Therapeutic agents for von Willebrand disease (vWD).
| Agent . | Comments . |
|---|---|
| Desmopressin (DDAVP) | Useful in most cases of type 1 disease, occasionally in type 2 (may worsen thrombocytopenia in type 2B) |
| Antifibrinolytic agents | For mucosal or cutaneous bleeding; tranexamic acid is better tolerated orally than aminocaproic acid |
| Combination oral contraceptives | Used only for menorrhagia |
| vWF/VIII concentrates | Now commonly labeled and prescribed in von Willebrand factor (vWF) (ristocetin cofactor) units |
| High purity vWF concentrate | In clinical trials |
| Cryoprecipitate | Recommended only if lyophilized concentrates are not available |
| Fibrin sealants or topical thrombin | Often useful in surface bleeding and dental extraction; risk of antibodies to thrombin and/or factor V |
| Platelet concentrates | Specific replacement of platelet vWF in severe deficiency; rarely necessary |
| Recombinant factor VIIa | Theoretically useful; has been used in acquired vWD |
| Agent . | Comments . |
|---|---|
| Desmopressin (DDAVP) | Useful in most cases of type 1 disease, occasionally in type 2 (may worsen thrombocytopenia in type 2B) |
| Antifibrinolytic agents | For mucosal or cutaneous bleeding; tranexamic acid is better tolerated orally than aminocaproic acid |
| Combination oral contraceptives | Used only for menorrhagia |
| vWF/VIII concentrates | Now commonly labeled and prescribed in von Willebrand factor (vWF) (ristocetin cofactor) units |
| High purity vWF concentrate | In clinical trials |
| Cryoprecipitate | Recommended only if lyophilized concentrates are not available |
| Fibrin sealants or topical thrombin | Often useful in surface bleeding and dental extraction; risk of antibodies to thrombin and/or factor V |
| Platelet concentrates | Specific replacement of platelet vWF in severe deficiency; rarely necessary |
| Recombinant factor VIIa | Theoretically useful; has been used in acquired vWD |