As we continue to make advancements in medicine, treatment options for bleeding disorders such as Hemophilia A, Hemophilia B, Von Willebrand disease, and other factor deficiencies are expanding.
With current estimates of 30,000–33,000 people living with hemophilia and approximately 3.2 million people living with von Willebrand disease in the U.S., proper medication, education, and therapy management are vital to positive outcomes (National Hemophilia Foundation, 2021). Home treatment for bleeding disorders is safe and convenient but requires proper education and support for patients and caregivers to most effectively manage care and achieve desired outcomes. One critical component of this care and support includes the proper storage and rotation of the specialty medications used to treat bleeding disorders. If products and equipment are correctly stored and handled, self-administration is safe, convenient, and effective. This short blog reviews some basic things to consider regarding the storage of specialty medication used to treat bleeding disorders.
Storing Your Factor Products
Proper storage of your factor products is critical to ensure the stability and effectiveness of the product. Products that are not correctly stored risk the chance of becoming ineffective or inactive to manage or prevent a bleed (Frase 2014). When comparing factor products, each one may vary when looking at the storage and stability of the product in the vial. Talk to your pharmacist, and review the manufacturer’s directions or package insert for your specific product regarding how to maintain the proper stability of the factor.
Manufacturers typically recommend storing your factor products in the refrigerator (36°-46°F), while many have the capability of being held at stable room temperatures (up to 86°F) for periods of 3 months to 12 months (James 2021). This allows for flexibility in day-to-day life and travels out of town. One mistake to avoid is allowing the refrigerated factor to warm up to room temperature, then refrigerating it again. Another thing to remember is factor products should never be frozen to avoid cracking or breaking the vials.
What about Hemlibra?
Hemlibra is unique as it is a monoclonal antibody for Hemophilia A. The storage and stability also vary from the previously discussed factor products. Hemlibra is to be refrigerated (36°-46°F) and should not exceed temperatures of (86°F) or time out of refrigeration of 7 days (Genentech, 2017). This allows for slightly less flexibility if refrigeration is not available compared to factor products. However, unopened vials of Hemlibra may be stored out of and then returned to refrigeration, which can be convenient when traveling (Genentech 2017).
Expiring Factor
It is very important to keep track and note product expiration dates. Factor stability times vary product to product and should be disposed of when the product hits the expiration date. Checking expiration dates monthly and posting the date somewhere visible is an easy way to avoid using the expired factor. When you receive a new shipment, it is recommended to rotate stock, meaning you would put the most recent factor received in the back and use the factor in the front first.
All in all, whether you have questions on storage, stability, or expiration dates of your products, you can always check with your BioMatrix pharmacist, Regional Care Coordinator, Hemophilia Treatment Center, manufacturer package insert, or by contacting the manufacturer directly.
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References
“Von Willebrand Disease.” (15 Sept 2022). National Hemophilia Foundation, https://www.hemophilia.org/bleeding-disorders-a-z/types/von-willebrand-disease.
James, Paula D., et al. “Ash ISTH NHF WFH 2021 Guidelines on the Diagnosis of Von Willebrand Disease.” American Society of Hematology, American Society of Hematology, 12 Jan. 2021, https://ashpublications.org/bloodadvances/article/5/1/280/474888/ASH-ISTH-NHF-WFH-2021-guidelines-on-the-diagnosis.
Hemaware. (2010, June 21). Safely Storing Factor at Home. HemAware. (15 September 2022). From https://hemaware.org/bleeding-disorders-z/safely-storing-factor-home.
Hemlibra® [package insert]. San Francisco (CA): Genentech Inc.; 2017.
