Antihemophilic factor VIII (Eloctate®)
OFFICE ADMINISTRATION / HOME HEALTH
Indications for Prior Authorization:
- Adults and children with hemophilia.
- A for control and prevention of bleeding episodes, perioperative management and routine prophylaxis
The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:
- Any other diagnosis not listed in the approved indications
- Routine prophylaxis: 50 IU/Kg every 4 days
- Adjust dose based on response
- Half-life in children less than 6 is shorter and they may require larger doses or more frequent administration.
Last review date: August 4, 2014