Hemlibra (emicizumab or emicizumab-kxwh) is used to prevent or reduce the number of bleeding episodes in people with hemophilia A, a genetic disorder that causes the blood to not clot properly due to a missing clotting factor called factor VIII. It's given as an injection under the skin, so you don't need to infuse it through your veins like some other medications used to treat this condition. It can be given at home, and dosing ranges from once a week to once a month.
Prevention of bleeding episodes in children and adults with hemophilia A
People with hemophilia A have either no or a lower amount of a protein called clotting factor VIII, one of the many clotting factors that help control bleeding. When you get injured and start bleeding, clotting factor VIII bridges two other clotting factors together (factor IX and factor X) to help the blood clot in order to stop the bleed. When there's less or factor VIII in the blood, the blood can't clot as well. This puts you at higher risk for bleeds.
Hemlibra (emicizumab) is a monoclonal antibody that does the same job as factor VIII of bringing two important clotting factors together to continue the clotting process in the blood.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Works well to prevent bleeding episodes in people with hemophilia A with or without factor VIII inhibitors
Stays in your body longer compared to factor VIII treatment
Can be given once a week to once a month, so flexible dosing schedule
Can be used in people of all ages
Injected under the skin instead of infused through the veins, like some other medications used to treat hemophilia A
Brand name only, so might be expensive
Unknown if safe during pregnancy or while breastfeeding
Can cause unpleasant side effects like headache and joint pain
Can put you at risk for blood clots or damage to your blood vessels
Before starting Hemlibra (emicizumab), discuss with your provider when you should stop your other medications used for hemophilia A.
Read the instructions for use and watch this video on how to inject Hemlibra (emicizumab). Your provider will train you on how to inject yourself or your child with Hemlibra (emicizumab). Talk with your provider or pharmacist if you have any questions on how to use this medication.
Hemlibra (emicizumab) comes in different strengths, and you might need to use more than one to make up your dose. Never combine different vials of different strengths into one injection. You should only use one vial at a time to prevent damaging the medication and giving yourself the wrong dose.
When you're ready to use Hemlibra (emicizumab), take the vial out of the refrigerator 15 minutes before you prepare your injection to allow it to come to room temperature. This will make it more comfortable when you inject it.
Check to make sure the color in the Hemlibra (emicizumab) vial is colorless to slightly yellow. If it's cloudy, hazy, colored, contains particles (solid chunks), or if the cap is missing, don't use the vial and contact your provider for further instructions. Never shake Hemlibra (emicizumab) since this can damage the medication.
You can inject Hemlibra (emicizumab) into your thigh, stomach, or outer upper arm (with help from a caregiver). Discuss the best site to inject yourself with your provider and make sure you're comfortable with the technique.
Use the syringes, transfer needles, and injection needles only once when giving Hemlibra (emicizumab) to avoid contamination (spreading germs). Once you prepare your dose, give it right away and don't save it for later because it might not work as well anymore.
Throw the used needles and syringes away in a sharps container or a large, empty, plastic container (such as a laundry detergent container) after your injection to avoid needlestick injuries.
Store Hemlibra (emicizumab) in the refrigerator in its original carton. It shouldn't be kept out of the refrigerator for more than a total of 7 days or reach a temperature more than 86 degrees F. If this happens, throw the medication away and ask your provider or pharmacist about a replacement.
Hemlibra (emicizumab) can interfere with certain lab tests, so make sure to tell all of your providers you're taking it.
Hemlibra (emicizumab) 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.
Risk factors: Taking activated prothrombin complex concentrate (aPCC) together with Hemlibra (emicizumab)
In some people taking Hemlibra (emicizumab) together with aPCC, a medication used to control bleeding in people with hemophilia A and B, blood clots in small blood vessels (thrombotic microangiopathy) and other parts of the body were reported. If this happens, you need to stop aPCC and temporarily stop Hemlibra (emicizumab). You'll typically start to recover in weeks to months after stopping aPCC. Since Hemlibra (emicizumab) stays in your body for a long time, you're at risk for this interaction with aPCC for up to 6 months after your last Hemlibra (emicizumab) dose. Your provider will monitor your blood counts while you're taking both of these medications together. Get medical help right away if you experience symptoms such as swollen leg, pain in your leg, chest pain, difficulty breathing, feeling dizzy, and feeling confused.
When you're taking biologic medications like Hemlibra (emicizumab), sometimes your body's immune system can create anti-medication antibodies (proteins) that attack the medication. This can cause your medication to not work a well. If you experience more bleeding episodes or feel like Hemlibra (emicizumab) isn't working well for you, contact your provider.
Your dose of Hemlibra (emicizumab) depends on your weight.
The typical starting dose is 3 mg/kg injected under the skin once weekly for the first 4 weeks. Your healthcare provider will have you continue with one of the following maintenance doses, depending on which is best for you:
1.5 mg/kg injected under the skin every week, OR
3 mg/kg injected under the skin every 2 weeks, OR
6 mg/kg injected under the skin every 4 weeks
Prevention of bleeding episodes in children and adults with hemophilia A
To prevent or treat bleeding in people with hemophilia A
Bedwetting - oral tablets only
Nocturia (a lot of urination at nighttime) in adults - sublingual tablets (Nocdurna) only
Von Willebrand disease - injection only
Hemophilia A - injection only
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.