Factor VIII replacement dosing

Because the half-life of factor IX is approximately 24 hours, dosing can be less frequentthan with factor VIII. Table 100-5 provides general guidelines for dosing factor IX, based on the site and severity of the bleeding episode. As with factor VIII replacement therapy, individual pharmacokinetics may vary, and monitoring the patient s factor IX levels helps optimize therapy. 

TABLE 64-3. Guidelines for Replacement Dosing with Factor VIII and Factor IX... 

Desmopressin can be administered every 12 to 24 hours, but the response diminishes with repeated treatment. After three to four doses, desmopressin is often no longer effective, and alternative replacement therapy may be necessary if prolonged treatment is required. Laboratory monitoring, including vWF Ag measurements, factor VIII assays, ristocetin cofactor activity assessments, and clinical examinations, will help determine the adequacy of treatment. 

---