Canterbury DHB


General Principles of Treatment

In This Section

Specialist Management


Pain Relief

Acute Joint Bleeding


Recording Treatment


Specialist Management

All patients with haemophilia, or other significant bleeding problems, should be registered with a Regional Haemophilia Centre and reviewed by a specialist haematologist on a regular basis. The frequency of review will depend on the severity of the haemophilia.



Factor VIII or IX activity


< 1%


1 to 5%


> 5%

Note: The plasma concentration of factor VIII or IX does not always correlate with the clinical severity of the disease. Some patients with factor concentrations between 1% and 5% have clinically severe disease.

FVIII: Refers to all types of Factor VIII products used to treat patients with factor VIII deficiency. This may be of recombinant or plasma derived.

FIX: Refers to all types of the Factor IX product used to treat patients with factor IX deficiency. It may be of recombinant or plasma derived. The dosing schedules are those generally recommended for plasma derived factor IX. Higher doses may be needed for patients receiving recombinant factor IX because of the lower recovery.

Pain Relief

Pain relief must be adequate, especially for large joint and muscle bleeds.

Acute Joint Bleeding

Treat minor joint bleeds with ice application, analgesics, and resting them in a functional position.


The factor VIII (or IX) level measured after a given dose of the specific factor can be expressed as (factor) “recovery”. This should be reviewed at least every two years but more frequently during rapid growth phases in childhood and adolescence, or where the presence of an inhibitor is suspected.



Recording Treatment

Encourage patients to keep a record of all bleeding episodes and details of their product usage.

Records of product use are kept at each treatment centre.

About this Canterbury DHB document (5234):

Document Owner:

Sean Macpherson (see Who's Who)

Last Reviewed:

November 2019

Next Review:

November 2022


Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5234