Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Von willebrand factor, Human coagulation factor viii may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for
Octanate LV belongs to a group of medicines called clotting factors and contains human blood coagulation factor VIII. This is a special protein involved in blood clotting. Octanate LV is used to treat and prevent bleeding in patients with haemophilia A. This is a condition in which bleeding can go on for longer than expected. It is due to an hereditary lack of coagulation factor VIII in the blood. 2.
What do you need to know before you use Octanate LV
It is strongly recommended that every time you receive a dose of Octanate LV the name and batch number of the product are recorded in order to maintain a record of the batches used. Your doctor may recommend that you consider vaccination against hepatitis A and B if you regularly or repeatedly receive human-derived Factor VIII products. Do not use Octanate LV if you are allergic to human blood coagulation factor VIII or to any of the other ingredients of this medicine (listed in section 6).
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Warnings and precautions Talk to your doctor, pharmacist or nurse before using Octanate LV. Octanate LV contains very small amounts of other human proteins. Any medicine which contains proteins and which is injected into a vein (administered intravenously) can cause allergic reactions (See Section 4., "Possible side effects"). The formation of inhibitors (antibodies) is a known complication that can occur during treatment with all Factor VIII medicines. These inhibitors, especially at high levels, stop the treatment working properly and you or your child will be monitored carefully for the development of these inhibitors. If you or your child ́s bleeding is not being controlled with Octanate LV, tell your doctor immediately. Information about the blood and plasma used for Octanate LV When medicines are made from human blood or plasma, certain measures are put in place to prevent infections being passed on to patients. These include careful selection of blood and plasma donors to make sure those at risk of carrying infections are excluded, and the testing of each donation and pools of plasma for signs of virus/infections. Manufacturers of these products also include steps in the processing of the blood or plasma that can inactivate or remove viruses. Despite these measures, when medicines prepared from human blood or plasma are administered, the possibility of passing on infection cannot be totally excluded. This also applies to any unknown or emerging viruses or other types of infections. The measures taken are considered effective for enveloped viruses such as human immunodeficiency virus (HIV), hepatitis B (HBV) virus and hepatitis C virus (HCV), and for the non-enveloped hepatitis A virus (HAV). The measures taken may be of limited value against nonenveloped viruses such as parvovirus B19. Parvovirus B19 infection may be serious for pregnant women (infection of the baby) and for individuals whose immune system is depressed or who have some types of anaemia (e.g. sickle cell disease or abnormal breakdown of red blood cells). Other medicines and Octanate LV Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without prescription. Human blood coagulation factor VIII products are not known to interact with other medicinal products. Nonetheless, do not combine Octanate LV with other medicines during infusion. Pregnancy and breast-feeding Ask your doctor or pharmacist for advice before using any medicine. Driving and using machines No effects on ability to drive and use machines have been observed. Octanate LV contains up to 40 mg sodium (main component of cooking/table salt) per vial. This is equivalent to 2% of the recommended maximum daily dietary intake of sodium for an adult.
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3.
Octanate LV
Octanate LV should be administered intravenously after reconstitution with the supplied solvent. Treatment should be started under medical supervision. Dosage for the prevention of bleeding If you suffer from severe haemophilia A you should inject 20 to 40 IU of factor VIII per kg body weight every two or three days for long-term prevention. Your dosage should be adjusted according to your response. In some cases shorter dosage intervals or higher dosages may be necessary. Dosage calculation Always use Octanate LV exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Factor VIII activity refers to the amount of factor VIII present in the plasma. It is expressed either as a percentage (relative to normal human blood plasma) or in International Units (IU). The dosage of factor VIII is expressed in IU. One IU of factor VIII activity is equivalent to the amount of factor VIII in one ml of normal human blood plasma. One IU of factor VIII per kg body weight raises the plasma factor VIII activity by 1.5% – 2% of normal activity. To calculate your dosage, the level of factor VIII activity in your blood plasma is measured. This will indicate by how much the activity needs to be increased. Please consult your doctor if you are uncertain how much your factor VIII activity has to be increased or how to calculate your dosage. The dosage required is calculated using the following formula:
Required units = body weight (kg) x desired increase in factor VIII (%) (IU/dl) x 0.5
Your dosage and how often it must be administered (frequency) should always be oriented by the clinical efficacy in the individual patient. In the following bleeding events, factor VIII activity should not fall below the plasma activity level (in % of normal) shown in the following table, for the corresponding period. This table can be used to guide dosing in bleeding episodes and for surgery:
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Degree of bleeding/ Type of surgical procedure
Factor VIII level Frequency of dosage (hours between required (%) dosages) / (IU/dl) Duration of therapy (in days)
Bleeding Bleeding into a joint (early haemarthrosis), muscle bleeding or oral bleeding More extensive bleeding into a joint (haemarthrosis), muscle bleeding or effusion of blood (haematoma) Life-threatening bleeding such as in head surgery, bleeding in the throat, major abdominal bleeding
20 – 40
30 – 60
60 – 100
Repeat every 12 to 24 hours for at least 1 day, until the pain decreases or healing is achieved. Repeat infusion every 12 to 24 hours for 34 days or more until pain and disability have resolved. Repeat the infusion every 8 to 24 hours until the threat is resolved.
