Alhemo
Alhemo (concizumab or concizumab-mtci) is an injectable medication for people ages 12 years and older with hemophilia A or B, with or without factor inhibitors. It belongs to a drug class called tissue factor pathway inhibitor antagonists. It helps your blood clot more easily to help prevent bleeding episodes. Alhemo (concizumab) comes as a prefilled pen that you or a caregiver inject under the skin once a day. Some side effects can include injection-site reactions, headache, and hives.
What is Alhemo (concizumab)?
What is Alhemo (concizumab) used for?
- To prevent or reduce bleeding episodes in people 12 years and older with:
- Hemophilia A, with or without factor VIII inhibitors, or
- Hemophilia B, with or without factor IX inhibitors
How Alhemo (concizumab) works
Alhemo (concizumab) is a tissue factor pathway inhibitor antagonist. It blocks a protein in your body called tissue factor pathway inhibitor, or TFPI. This protein normally slows the clotting process.
By blocking TFPI, Alhemo (concizumab) helps your body's natural clotting process work better. This helps prevent bleeding episodes in people with hemophilia.
Drug facts
| Common Brands | Alhemo |
|---|---|
| Drug Class | TFPI antagonist |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Alhemo (concizumab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Hemophilia A or B with inhibitors:
- Injection-site reactions (e.g., bruising, redness, rash; 18%)
- Hives (6%)
Hemophilia A or B without inhibitors:
- Injection-site reactions (7%)
- Headache (7%)
Alhemo (concizumab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Blood clot: swelling, warmth, pain, or redness of the skin; chest pain; shortness of breath; sudden headache; confusion; trouble speaking or moving; droopy face; numbness on one side of your body; vision problems
- Serious allergic reaction: widespread itching; hives; swelling of your lips, tongue, or face; trouble swallowing; trouble breathing; chest tightness; dizziness
The following Alhemo (concizumab) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Headache
- Pain, redness, or irritation at injection site
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Pros and cons of Alhemo (concizumab)
Pros
- Works for hemophilia A or B, with or without inhibitors
- Given as an injection under the skin, instead of into a vein
- Prefilled pen with no mixing step
Cons
- Need to inject every day
- Can raise your risk of blood clots
- Not for active bleeding episodes
Pharmacist tips for Alhemo (concizumab)
- Learn how to use Alhemo (concizumab) before injecting it at home. Your hemophilia care team will show you how before you can do it on your own. Read the Instructions for Use and ask questions if anything isn't clear.
- Use Alhemo (concizumab) around the same time every day as prescribed. Missing doses make it harder to prevent bleeding episodes. This is especially important during the first 4 weeks while your hemophilia specialist is finding the right maintenance dose for you.
- If you miss an Alhemo (concizumab) dose during the first 4 weeks, tell your prescriber and restart the 0.2 mg/kg daily dose. If you've already reached your maintenance dose, call your prescriber. Depending on how many doses you've missed, you might continue your usual dose or need to restart at a different dose.
- Talk to your hemophilia specialist before using factor replacement treatments or bypassing agents, such as Feiba, while taking Alhemo (concizumab). Using high or frequent doses of these treatments can raise your risk of blood clots. Your specialist will tell you how to use these treatments safely.
- Watch for signs of a serious blood clot while taking Alhemo (concizumab). They can include swelling, warmth, or pain in the leg. Other signs are chest pain, shortness of breath, trouble speaking, severe headache, confusion, or vision changes. Get medical help right away if these happen.
- If you're planning to have surgery, tell your hemophilia specialist. They might have you stop using Alhemo (concizumab) a few days before surgery and restart it after you've healed. Don't stop or restart Alhemo (concizumab) on your own. Follow your specialist's instructions.
- Talk to your hemophilia specialist first before stopping Alhemo (concizumab). They'll help find ways to protect you from bleeding episodes.
How to store Alhemo (concizumab):
- Keep new, unused Alhemo (concizumab) pens in the refrigerator at 36°F to 46°F. Don't freeze them. After you start using a pen, you can store it in the refrigerator or at room temperature below 86°F for up to 28 days. After 28 days, throw it away even if there's medication left.
