If you have hemophilia A, ongoing monitoring and treatment is needed to prevent excessive bleeding and complications. There’s no cure for this condition, but with proper care and management you can enjoy a good quality of life. Treatment may involve a combination of on-demand and preventive medications to stop bleeding and reduce its occurrence.

Talk to your doctor about the following fast-acting drugs and prophylaxis plans for hemophilia A. What will work best for you depends on the severity of your condition, your overall health, and other factors.

On-demand treatments

Mild forms of hemophilia A may respond positively to periodic on-demand treatments. If you have a mild type of hemophilia A, it means you don’t bleed spontaneously, and you only tend to bleed after an injury. Your doctor can help you make this determination.

On-demand or rescue treatments for mild hemophilia A primarily involve desmopressin (DDAVP) injections. DDAVP is a hormonal injection that induces factor VIII releases in your blood. When taken at the first sign of injury, this can help your blood to clot as it should. This way, you don’t bleed excessively. These injections are prescribed and given by your doctor. DDAVP is also available as a nasal spray you can use at home or on the go.

While DDAVP can help stop excessive bleeding, it shouldn’t be used on a regular basis because that could reduce its efficacy. If you find you’re using DDAVP more than a few times per month, you may need to talk to your doctor about your treatment plan and consider other therapies.

Severe hemophilia A may also be treated with clotting factor VIII infusions. When used as an on-demand treatment, these infusions provide emergency clotting agents if you experience bleeding. Clotting factor infusions are made from either plasma or components engineered in the lab to encourage blood clotting. The downside to on-demand infusions for severe hemophilia A is that the clotting factors may not be delivered in a timely fashion to stop bleeding when it occurs.

Prophylactic treatments

Infusion therapy is also used in the prophylactic treatment for hemophilia A. Preventive blood infusions help increase the amount of clotting factor VIII in the body so that you don’t have frequent or long-lasting bleeds. The number of infusions you receive depends on how severe your condition is. You may be able to do these infusions at home.

Prophylaxis with infusions can also help prevent internal bleeding caused by hemophilia A. While some cases of internal bleeding are evident with bruising, others or not. Without treatment, internal bleeding can be especially dangerous and lead to nerve and tissue damage.

Possible side effects of infusion therapy include viral infections and the development of antibodies that destroy factor VIII. Your doctor may prescribe antifibrinolytic drugs along with infusions. These oral medications help to prevent the breakdown of clots.

Prophylaxis for hemophilia A also means taking extra measures to reduce your risk of injury. For instance:

  • wearing protective gear when playing higher-risk sports or performing other activities
  • going to physical therapy to help reduce the impact of bleeding at the joints
  • protecting the ends of furniture and other areas that you’re prone to bump into

Still, even with mild to moderate hemophilia A, the above precautions don’t necessarily mean you don’t need medications. In fact, some drugs for hemophilia A can help prevent the onset of bleeding in certain situations. For example, if you’re going to play a higher-risk sport or undergo dental work, you may need to take DDAVP as a precaution.

Which option to choose

The treatments you will take for hemophilia A ultimately depend on the severity of your condition. While factor VIII medications can help with clotting, preventive measures may be equally important.

Age is another important consideration. Since hemophilia A is present from birth, many people are diagnosed during childhood. More severe cases are evident during infancy. Living a long life is possible with this condition, but older adults may be more vulnerable to excessive bleeding and complications. As you grow older, your doctor may recommend having emergency injections as a precaution. On the other hand, treatment for children focuses on preventing unnecessary injury and using infusion prophylaxis for children with severe hemophilia A.

Bottom line

Hemophilia A drug treatments have evolved, allowing people with this condition to live longer and enjoy a better quality of life. Both on-demand and preventive drug treatments can help your condition by stopping bleeding, while also decreasing the occurrence of bleeding. Talk to your doctor to learn about your options and what will work best for you.

Researchers are also working on gene therapies for hemophilia A. This would involve the replacement of missing or damaged genes that could be contributing to the disease. According to the National Human Genome Research Institute, this could pave the way to a possible cure. You may want to consider talking to your doctor about participating in clinical trials.