Surgery Minor including tooth extraction
30 – 60
Every 24 hours for at least 1 day, until healing is achieved.
Major
80 – 100
Repeat infusion every 8 to 24 hours until adequate wound healing, then therapy for at least another 7 days to maintain factor VIII activity at 30% to 60%.
(before and after an operation)
Your doctor will advise you about the dosage and the frequency with which you should use Octanate LV. Your response to factor VIII products may vary. The factor VIII level in your blood should therefore be measured during the treatment to calculate the correct dosage and frequency of infusion. Use in children Clinical studies did not identify any special dosage requirements for children. For both treatment and prophylaxis, the dosage is the same in adults and children.
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Instructions for Home Treatment •
Please read all the instructions and follow them carefully!
•
Do not use Octanate LV after expiry date given on the label.
•
During the procedure described below, sterility must be maintained!
•
Reconstituted medicinal product should be inspected visually for particulate matter and discoloration prior to administration.
•
The solution should be clear or slightly opalescent. Do not use solutions that are cloudy or have deposits.
•
Use the prepared solution immediately, to prevent microbial contamination.
•
Only use the infusion set provided. The use of other injection/infusion equipment can cause additional risks and treatment failure.
Instructions for preparing the solution: 1.
Do not use the product directly from the refrigerator. Allow the solvent and the powder in the closed vials to reach room temperature.
2.
Remove the flip off caps from both vials and clean the rubber stoppers with one of the provided alcohol swabs.
3.
The transfer set is depicted in Fig. 1. Place the solvent vial on an even surface and hold it firmly. Take the transfer set and turn it upside down. Place the blue part of the transfer set on top of the solvent vial and press firmly down until it snaps (Fig. 2+3). Do not twist while attaching.
Powder adapter (white part) Solvent adapter (blue part)
Fig. 1
Fig. 2
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Fig. 3
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4.
Place the powder vial on an even surface and hold it firmly. Take the solvent vial with the attached transfer set and turn it upside down. Place the white part on top of the powder vial and press firmly down until it snaps (Fig. 4). Do not twist while attaching. The solvent flows automatically into the powder vial.
Fig. 4
5.
With both vials still attached, gently swirl the powder vial until the product is dissolved. The dissolving is completed in less than 10 minutes at room temperature. Slight foaming might occur during preparation. Unscrew the transfer set into two parts (Fig. 5). Foaming will disappear. Dispose the empty solvent vial with the blue part of the transfer set. Fig. 5
Instructions for injection: As a precaution, your pulse rate should be taken before and during the injection. If a marked increase in your pulse rate occurs, reduce the injection speed or interrupt the administration for a short time. 1.
Attach the syringe to the white part of the transfer set. Turn the vial upside down and draw the solution into the syringe (Fig. 6). The solution should be clear or slightly opalescent. Once the solution has been transferred, firmly hold the plunger of the syringe (keeping it facing down) and remove the syringe from the transfer set (Fig. 7). Dispose the empty vial together with the white part of the transfer set.
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Fig. 6
Fig. 7
2.
Clean the chosen injection site with one of the provided alcohol swabs.
3.
Attach the provided infusion set to the syringe
4.
Insert the injection needle into the chosen vein. If you have used a tourniquet to make the vein easier to see, this tourniquet should be released before you start injecting Octanate LV.
5.
No blood must flow into the syringe due to the risk of formation of fibrin clots.
6.
Inject the solution into the vein at a slow speed, not faster than 2-3 ml per minute.
