Starting Hemlibra (emicizumab-kxwh)Your first 90 days with hemophilia A: the steps, the dates and who to call

How you take it

A shot under the skin once a week for the first 4 weeks. After that, once a week, every 2 weeks or every 4 weeks, on the schedule your doctor picks.

Before your first dose

• A plan from your doctor for your current bleed-prevention medicine. If you or your child take a bypassing agent to prevent bleeds, it stops the day before the first Hemlibra shot. Factor VIII used to prevent bleeds may keep going for the first week.
• A written plan for treating a bleed, including which medicine to use and how much. If FEIBA (aPCC) is ever needed, ask your doctor before using more than 100 units per kilogram in total.
• Shot training at the doctor's office for you or the person giving the shot. Children under 7 should not give their own shots, so a parent or caregiver does it.
• Your weight or your child's weight, because the dose is based on it. Tell your doctor when it changes.
• Your doctor's office sends one form and you sign a consent form for HEMLIBRA Access Solutions, the drugmaker's support program. A Case Manager then checks your insurance.
• Your insurance approves the medicine. Then a specialty pharmacy ships the vials and needles. The vials go in the fridge.

The first 90 days

1. Before the first doseForms, then the benefits check
2. Once approvedDelivery and training
3. Day beforeThe day before the first shot, bypassing agent prevention stops
4. Day 1Loading dose 1
5. Day 8Loading dose 2
6. Day 15Loading dose 3
7. Day 22The last of the 4 weekly starting shots. Ask the pharmacy about your next order
8. Day 29Week 5, the regular schedule your doctor picked begins
9. Every-2-week scheduleSecond maintenance dose, if every 2 weeks
10. Every-4-week scheduleSecond maintenance dose, if every 4 weeks
11. Day 85Three months in