Dosing Options

Go ahead. Give it a shot.

  • HEMLIBRA is a shot that goes directly under the skin (a subcutaneous injection), similar to the way someone with diabetes injects insulin
  • You don’t need to find a vein to take your dose of HEMLIBRA
  • It can take less than a minute to inject HEMLIBRA after it’s prepared


It can be taken once a week, once every 2 weeks, or once every 4 weeks.

For the first 4 weeks of treatment only, you must use HEMLIBRA once a week. This will build up the levels of HEMLIBRA in your blood.

Your maintenance dose starts at Week 5. Your doctor will help you choose a dosing schedule that’s right for you. There are 3 options:

Before you start:

  • People without factor VIII inhibitors may continue using routine factor VIII for the first week after starting HEMLIBRA
  • People with factor VIII inhibitors should stop using bypassing agents the day before starting HEMLIBRA
HEMLIBRA® (emicizumab-kxwh) Dosing Schedule Meet Miranda

“[HEMLIBRA has] allowed us the flexibility in our days, and not be tied down to doing a medication all of the time.”

— Miranda, mom of twin 7-year-old boys with hemophilia A without factor VIII inhibitors, Indiana

Watch Miranda’s Story

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How to Inject HEMLIBRA

A video showing how to prepare and inject HEMLIBRA

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Individual results may vary. Not all patients in the clinical trials had zero bleeds. See results for clinical trial patients with or without factor VIII inhibitors here.

The HEMLIBRA community members shown have been compensated for their participation.

When starting HEMLIBRA, a “loading dose” is taken once weekly for 4 weeks. After that, HEMLIBRA offers 3 regular dosing options: once weekly, once every 2 weeks, or once every 4 weeks. Talk to a doctor about dosing.

§Number of people with hemophilia A treated with HEMLIBRA as of February 2022.

Frequently Asked Questions

Have questions about HEMLIBRA? We have answers.

More Than 15,000 People Have Been Treated With HEMLIBRA Worldwide§

Ready to talk to your doctor? Download the doctor discussion guide to start the conversation.

What is HEMLIBRA?

HEMLIBRA is a prescription medicine used for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adults and children, ages newborn and older, with hemophilia A with or without factor VIII inhibitors.

What is the most important information I should know about HEMLIBRA?

HEMLIBRA increases the potential for your blood to clot. People who use activated prothrombin complex concentrate (aPCC; Feiba®) to treat breakthrough bleeds while taking HEMLIBRA may be at risk of serious side effects related to blood clots.

These serious side effects include: 

  • Thrombotic microangiopathy (TMA), a condition involving blood clots and injury to small blood  vessels that may cause harm to your kidneys, brain, and other organs 
  • Blood clots (thrombotic events), which may form in blood vessels in your arm, leg, lung, or head  

Talk to your doctor about the signs and symptoms of these serious side effects, which can include: 

  • Confusion
  • Stomach, chest, or back pain
  • Weakness
  • Nausea or vomiting
  • Swelling, pain, or redness
  • Feeling sick or faint
  • Decreased urination
  • Swelling of arms and legs
  • Yellowing of skin and eyes
  • Eye pain, swelling, or trouble seeing
  • Fast heart rate
  • Numbness in your face
  • Headache
  • Shortness of breath
  • Coughing up blood

If you experience any of these symptoms during or after treatment with HEMLIBRA, get medical help right away. 

Carefully follow your healthcare provider’s instructions regarding when to use an on-demand bypassing agent or factor VIII, and the dose and schedule to use for breakthrough bleed treatment. If aPCC (Feiba®) is needed, talk to your healthcare provider in case you feel you need more than 100 U/kg of aPCC (Feiba®) total. 

Your body may make antibodies against HEMLIBRA, which may stop HEMLIBRA from working properly. Contact your healthcare provider immediately if you notice that HEMLIBRA has stopped working for you (eg, increase in bleeds).

The most common side effects of HEMLIBRA include: injection site reactions (redness, tenderness, warmth, or itching at the site of injection), headache, and joint pain. These are not all of the possible side effects of HEMLIBRA. You can speak with your healthcare provider for more information.

What else should I know about HEMLIBRA?

See the detailed “Instructions for Use” that comes with your HEMLIBRA for information on how to prepare and inject a dose of HEMLIBRA, and how to properly throw away (dispose of) used needles and syringes.

  • Stop taking your prophylactic bypassing therapy the day before you start HEMLIBRA
  • You may continue taking your prophylactic factor VIII for the first week of HEMLIBRA

HEMLIBRA may interfere with laboratory tests that measure how well your blood is clotting and create an inaccurate result. Speak with your healthcare provider about how this may affect your care. 

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Only use HEMLIBRA for the condition it was prescribed. Do not give HEMLIBRA to other people, even if they have the same symptoms that you have. It may harm them.

Tell your healthcare provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, or herbal supplements. Keep a list of them to show your healthcare provider and pharmacist.

Before using HEMLIBRA, tell your healthcare provider about all of your medical conditions, including if you are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed.

Since HEMLIBRA was tested in males, there is no information on whether HEMLIBRA may impact your unborn baby or breast milk. Females who are able to become pregnant should use birth control during treatment.

Side effects may be reported to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Please see Important Safety Information, including Serious Side Effects, as well as the HEMLIBRA full Prescribing Information and Medication Guide.