If you use more than one vial of Octanate LV powder for one treatment, you may use the same infusion set and syringe again. The transfer set is for single use only. Any unused product or waste material should be disposed of in accordance with local requirements. If you use more Octanate LV than you should No symptoms of overdose with human coagulation factor VIII have been reported. However, the recommend dosage should not be exceeded. If you forget to take Octanate LV Do not take a double dose to make up a forgotten dose. Proceed with the next dose immediately and continue as advised by your doctor or pharmacist.
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If you have any further questions on the use of this product, ask your doctor or pharmacist 4.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Even though rare (affects 1 to 10 users in 10,000), hypersensitivity or allergic reactions have been observed in patients treated with factor VIII containing products. Contact your doctor if you suffer from the symptoms: being sick (vomiting), burning and stinging at the infusion site, chest tightness, chills, faster heart beat (tachycardia), feeling sick (nausea), feeling of pins and needles (tingling), flushing, headache, hives (urticaria), low blood pressure (hypotension), rash, restlessness, swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing (angioedema), tiredness (lethargy), wheezing. In very rare (affects less than 1 user in 10,000) cases, this hypersensitivity may lead to a severe life-threatening allergic reaction called anaphylaxis, which may include shock, as well as some or all of the symptoms described above. In this case contact your doctor immediately or call for an ambulance. Other rare side effects (affects 1 to 10 users in 10,000) Fever For children not previously treated with Factor VIII medicines, inhibitor antibodies (see section 2) may form very commonly (more than 1 in 10 patients); however patients who have received previous treatment with Factor VIII (more than 150 days of treatment) the risk is uncommon (less than 1 in 100 patients). If this happens you or your child ́s medicines may stop working properly and you or your child may experience persistent bleeding. If this happens, you should contact your doctor immediately. For information on viral safety see section 2. (Take special care with Octanate LV – Information about the blood and plasma used for Octanate LV). Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible
not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store By reporting side effects you can help provide more information on the safety of this medicine. 5.
Octanate LV
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the label. The expiry date refers to the last day of that month. Store in a refrigerator (2°C – 8°C).
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Do not freeze. Keep the vials in the outer carton in order to protect from light. Use the reconstituted solution immediately and for single use only. Do not use this medicine if you notice cloudy or incompletely dissolved solutions. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. 6.
What Octanate LV contains The active substance is the human blood coagulation factor VIII. Volume and concentrations
Octanate LV® powder vial size (IU FVIII)
Solvent vial size (to be added to Octanate LV® powder vial) (ml)
Nominal concentration of reconstituted solution (IU FVIII/ml)
500 IU
5
100
1000 IU
5
200
The other ingredients are: For the powder: sodium citrate, sodium chloride, calcium chloride, glycine For the solvent: water for injections. What Octanate LV looks like and contents of the pack Octanate LV is presented as a powder and solvent for solution for injection. The powder is white or pale yellow, also appearing as a friable mass. The solvent is a clear, colourless liquid. The 2 available strengths differ in the amount of human blood coagulation factor VIII and solvent: 100 IU/ml powder and solvent:
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Octanate LV: Austria, Cyprus, Denmark, France, The Netherlands, Malta, Poland, Romania, Spain, Sweden, The United Kingdom
•
Octafil LV: Finland
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Octanate: Belgium, Czech Republic, Germany, Ireland, Italy, Latvia, Lithuania, Luxembourg, Portugal
•
Octanate Kons: Slovenia
This leaflet was last revised in 09/2023
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Octanate LV 200 IU/ml powder and solvent for solution for injection comes as injection containing 200iu/ml. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Octanate LV 200 IU/ml powder and solvent for solution for injection is von willebrand factor, human coagulation factor viii.
This leaflet reproduces the patient information leaflet approved for Octanate LV 200 IU/ml powder and solvent for solution for injection, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Treatment and prophylaxis of bleeding in patients with haemophilia A (congenital factor VIII deficiency).
Octanate LV can be used for all age groups.
This preparation does not contain von Willebrand factor in pharmacologically effective quantities and is therefore not indicated in von Willebrand's disease.
Treatment should be under the supervision of a physician experienced in the treatment of haemophilia.
Treatment monitoring
During the course of treatment, appropriate determination of factor VIII levels is advised to guide the dose to be administered and the frequency of repeated infusions. Individual patients may vary in their response to factor VIII, demonstrating different half-lives and recoveries. Dose based on bodyweight may require adjustment in underweight or overweight patients. In the case of major surgical interventions in particular, precise monitoring of the substitution therapy by means of coagulation analysis (plasma factor VIII activity) is indispensable.
