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Most cases of von Willebrand disease are mild and often don’t require
treatment. Treatment may only be needed to prevent or treat bleeding
associated with surgery, tooth extraction, or an accident. For those who need
treatment, one or more of the following may be used:
- Medicine to increase the level of von Willebrand factor in the blood
- Medicine to prevent the breakdown of clots
- Medicine to control heavy menstrual bleeding in women
- Injection of clotting factor concentrates (containing von Willebrand
factor and factor VIII)
Your doctor will decide what treatment you need based on the severity and
the type of disease you have. Specific treatments include:
- Desmopressin (DDAVP), a synthetic hormone usually given by injection or
nasal spray. DDAVP makes the body release stored von Willebrand factor
into circulation, and it also increases the level of factor VIII activity.
DDAVP is effective in treating most patients with type 1 von Willebrand
disease and some patients with type 2A, 2M, or 2N von Willebrand disease.
DDAVP can usually only be used two to four times for an individual
bleeding episode because the body has a limited amount of stored von
Willebrand factor.
- Replacement therapy, which is the injection of a concentrated amount of
von Willebrand factor and factor VIII into the body. This treatment can be
used in:
- People who can’t take DDAVP or who need prolonged treatment
- People with type 1 disease who don’t respond to DDAVP
- People with type 2A, 2B, 2M, or 2N disease
- People with type 3 disease
- Oral contraceptives (or birth control pills), which can help women who
have heavy menstrual bleeding.
- Antifibrinolytic drugs, which help prevent the breakdown of clots that
form at bleeding sites. These drugs are used mostly to stop or prevent
bleeding following minor surgery, tooth extraction, or an injury. They may
be used alone or together with DDAVP or replacement therapy.
- Fibrin glue, which is medicine placed directly on a wound to stop the
bleeding.
Bleeding that can’t be controlled can become life threatening. Rarely,
people with severe forms of von Willebrand disease will need to seek immediate
medical treatment to stop bleeding.
Reference:
National Heart, Lung, and Blood Institute, USA.
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