How to use Alhemo (concizumab):
- Follow your care team's directions to prepare, prime, and inject the Alhemo (concizumab) pen. Ask your care team if you're not sure what to do.
- Before injecting Alhemo (concizumab), wash your hands with soap and water. Check that the liquid is clear and colorless to slightly yellow. It might have white or clear particles. Don't use the pen if the liquid looks discolored.
- If your Alhemo (concizumab) pen is cold, let it warm to room temperature in the palms of your hands before injecting. Don't warm it any other way.
- Use a new needle every time you inject Alhemo (concizumab). Reusing needles can raise the risk of infection, pain, and dose problems.
- Inject Alhemo (concizumab) into your stomach area (at least 2 inches from your belly button) or thigh. Choose a different area for your injection every day. Also avoid areas that are tender, bruised, red, hard, scarred, or have stretch marks or moles. This helps lower skin irritation and helps the medication absorb properly.
- Don't share Alhemo (concizumab) pens with anyone, even if you've changed the needle. Sharing pens can spread germs and raise the risk of infection.
- Throw away used Alhemo (concizumab) pens and needles in a sharps container. Safe sharps disposal helps protect you and other people from needle sticks and infection. Don't throw away used pens and needles in the regular trash.
Risks and warnings for Alhemo (concizumab)
Alhemo (concizumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Blood clots
- Risk factors: High or frequent doses of breakthrough bleed treatments | Blood vessel problems | Crush injury | Cancer | Blood-clotting problems | Infection that has spread to your blood
Alhemo (concizumab) can raise your risk of blood clots. Your risk might be higher if you have other health conditions that raise your chance of blood clots. It also might be higher if you need high or frequent doses of certain clotting treatments while taking Alhemo (concizumab). Tell your hemophilia specialist about your health conditions and medications so they can check your risk.
Blood clots can block blood flow to different parts of your body. This can include your legs, lungs, heart, or brain. Some clots can become dangerous fast since they can affect how important organs work. Watch for swelling, warmth, or pain in one area. Also watch for chest pain, shortness of breath, confusion, trouble speaking, sudden severe headache, or vision changes. These can be signs of a serious blood clot. If this happens, stop using Alhemo (concizumab) and get medical help right away.
Your care team will monitor your risk of blood clots while you're using Alhemo (concizumab). Don’t change your clotting treatment on your own. Follow your prescriber's instructions, especially if you need treatment for breakthrough bleeding or have surgery planned.
Allergic reactions
Alhemo (concizumab) can cause allergic reactions, including a severe reaction called anaphylaxis. Mild reactions can include a rash, redness, itching, hives, or stomach pain. Severe symptoms can cause swelling of your lips, tongue, or face. They can also include trouble breathing or swallowing, chest tightness, or feeling faint.
Watch for these reactions after each Alhemo (concizumab) injection. If you have mild symptoms, call your prescriber right away. If you have trouble breathing or swelling of your face or throat, stop using Alhemo (concizumab) and get emergency medical help right away.
Alhemo (concizumab) dosage
Pen| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1.5ml of 150mg/1.5ml | 2 pens | $52,019.05 | $26,009.53 |
| 1.5ml of 60mg/1.5ml | 5 pens | $52,019.05 | $10,403.81 |
| 3ml of 300mg/3ml | 2 pens | $104,031.84 | $52,015.92 |
Typical dosage for Alhemo (concizumab)
Inject Alhemo (concizumab) under the skin once a day. Your dose is based on your body weight.
-
Day 1: The typical starting dose is 1 mg/kg injected once under the skin.
-
Day 2 and beyond: The typical dose is 0.2 mg/kg injected under the skin once a day.
About 4 weeks after you start Alhemo (concizumab), your prescriber will check how much of the medication is in your blood before your next dose. If needed, they'll adjust your dose based on your blood test results.
How much does Alhemo (concizumab) cost?
$52,019.05
What are alternatives to Alhemo (concizumab)?
Alhemo (concizumab) images
