HAEMOCTIN SDH 1000 FOR INJECTION 1000 IU/VIAL [SIN15337P]

Product Info

HAEMOCTIN SDH 1000 FOR INJECTION 1000 IU/VIAL

[SIN15337P]

Indication

Indications
Treatment and prophylaxis of bleeding in patients with haemophilia A (congenital factor VIII deficiency).
This product may be used in the management of acquired factor VIII deficiency.
This preparation does not contain von Willebrand factor in pharmacologically effective quantities and is therefore not indicated in von Willebrand's disease.

Dosing

Dosage and method of administration
Treatment should be initiated under the supervision of a physician experienced in the treatment of haemophilia.

Treatment monitoring
During the course of treatment, appropriate determination of factor VIII levels is advised to guide the dose to be administered and the frequency of repeated infusions. Individual patients may vary in their response to factor VIII, demonstrating different half-lives and recoveries. Dose based on bodyweight may require adjustment in underweight or overweight patients. In the case of major surgical interventions in particular, precise monitoring of the substitution therapy by means of coagulation analysis (plasma factor VIII activity) is indispensable.

When using an in vitro thromboplastin time (aPTT)-based one stage clotting assay for determining factor VIII activity in patients’ blood samples, plasma factor VIII activity results can be significantly affected by both the type of aPTT reagent and the reference standard used in the assay. Also there can be significant discrepancies between assay results obtained by aPTT-based one stage clotting assay and the chromogenic assay according to Ph. Eur. This is of importance particularly when changing the laboratory and/or reagents used in the assay.

Dosage
The dose and duration of the substitution therapy depend on the severity of the factor VIII deficiency, on the location and extent of the bleeding and on the patient's clinical condition.

The number of units of factor VIII administered is expressed in International Units (IU), which are related to the current WHO concentrate standard for factor VIII products. Factor VIII activity in plasma is expressed either as a percentage (relative to normal human plasma) or in International Units (relative to an International Standard for factor VIII in plasma).

One International Unit (IU) of factor VIII activity is equivalent to that quantity of factor VIII in one ml of normal human plasma.

On demand treatment
The calculation of the required dose of factor VIII is based on the empirical finding that 1 International Unit (IU) factor VIII per kg body weight raises the plasma factor VIII activity by 1 % to 2 % of normal activity. The required dose is determined using the following formula:
Required Units = body weight (kg) x desired factor VIII rise (%) x 0.5
The amount to be administered and the frequency of administration should always be oriented to the clinical effectiveness in the individual case.

In the case of the following haemorrhagic events, the factor VIII activity should not fall below the given plasma activity level (in % of normal) in the corresponding period. The following table can be used to guide dosing in bleeding episodes and surgery:

Prophylaxis
For long term prophylaxis against bleeding in patients with severe haemophilia A, the usual doses are 20 to 40 international units of factor VIII per kg body weight at intervals of 2 to 3 days. In some cases, especially in younger patients, shorter dosage intervals or higher doses may be necessary.

Method of administration
Intravenous use. It is recommended not to administer more than 2–3 ml Haemoctin SDH/ min. Absolute sterility is to be ensured in all steps of the procedure!

Dissolution of the concentrate:

• Bring the unopened vials of the solvent (water for injections) and product to room temperature. If a water bath is used for warming, it must be scrupulously ensured that the water does not come into contact with the caps or stoppers of the vials. Otherwise contamination of the medicine may occur.

• Very important for proper use of the transfer system: prior to opening, make sure that the white lower part of the transfer system sits directly on the ground of the blister (Fig. 1a: correct/ Fig. 1b: not correct). If not correct: push the transfer system down in the blister until the white lower part of the transfer system sits directly on the ground of the blister (Fig. 1c).

• Remove the caps from the solvent and the product vial in order to expose the central portions of the rubber stoppers (Fig. 2). Ensure that the rubber stoppers of the product and solvent vials are treated with a disinfectant.

• Remove the top of the transfer system packaging (Fig. 3).

• Place the solvent vial on even surface. Place the blue part of the transfer system within the blister straight onto the upright standing vial containing the solvent (Fig. 4). Do not twist the transfer system!

• Remove the remaining part of the blister from the transfer system. Do not squeeze the blister! Now the white part of the transfer system is visible (Fig. 5).

• Place the product vial on an even surface.

• Turn the combination of transfer system and solvent vial upside down. Push the spike of the white part of the adapter straight down through the product vial stopper (Fig. 6). The vacuum present in the product vial causes the solvent to flow into the product vial.

• Gently swirling the product vial helps in dissolving the powder. Do not shake vigorously, all foaming is to be avoided! The solution is clear or slightly opalescent.

• Afterwards unscrew the blue part of the transfer system together with the solvent vial counterclockwise (Fig. 7). Discard the solvent vial with the blue part of the transfer system attached. The Luer-Lock connector is now visible.

The solution ready for use should be used immediately after dissolving. Do not use solutions that are cloudy or contain visible particles

Injection:

• Once you have dissolved the powder as described above, screw the enclosed syringe onto the Luer-Lock connector of the product vial with the white part of the transfer system (Fig. 8). This allows you to easily draw the dissolved drug (Haemoctin SDH 250: total volume of 2.5 ml, Haemoctin SDH 500/1000: total volume of 5 ml) into the syringe. A separate filter is not necessary because the transfer system has its own integral filter.

• Carefully disconnect the vial with the white part of the transfer system from the syringe. Use the enclosed butterfly needle and administer immediately by slow intravenous injection. The injection rate must not exceed 2–3 ml/minute.

• After the butterfly needle has been used, it can be made safe with the protective cap.

Contraindications

Contraindications
Hypersensitivity to the active substance or to any of the excipients.