Factor XIII (Specialist drug)

How it works

It replaces deficient factor XIII, which cross-links fibrin to stabilise the clot, so its replacement strengthens and stabilises clot formation.

Prescribing in practice

• Hypersensitivity reactions and, rarely, inhibitory antibodies to factor XIII can occur, so patients should be observed during administration and assessed if response is inadequate.
• Regular prophylactic replacement is the mainstay of management because of the long-term bleeding risk, including intracranial haemorrhage, in severe deficiency.
• The product brand and batch number should be recorded for each administration for traceability.

Monitoring

Monitor factor XIII activity and clinical response, and assess for inhibitors if the expected response is not achieved.

Counselling the patient

• Report any rash, wheeze or swelling during or after an infusion.
• Attend for regular prophylactic treatment as advised to reduce the risk of serious bleeding.

Evidence & guidelines

Replacement therapy for congenital factor XIII deficiency is established practice delivered through specialist haematology services.