Pediatric Von Willebrand Disease Follow-up

Updated: Feb 05, 2019
  • Author: Suchitra S Acharya, MD, MBBS; Chief Editor: Hassan M Yaish, MD  more...
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Follow-up

Inpatient & Outpatient Medications

The following may be used in patients with von Willebrand disease (VWD):

  • Epsilon amino caproic acid (Amicar)

    • Inhibition of fibrinolysis

    • Useful in mucous membrane bleeding

    • Dose: 100 mg/kg/dose orally every 4-6 hours

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Deterrence/Prevention

Avoid medications with known antiplatelet effects. Although aspirin is rarely taken by children, over-the-counter compounds containing acetylsalicylic acid often are used by adolescents. Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are reversible cyclooxygenase inhibitors and may cause intestinal bleeding. The risks of these and other medicines with antiplatelet effects should be considered in light of the severity of the von Willebrand disease. Provide patients with von Willebrand disease a list of prescription and nonprescription medications to avoid. This list should include the following:

  • Over-the-counter medications

    • Aspirin

    • Ibuprofen

    • Naproxen

    • Antihistamines

    • Ethanol

  • Antiplatelet agents

    • Dipyridamole

    • Ticlopidine

    • Prescription nonsteroidal anti-inflammatory compounds

  • Antimicrobials

    • High-dose penicillins

    • Cephalosporins

    • Nitrofurantoin

    • Hydroxychloroquine

  • Cardiovascular medications

    • Propranolol

    • Furosemide

    • Calcium channel blockers

    • Quinidine

  • Others

    • Caffeine

    • Tricyclic antidepressants

    • Phenothiazines

    • Valproate

    • Heparin

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Prognosis

Individuals with von Willebrand disease have a lifelong tendency toward easy bruising, frequent epistaxis, and menorrhagia.

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Patient Education

Patients should avoid medications with antiplatelet activity. Mild activity restrictions may be necessary.

For patient education information, see eMedicineHealth's Skin Conditions and Beauty Center, as well as the patient education article Bruises.

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