Drug reference

Emicizumab

Monoclonal Antibody · Hemostatic Agent

Monoclonal AntibodyHemostatic Agent

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

Manufacturer advises use only if potential benefit outweighs risk; no information available on human pregnancy.

FDA category + note

Top interactions

Anti Inhibitor Coagulant ComplexSevereDatabaseDDInter

Mechanism

Emicizumab is a bispecific monoclonal antibody that bridges activated factor IX and factor X. This action restores the function of missing activated factor VIII, which is essential for effective haemostasis in patients with hemophilia A.

Indications

Prophylaxis of hemorrhage in hemophilia A (congenital factor VIII deficiency) with or without factor VIII inhibitorsSevere hemophilia A with or without inhibitorsAcquired FVIII inhibitors

Dosing

Adult: Initial loading dose: 3 mg/kg once weekly for 4 weeks (subcutaneously). Maintenance dose: 1.5 mg/kg once weekly, or 3 mg/kg every 2 weeks, or 6 mg/kg every 4 weeks (subcutaneously).
Pediatric: Initial loading dose: 3 mg/kg once weekly for 4 weeks (subcutaneously). Maintenance dose: 1.5 mg/kg once weekly, or 3 mg/kg every 2 weeks, or 6 mg/kg every 4 weeks (subcutaneously).

Pharmacokinetics

Half-life

approximately 27 days

Bioavailability

80–90% after subcutaneous injection

Side effects

Common

ArthralgiaDiarrhoeaFeverHeadacheMyalgia

Serious

Cavernous sinus thrombosis
Embolism and thrombosis (especially with concomitant bypassing agents/prothrombin complex concentrates)
Skin necrosis
Thrombotic microangiopathy