Typical doses of factor VIII concentrate containing von Willebrand factor (vWF) in the prevention and treatment of bleeding in patients with severe vWF and factor VIII deficiency (<10%)

Table 9.2-2. Typical doses of factor VIII concentrate containing von Willebrand factor (vWF) in the prevention and treatment of bleeding in patients with severe vWF and factor VIII deficiency (<10%)
Type of bleeding	Dose (IU/kg)a	Frequency of administration	Suggested plasma activity of factor VIII or vWF (% of normal)
Major surgeryb	50	Before procedure, then every 12-24 h until wound is completely healed	>50% for 5-7 days, then dose may be reduced
Minor surgery	40	Before procedure, then every 24-48 h until wound is completely healed	>30% for 1-5 days
Tooth extractionc	30	Once before procedure	>50% for 12 h
Minor bleeding	25	Repeat every 24 h if necessary	>30% until bleeding stops
Delivery	40	Every 24 h	>50% on day of delivery and for subsequent 3-4 days
a In children increase each dose by 20% because of the higher relative plasma volume. b In patients with severe bleeding (eg, central nervous system hemorrhage) use the same doses as for major surgery. To reduce the risk of thrombosis, maintain plasma factor VIII activity <250% of normal. c For 3 to 7 days after the extraction, additionally administer tranexamic acid 10 to 15 mg/kg orally every 8 hours.