Von Willebrand factor (Specialist drug)

How it works

It replaces deficient or dysfunctional von Willebrand factor, promoting platelet adhesion at sites of vascular injury and stabilising circulating factor VIII.

Prescribing in practice

• Excessive or repeated dosing can produce sustained high von Willebrand factor and factor VIII levels that raise thrombotic risk, so dosing should be guided by factor levels and bleeding indication under haematology supervision.
• Hypersensitivity and, rarely, inhibitory antibody development can occur, requiring monitoring and management.
• As a plasma-derived product, standard viral-safety precautions apply and appropriate immunisation against hepatitis is advisable.

Monitoring

Monitor von Willebrand factor and factor VIII activity, alongside clinical bleeding response, to guide dosing.

Counselling the patient

• Report signs of clotting such as leg swelling, chest pain, or breathlessness promptly.
• Report any reaction during the infusion, including rash or breathlessness.
• Carry information about your bleeding disorder and treatment for use in emergencies.

Evidence & guidelines

Von Willebrand factor concentrate is an established replacement therapy for von Willebrand disease, used in line with national haemophilia and bleeding-disorder guidance.