Taking Hemlibra

Hemlibra is different to factor VIII replacement therapy. It is used for people with severe haemophilia A (FVIII<1%), moderate haemophilia A with a severe bleeding phenotype (FVIII ≥1 - ≤5%) and also for people with FVIII inhibitors. You have been prescribed Hemlibra because you and your healthcare team decided it was right for you; it does NOT mean you have inhibitors to factor VIII.

Hemlibra is given as an injection under the skin, called a subcutaneous injection. This may be different from what you’re used to.

Hemlibra must be taken regularly as prophylaxis

Hemlibra is taken once-weekly for the first 4 weeks (this is called your loading dose) and then once every one, two or four weeks thereafter.
Your Hemlibra dose is not routinely adjusted according to your blood results. You must not adjust the dose yourself, for example if you are planning on playing any sports.
If you have a bleed you should not take additional Hemlibra.
If you are already using factor VIII prophylaxis this can be continued for the first 7 days of your Hemlibra prophylaxis.

What happens if i have a bleed

Your dose is based on your body weight

For the first 4 weeks, you take a loading dose once a week (3.0 mg/kg).

From week 5, you then carry on taking a maintenance dose. This will be either:

once every week (1.5 mg/kg)
once every 2 weeks (3.0 mg/kg)
once every 4 weeks (6.0 mg/kg)

Hemlibra is always prescribed as routine prophylaxis. It is essential to take Hemlibra regularly to have a better chance of preventing bleeds.

Dos

Take Hemlibra regularly as instructed

Continue to take Hemlibra, even if you haven’t had a bleed in a while

If your prescribed dose is more than 2 mL you will need to have more than one subcutaneous injection of Hemlibra. These injections must be given on the same day with each injection at least 2.5cm away from the area used for the previous one

Don'ts

Do not take extra Hemlibra, even if you do have a bleed

Do not adjust your dose of Hemlibra yourself

Once you have taken Hemlibra for 4 weeks at the loading dose you will continue to inject Hemlibra regularly, as instructed by your haemophilia team.

Regular blood tests to check your factor levels are not needed when you are taking Hemlibra. Your dose is not based on your clotting factor levels.

If you do need to have any laboratory or blood tests, tell your doctor you are taking Hemlibra, as it can interfere with some laboratory tests, leading to inaccurate results.

Preparing for Hemlibra injections

Wash your hands well with soap and water before preparing and administering Hemlibra.

Before use, allow the vial(s) to reach room temperature for about 15 minutes on a clean flat surface away from direct sunlight.

Check the expiry date and check the liquid in the vial is clear and colourless or slightly yellow. Do not use the vial if the liquid is cloudy, hazy, discoloured or contains any visible particles.

For each injection, use a different area of the body to the one you used last time. You should use a different injection site for each injection, at least 2.5cm away from the area you used for your previous injection. This also applies if you need to have more than one injection for your prescribed dose.

Clean the chosen injection site area using an alcohol wipe and let the skin dry for at least 10 seconds.

Where to inject Hemlibra

The recommended injection sites are the abdomen and thigh. Additionally, the outer arm, when administered by a caregiver.

These sites are recommended because they have an easily accessible area of fatty tissue just below the skin.

Do not inject into areas that could be irritated by a belt or waistband. Do not inject into moles, scars, bruises, or areas where the skin is tender, red, hard or if the skin is broken.

How to take Hemlibra

There are detailed instructions in the Hemlibra package leaflet that comes with your medication. This includes how to prepare your vial(s) and how to inject Hemlibra.

Your haemophilia team will teach you how to perform subcutaneous injections
Your haemophilia team will calculate your dose of Hemlibra based on your weight
- Let them know if you lose or gain weight so that they can adjust your Hemlibra dose
- Do not try to calculate your dose of Hemlibra yourself
The acronym PARIS can help you to remember each step correctly and make injecting Hemlibra more comfortable