> > > Perioperative Management

Recommended dosing for treatment of bleeding episodes and surgery.1

Keep NovoSeven® RT on hand to treat as soon as possible after a bleeding episode starts.

For detailed dosing information, please see the Prescribing Information.

CONGENITAL HEMOPHILIA A OR B WITH INHIBITORS

(for perioperative management)

MINOR:

Initial:

90 mcg/kg immediately before surgery

repeat every 2 hours for the duration of the surgery

Post surgical:

90 mcg/kg every 2 hours after surgery for 48 hours

then every 2-6 hours until healing occurs

Calculate a dose for your patient

MAJOR:

Initial:

90 mcg/kg immediately before surgery

repeat every 2 hours for the duration of the surgery

Post surgical:

90 mcg/kg every 2 hours after surgery for 5 days

then every 4 hours or by continuous infusion at 50 mcg/kg/hr until healing occurs

ACQUIRED HEMOPHILIA

(for perioperative management)

MINOR OR MAJOR:

70-90 mcg/kg immediately before surgery and every 2-3 hours

for the duration of surgery and until hemostasis is achieveda

Calculate a dose for your patient

CONGENITAL FACTOR VII

(for perioperative management)

MINOR OR MAJOR:

15-30 mcg/kg immediately before surgery and every 4-6 hours

for the duration of surgery and until hemostasis is achieveda

Calculate a dose for your patient

GLANZMANN’S THROMBASTHENIA

WITH REFRACTORINESS TO PLATELET TRANSFUSIONS, WITH OR WITHOUT ANTIBODIES TO PLATELETS
(for perioperative management)

MINOR OR MAJOR:

Initial:

90 mcg/kg immediately before surgery and every 2 hours

for the duration of the procedurea

Post surgical:

90 mcg/kg every 2 hours to prevent post-operative bleedinga

Higher doses of 100-140 micrograms per kg can be used for surgical patients who have clinical refractoriness with or without platelet-specific antibodies

Calculate a dose for your patient

aThe minimum effective dose has not been determined.

Available from Novo Nordisk:

Esperoct® logo

Visit website
Prescribing Information

Esperoct® logo

Visit website
Prescribing Information

Rebinyn® logo

Visit website
Prescribing Information

Rebinyn® logo

Visit website
Prescribing Information

Novoeight® logo

Visit website
Prescribing Information

Novoeight® logo

Visit website
Prescribing Information

Tretten® logo

Visit website
Prescribing Information

Tretten® logo

Visit website
Prescribing Information

Selected Important Safety Information

WARNING: THROMBOSIS

  • Serious arterial and venous thrombotic events following administration of NovoSeven® RT have been reported
  • Discuss the risks and explain the signs and symptoms of thrombotic and thromboembolic events to patients who will receive NovoSeven® RT
  • Monitor patients for signs or symptoms of activation of the coagulation system and for thrombosis

Warnings and Precautions

  • Serious arterial and venous thrombotic events have been reported in clinical trials and postmarketing surveillance
  • Patients with congenital hemophilia receiving concomitant treatment with aPCCs (activated prothrombin complex concentrates), older patients particularly with acquired hemophilia and receiving other hemostatic agents, and patients with a history of cardiac and vascular disease may have an increased risk of developing thrombotic events

Indications and Usage

NovoSeven® RT (coagulation Factor VIIa, recombinant) is a coagulation factor indicated for:

  • Treatment of bleeding episodes and perioperative management in adults and children with hemophilia A or B with inhibitors, congenital Factor VII (FVII) deficiency, and Glanzmann’s thrombasthenia with refractoriness to platelet transfusions, with or without antibodies to platelets
  • Treatment of bleeding episodes and perioperative management in adults with acquired hemophilia

Important Safety Information

WARNING: THROMBOSIS

  • Serious arterial and venous thrombotic events following administration of NovoSeven® RT have been reported
  • Discuss the risks and explain the signs and symptoms of thrombotic and thromboembolic events to patients who will receive NovoSeven® RT
  • Monitor patients for signs or symptoms of activation of the coagulation system and for thrombosis

Warnings and Precautions

  • Serious arterial and venous thrombotic events have been reported in clinical trials and postmarketing surveillance
  • Patients with congenital hemophilia receiving concomitant treatment with aPCCs (activated prothrombin complex concentrates), older patients particularly with acquired hemophilia and receiving other hemostatic agents, and patients with a history of cardiac and vascular disease may have an increased risk of developing thrombotic events
  • Hypersensitivity reactions, including anaphylaxis, can occur with NovoSeven® RT. Patients with a known hypersensitivity to mouse, hamster, or bovine proteins may be at a higher risk of hypersensitivity reactions. Discontinue infusion and administer appropriate treatment when hypersensitivity reactions occur
  • Factor VII deficient patients should be monitored for prothrombin time (PT) and factor VII coagulant activity (FVII:C). If FVII:C fails to reach the expected level, or PT is not corrected, or bleeding is not controlled after treatment with the recommended doses, antibody formation may be suspected and analysis for antibodies should be performed
  • Laboratory coagulation parameters (PT/INR, aPTT, FVII:C) have shown no direct correlation to achieving hemostasis

Adverse Reactions

  • The most common and serious adverse reactions in clinical trials are thrombotic events. Thrombotic adverse reactions following the administration of NovoSeven® RT in clinical trials occurred in 4% of patients with acquired hemophilia and 0.2% of bleeding episodes in patients with congenital hemophilia

Drug Interactions

  • Thrombosis may occur if NovoSeven® RT is administered concomitantly with Coagulation Factor XIII

Please click here for Prescribing Information

Reference:

  1. NovoSeven RT [package insert]. Plainsboro, NJ: Novo Nordisk Inc; 2019.