12-24hr for at least 1 day until adequate wound healing complete, then continue therapy for at least another 7 days to maintain Factor VIII activity of 30-60% (IU/dL)

Routine prophylaxis dose

• NovoEight (<12 years): 25-60 IU/kg IV 3x/week, OR 25-50 IU/kg IV every other day
• NovoEight (≥12 years): 20-50 IU/kg IV 3x/week, OR 20-40 IU/kg IV every other day
• Kogenate FS, Helixate FS: 25 IU/kg IV every other day
• Advate: 20-50 IU/kg IV every other day
• Eloctate: 50 IU/kg IV q4days; adjust based on patient response (range: 24-65 IU/kg at 3-5 day intervals); more frequent or higher doses up to 80 IU/kg may be required for children aged <6 years
• Nuwiq (2-11 years): 30-50 IU/kg IV every other day or 3x/week
• Nuwiq (12-17 years): 30-40 IU/kg IV every other day
• Adynovate (≥12 years): 40-50 IU/kg IV 2x/week; adjust dose based on clinical response
• Adynovate (<12 years): 55 IU/kg IV 2x/week; adjust dose based on clinical response, not to exceed 70 IU/kg
• Kovaltry (≤12 years): 25-50 IU/kg IV 2-3 x/week or every other day according to individual requirements
• Afstyla (<12 years): 30-50 IU/kg IV 2-3 times per week Afstyla (≥12 years): 20-50 IU/kg IV 2-3 times per week
• Jivi (≥12 years): 30-40 IU/kg IV 2x/week; based on bleeding episodes, may adjust to 45-60 IU/kg q5days; may further individually adjust to less or more frequent dosing