Factor XI Deficiency Medication

Updated: Oct 30, 2019
  • Author: Jamie E Siegel, MD; Chief Editor: Srikanth Nagalla, MD, MS, FACP  more...
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Medication

Medication Summary

Medications for prophylaxis and treatment of bleeding in patients with factor XI deficiency include fresh frozen plasma and antifibrinolytic agents. Treatment choices are guided by patient factors and clinical circumstances.

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Blood products

Class Summary

To achieve a FXI level of 50%, a patient needs to have half of their plasma volume replaced.

Directed-donor fresh frozen plasma can be arranged for elective procedures, but a large volume of plasma will need to be stored to transfuse for the required 7-14 days after surgery. One study has demonstrated that solvent detergent fresh frozen plasma has a half-life of 45 hours, while a second study has shown that FXI is decreased in the product.

Fresh frozen plasma (FFP, Octaplas)

Plasma is the fluid compartment of blood containing the soluble clotting factors. Octaplas is a solvent detergent treated, pooled FFP.

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Antifibrinolytic Agents

Class Summary

May consider prophylactic administration with antifibrinolytics prior to minor procedures (eg, dental).

Aminocaproic acid (Amicar)

Inhibits fibrinolysis via inhibition of plasminogen activator substances and, to a lesser degree, through antiplasmin activity. Main problem is that the thrombi that form during treatment are not lysed, and effectiveness is uncertain.

Tranexamic acid injection (Cyklokapron)

Alternative to aminocaproic acid. Inhibits fibrinolysis by displacing plasminogen from fibrin.

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