Posology
The dose and duration of the substitution therapy depend on the severity of the factor VIII deficiency, on the location and extent of the bleeding, and on the patient's clinical condition.
The number of units of factor VIII administered is expressed in International Units (IU), which are related to the current WHO concentrate standard for factor VIII products. Factor VIII activity in plasma is expressed either as a percentage (relative to normal human plasma) or in International Units (relative to an International Standard for factor VIII in plasma).
One International Unit (IU) of factor VIII activity is equivalent to that quantity of factor VIII in one ml of normal human plasma.
On-demand treatment
The calculation of the required dosage of factor VIII is based on the empirical finding that 1 International Unit (IU) factor VIII per kg body weight raises the plasma factor VIII activity by 1.5 % to 2 % of normal activity. The required dosage is determined using the following formula:
Required units = body weight (kg) x desired factor VIII rise (%) (IU/dl) x 0.5
The amount to be adminiseredand the frequency of administration should always be oriented to the clinical effectiveness in the individual case.
In the case of the following haemorrhagic events, the factor VIII activity should not fall below the given plasma activity level (in % of normal) in the corresponding period. The following table can be used to guide dosing in bleeding episodes and surgery:
Degree of haemorrhage/Type of surgical procedure
Factor VIII level required (%) (IU/dl)
Frequency of doses (hours) / Duration of therapy (days)
Haemorrhage
Early haemarthrosis, muscle bleeding or oral bleeding
20 - 40
Repeat every 12 to 24 hours. At least 1 day, until the bleeding episode as indicated by pain is resolved or healing is achieved.
More extensive haemarthrosis, muscle bleeding or haematoma
30 - 60
Repeat infusion every 12 to 24 hours for 3 to 4 days or more until pain and acute disability are resolved.
Life-threatening haemorrhages
60 - 100
Repeat infusion every 8 to 24 hours until threat is resolved.
Surgery
Minor Surgery
including tooth extraction
30 - 60
Every 24 hours, at least 1 day, until healing is achieved.
Major Surgery
80 - 100(pre- and postoperative)
Repeat infusion every 8 to 24 hours until adequate wound healing, then therapy for at least another 7 days to maintain a FVIII activity of 30% to 60%.
Prophylaxis
For long-term prophylaxis against bleeding in patients with severe haemophilia A, the usual doses are 20 to 40 IU of factor VIII per kg body weight at intervals of 2 to 3 days.
In some cases, especially in younger patients, shorter dosage intervals or higher does may be necessary.
Continuous infusion
Prior to surgery, a pharmacokinetic analysis should be performed to obtain an estimate of clearance.
The initial infusion rate can be calculated as follows: Clearance x desired steady state level = infusion rate (IU/kg/hr).
After the initial 24 hours of continuous infusion, the clearance should be calculated again every day using the steady state equation with the measured level and the known rate of infusion.
Paediatric population
A clinical study which was conducted in 15 patients of 6 years of age or less did not identify any special dosage requirements for children.
For both treatment and prophylaxis, the posology is the same in adults and children.
Method of administration
Intravenous use.
It is recommended not to administer more than 2 - 3 ml per minute.
For instructions on reconstitution of the medicinal product before administration, see section 6.6.
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Traceability
In order to improve traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.
Hypersensitivity
Allergic type hypersensitivity reactions are possible with Octanate LV. The product contains traces of human proteins other than factor VIII. If symptoms of hypersensitivity occur, patients should be advised to discontinue use of the medicinal product immediately and contact their physician. Patients should be informed of the early signs of hypersensitivity reactions including hives, generalised urticaria, tightness of the chest, wheezing, hypotension, and anaphylaxis.
.In case of shock, standard medical treatment of shock should be implemented.
Inhibitors
The formation of neutralising antibodies (inhibitors) to factor VIII is a known complication in the management of individuals with haemophilia A. These inhibitors are usually IgG immunoglobulins directed against the factor VIII procoagulant activity, which are quantified in Bethesda Units (BU) per ml of plasma using the modified assay. The risk of developing inhibitors is correlated to the severity of the disease as well as the exposure to factor VIII, this risk being highest within the first 50 exposure days, but continues throughout life although the risk is uncommon The clinical relevance of inhibitor development will depend on the titre of the inhibitor, with low titre posing less of a risk of insufficient clinical response than high titre inhibitors.
