Medications for von Willebrand Disease

At Hassenfeld Children’s Hospital at NYU Langone, doctors may recommend one or more medications for von Willebrand disease based on the type your child has and the severity of symptoms. Most medications are used occasionally to prevent or control excessive bleeding in certain situations, such as before or after surgery or dental procedures. Others may be used to control heavy bleeding during menstrual periods.

One or a combination of these medications is usually effective in preventing or stopping excessive bleeding in children with type 1 or 2 von Willebrand disease. For children with type 3, the most severe form of this condition, our doctors recommend avoiding certain medications like aspirin or nonsteroidal anti-inflammatory drugs and contact sports, such as football or boxing. Our team works with your family to help you choose the safest activities for your child.

Desmopressin

Desmopressin, also known as DDAVP^®, is a synthetic hormone that stimulates the release of von Willebrand factor from the cells that line blood vessels. This medication, available as a nasal spray or injection, is often recommended for children or adolescents with type 1 or certain forms of type 2 von Willebrand disease to control bleeding before surgery, during menstrual periods, or during a prolonged nosebleed.

Common side effects of DDAVP^® include headaches, low blood pressure, and a temporary increase in heart rate.

Von Willebrand Factor Replacement

Your child’s doctor may recommend replacing von Willebrand factor through a vein as an intravenous (IV) treatment. This therapy may be used regularly to prevent or control bleeding in children who do not respond to DDAVP^® or have more severe bleeding episodes, which can occur in those with type 3 von Willebrand disease. It may also be given before surgical procedures.

Some children experience chest tightness, a rash, or swelling after an infusion of von Willebrand factor.

Clot Stabilizers

Clot stabilizers, also known as antifibrinolytics, slow down the formation of fibrin, a substance that breaks down blood clots. Antifibrinolytic medications, such as aminocaproic acid, may be given to your child by mouth or through an IV infusion to stop bleeding from a surgical procedure or injury. Your child also may receive an oral solution for rinsing the mouth before or after a dental procedure.

These medications can cause nausea, vomiting, and excessive clotting, which can lead to the formation of blood clots, a serious complication.

Fibrin Sealant

Also called fibrin glue, a fibrin sealant is a topical treatment containing substances, such as thrombin or fibrinogen, that enhance blood clotting. The doctor may recommend that you apply fibrin sealant to your child’s nasal surface to stop a nosebleed or to the gums to stop bleeding after a dental procedure. Doctors may use it to stop bleeding if your child has surgery.

Hormonal Contraceptives

Contraceptives that contain hormones can help to limit blood loss during menstrual periods. Our doctors may recommend that adolescent girls with von Willebrand disease who have heavy menstrual periods take oral contraceptives, or birth control pills.

For young adult women, our doctors may recommend a hormone-releasing intrauterine device, also known as an IUD. Some teens and women with von Willebrand disease require a combination of hormonal contraceptives with antifibrinolytics or DDAVP^® to treat heavy menstrual flow.