What is emicizumab?

Emicizumab (also called Hemlibra®)  is a medicine that acts like FVIII (factor 8) in the body to help your blood to clot. This medicine is used to prevent bleeding in some patients with FVIII deficiency (hemophilia A). It is a colorless to pale yellow liquid that is injected under the skin.

This medicine is available in the following strengths:

  • 30 mg/1 ml (this is a different concentration than the other vials)
  • 60 mg/0.4 ml
  • 105 mg/0.7 ml
  • 150 mg/1 ml

Possible side effects of emicizumab

  • Injection site reactions: redness, swelling, warmth, pain
  • Fever
  • Headache
  • Joint or muscle pain
  • Diarrhea

Call the doctor right away if you have any of the following side effects:

  • Symptoms of a blood clot
    • Arms, legs, face: swelling, redness, pain
    • Numbness, weakness, changes in awareness, facial drooping or drooling, visual changes, severe headache
    • Short of breath, chest pain, trouble breathing, or coughing up blood
  • Symptoms of TMA (thrombotic microangiopathy), which is a condition where small clots can form in organs, commonly the kidneys and brain
    • Feeling fatigued, dizzy, short of breath
    • Bruises, gum or nose bleeds, minor cuts that bleed a lot
    • Confusion, seizures, sleepiness
    • Decreased urine, swollen legs, high blood pressure

These are the most common or serious side effects, but there may be more. Report all side effects to your medical team.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for emicizumab

  • Store emicizumab in the refrigerator in the original package to protect from light.
    • Emicizumab may be stored at room temperature for up to 7 days, but refrigeration is preferred.
    • Do not shake this medicine.
  • This medicine is offered in many strengths. Always check to be sure that you receive the same strength of medicine each time you pick up a new supply.
    • If the strength is different, the amount of medicine you need to take may also change.
    • If you receive a different strength of emicizumab and this change has not been discussed with you, call your clinic or the pharmacy.
  • Each vial may only be used for one (1) dose, throw away any unused medicine after each injection or at the expiration date.

How to give emicizumab

  • Emicizumab is given as an injection (shot) into the skin one (1) time each week. This injection (shot) is given into the fatty areas of the body called “injection sites.”
  • Dosing
    • For doses in the first 4 weeks, a loading dose (higher dose) will be given. During this time, your nurse will teach you how to give the medicine while at the hospital.
    • For doses after the first 4 weeks, a maintenance dose (lower dose) will be given and continued one (1) time each week at home.

Using emicizumab with other medicines

  • Medicines that affect how your blood clots must be used very cautiously with emicizumab.
    • The preferred treatment of an acute bleed while on this medicine is rFVIIa (Novoseven®).  The staff will give you a treatment plan including this medicine.
    • Do not give FEIBA® with this medicine for any reason unless directly supervised by your medical team.
    • Avoid other medicines such as Amicar® (aminocaproic acid) and Lysteda® (tranexamic acid) unless directly supervised by your medical team.
    • If you are unsure if it is safe to take a medicine while on emicizumab, contact your medical team right away.

Please refer to Do you know…. “How to give subcutaneous injections” and “Withdrawing medicine from a vial.”


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).