Treatment of haemophilia

Desmopressin

Desmopressin (DDAVP) is a synthetic hormone, which is man-made and contains no human blood products. It works by releasing the clotting factor stored in the body from the lining of the blood vessels, causing a temporary rise in factor levels. Desmopressin can be taken in any of the following ways:

As an injection into the vein (intravenously)
As an injection under the skin (subcutaneously)
As a nasal spray

Different people will have different responses to desmopressin, and the doctor will carry out a test to check individual response before it is given as a treatment. This test should be carried out before treatment is needed, e.g. before surgery takes place.
It can sometimes have some mild side-effects, including:

facial flushing
mild headache
nausea and abdominal cramps.

Desmopressin is an anti-diuretic, i.e. it causes the body retain water, and it is recommended that after receiving desmopressin people drink only enough fluid to satisfy thirst. If a person has a severe headache or is unable able to pass water 24 hours after taking desmopressin, they should contact the haemophilia centre or A&E department.
In major surgery, desmopressin alone may not be enough to control bleeding, and it may also be necessary to receive a clotting factor concentrate.

Tranexamic acid

Tranexamic acid works by helping to slow down the body’s natural process of breaking down a clot, which helps to stop the bleeding. It can be used on-demand, typically the day before a period is due until the bleeding slows down. Tranexamic acid usually comes in tablet form, although it can be given intravenously or as a liquid medicine which is particularly suitable for children. It can be used on its own to treat minor bleeding episodes, or in combination with other treatments such as desmopressin or clotting factor concentrates.

Clotting factor concentrates

Clotting factor treatment temporarily replaces the factor VIII or IX in the blood, helping to control bleeding. It is given by intravenous injection.

Immunisation against hepatitis A and B

If a bleeding disorder is present, or a person is more likely than usual to need a blood transfusion, immunisation against hepatitis A and B is recommended. The haemophilia centre can provide information on this, and the injection can be given subcutaneously (under the skin) rather than into the muscle to avoid bruising. There is no vaccination against hepatitis C.

Hormone treatment

Hormones circulate naturally in the bloodstream. Levels of oestrogen and progesterone increase during pregnancy and breastfeeding, and periods are suppressed. Using these hormones to control monthly blood loss is a medical way of doing what nature does naturally during pregnancy, raising levels of factor VIII (but not factor IX).

The combined oral contraceptive pill contains read more