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How to mix factor VIII (Advate®) at home


There are 3 easy steps to mixing factor VIII medicine (Advate®) needed to inject for hemophilia A:

  • Press:  Press firmly and the system will be activated;
  • Swirl:  A gentle swirl allows for proper mixing; and
  • Flip and Withdraw:  The dose is ready to be withdrawn from the system.

Below are the detailed steps you must take to ensure that the factor is safely mixed and ready for you to give through an IV. This Do You Know will discuss the Baxject III® device that is used to connect the sterile water (diluent) vial with the medicine (Advate) vial. To see a video of the process, visit the Baxter website at

Advate supplies

Mixing factor

Gather all your supplies on a clean surface, wash your hands, and put on gloves. Gloves are optional for home infusion. Check the expiration date, and allow Advate to warm to room temperature.

Advate step 1

Step 1

Open the package holding the Baxject III mixing device by peeling away the lid. Place the vial on a flat surface in an upright position with the blue stripe on top. Do not use if it is cloudy or you see particles in the sterile water. Keep the vial upright. Do not lay it down flat.

Advate step 2

Step 2

  • Hold the vial with one hand.
  • With the other hand, press down firmly on the top until it is pushed all the way down and the sterile water (diluent) from the top vial flows into the bottom (Advate) vial.
Advate step 3

Step 3

  • Gently swirl the vial in a circular motion until the Advate is dissolved. 
  • Do not shake to mix. If you see powder, continue to gently swirl the vial. This will mix the solution together.
  • The mixture should become clear. If it is not clear, discard it and use another dose of factor. Then, call the Hematology Clinic at 901-595-5041.
Advate step 4

Step 4

  • Remove the blue cap from the side of the device.
  • Remove the cap on the syringe (if there is one).
  • Connect the syringe to the side port by twisting it to the right.
  • Do not inject any air.
Advate step 5
  • Turn the vials over so that the blue strip of the Baxject III is now on the bottom.
  • Slowly pull back on the plunger of the syringe and allow the medicine to fill the syringe.
  • If the solution does not go into the syringe, check to make sure that both vials are pressed firmly together.
  • Twist the syringe off the side port. Be sure not to touch the end of the syringe.
Advate step 6
  • It is all right if a small amount of fluid is left in the vial.
  • Remove any air from the syringe before giving the medicine.
  • Attach the medicine to the needle set before you to infuse.
  • For infusing the factor, please see “Do You Know… Giving Factor at Home Through an IV.”
  • Remember to always place the sticker from the package in your book.


If you have questions or concerns about giving factor at home through an IV or mixing factor with the Baxject III device, please call the Hematology Clinic at 901-595-5041. If you are calling after hours or on the weekend, dial 901-595-3300 and ask for the nursing coordinator or the doctor on call. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833) and press 0 when the call connects.


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).

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