In general, all patients treated with coagulation factor VIII products should be carefully monitored for the development of inhibitors by appropriate clinical observations and laboratory tests. If the expected factor VIII activity plasma levels are not attained, or if bleeding is not controlled with an appropriate dose, testing for factor VIII inhibitor presence should be performed. In patients with high levels of inhibitor, factor VIII therapy may not be effective and other therapeutic options should be considered. Management of such patients should be directed by physicians with experience in the care of haemophilia and factor VIII inhibitors.
Cardiovascular events
In patients with existing cardiovascular risk factors, substitution therapy with FVIII may increase the cardiovascular risk.
Catheter-related complications
If a central venous access device (CVAD) is required, risk of CVAD-related complications including local infections, bacteraemia and catheter site thrombosis should be considered.
Transmissible agents
Standard measures to prevent infections resulting from the use of medicinal products prepared from human blood or plasma include selection of donors, screening of individual donations and plasma pools for specific markers of infection and the inclusion of effective manufacturing steps for the inactivation/removal of viruses. Despite this, when medicinal products prepared from human blood or plasma are administered, the possibility of transmitting infective agents cannot be totally excluded. This also applies to unknown or emerging viruses and other pathogens.
The measures taken are considered effective for enveloped viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV), and for the non-enveloped virus hepatitis A virus (HAV). The measures taken may be of limited value against non-enveloped viruses such as parvovirus B19. Parvovirus B19 infection may be serious for pregnant women (foetal infection) and for individuals with immunodeficiency or increased erythropoiesis (e.g. hemolytic anaemia).
Appropriate vaccination (hepatitis A and B) should be considered for patients in regular/repeated receipt of human plasma-derived factor VIII products.
It is strongly recommended that every time Octanate LV is administered to a patient, the name and batch number of the product are recorded in order to maintain a link between the patient and the batch of the product.
This medicinal product contains up to 1.75 mmol sodium (40 mg) per vial, equivalent to 2% of the WHO recommended maximum intake of 2 g sodium for an adult.
Paediatric population
The listed warnings and precautions apply to both adults and children.
No interactions of human coagulation factor VIII products with other medicinal products have been reported.
Animal reproduction studies have not been conducted with factor VIII. Based on the rare occurrence of haemophilia A in women, experience regarding the use of factor VIII during pregnancy and breast-feeding is not available. Therefore, factor VIII should be used during pregnancy and lactation only if clearly indicated.
Octanate LV has no influence on the ability to drive and use machines.
Summary of the safety profile
Hypersensitivity or allergic reactions (which may include angiooedema, burning and stinging at the infusion site, chills, flushing, generalised urticaria, headache, hives, hypotension, lethargy, nausea, restlessness, tachycardia, chest tightness, tingling, vomiting, wheezing) have been observed rarly, and may in some cases progress to severe anaphylaxis (including shock).
On rare occasions, fever has been observed.
Development of neutralising antibodies (inhibitors) may occur in patients with haemophilia A treated with factor VIII, including with Octanate LV see section 5.1. If such inhibitors occur, the condition will manifest itself as an insufficient clinical response. In such cases, it is recommended that a specialised haemophilia centre be contacted.
For safety information with respect to transmissible agents, see section 4.4.
Tabulated list of adverse reactions
The table presented below is according to the MedDRA system organ classification (SOC and Preferred Term Level).
Frequencies have been evaluated according to the following convention: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000), not known (cannot be estimated from the available data).
MedDRA Standard System Organ Class
Adverse Reaction
Frequency
Immune system disorders
Hypersensitivity reaction
Anaphylactic shock
Rare
Very rare
General disorders and administration site conditions
Pyrexia
Rare
Blood and lymphatic system disorders
FVIII inhibition
Uncommon (PTPs)*
Very common (PUPs)*
Investigations
Anti factor VIII antibody positive
Rare
* Frequency is based on studies with all FVIII products which included patients with severe haemophilia A. PTPs = previously-treated patients, PUPs = previously-untreated patients
Paediatric population
Frequency, type and severity of adverse reactions in children are the same as in adults.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system listed in Appendix V.
No case of overdose has been reported.
Medicines sold in Poland with the same active substance: W Polsce znany jako
⚠ Not the same combination. This medicine contains Von willebrand factor, Human coagulation factor viii. The products below do not contain exactly the same set of active substances — they are not direct substitutes.
Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
Ask anything about Octanate LV 200 IU/ml powder and solvent for solution for injection. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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