Sounds like 'EM-i-SIZ-ue-mab', it's also known as Hemlibra

Key points about emicizumab

  • Emicizumab is used to prevent bleeding in people with haemophilia. 
  • Emicizumab is an injection and is also called Hemlibra®.
  • Find out how to take it safely and the possible side effects. 
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  • Hemlibra belongs to a group of medicines called humanised monoclonal antibodies. People with haemophilia type A don’t have a clotting factor called factor VIII. Hemlibra works by attaching to proteins in your blood to help it clot properly without factor VIII.
  • Hemlibra® is also called emicizumab.
  • It's not used to treat bleeds once they happen but is used regularly to prevent bleeding. Read more about preventative therapy as part of treatment of haemophilia.

In Aotearoa New Zealand Hemlibra® is available as injections in these strengths:

  • 30 mg in 1 ml
  • 60 mg in 0.4 ml
  • 105 mg in 0.7 ml
  • 150 mg in 1 ml

Always use Hemlibra exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to use, how often to use it and any special instructions. Here is some guidance:

  • The dose of Hemlibra will be different for different people.
  • The dose is calculated depending on your weight and the medicine is injected once a week.
  • Depending on your response, your doctor may change the dose and how often you receive the injection.
  • Missed dose: If you forget a dose, inject the missed dose as soon as you remember. If you're due for an injection the same day as you remember, miss the dose and have the next injection at the right time. Don't inject 2 doses on the same day. If you're not sure what to do, ask your healthcare provider.
  • It's important to take it as prescribed: See tips to help you remember to take your medicines regularly.

  • Hemlibra is an injection given under the skin (known as a subcutaneous injection).
  • It can be injected in your lower abdomen (tummy), thigh or upper arm.
  • You need to talk with your doctor to decide if you will inject the medicine yourself, or if a healthcare provider or family member will do this for you.
  • If you are giving yourself the injection (self-injecting), you'll be trained by your doctor, nurse or pharmacist. It's not recommended than children under 7 years of age self-inject.
  • If you're injecting yourself, write down the name, strength and batch number of the medicine every time you use it.
  • Store Hemlibra vials in the fridge, in the original package. Don't freeze it. You can keep Hemlibra out of the fridge for up to 7 days (below 30°C).
  • Take the vial out of the fridge 15 minutes before you inject it.
  • Don't shake the vial, and keep it away from direct sunlight.
  • Don’t use Hemlibra if looks cloudy or you can see bits floating in the clear or slightly yellow liquid.
  • Once you've opened the vial, use it immediately and throw away any unused solution.
  • You'll need syringes and needles to prepare your dose. After you have prepared the syringe, don’t put the syringe back in the fridge. Use a new needle and syringe for each dose.
  • Dispose of used vials, needles and syringes in a puncture-proof container, eg, a sharps bin.

Here are some things to know when you're taking Hemlibra. Other things may be important as well, so ask your healthcare provider what you should know about.

  • Bypassing agents: It is very important to talk to your doctor about when and how to use bypassing agents to treat bleeds while using Hemlibra. How much bypassing agent you use may need to be changed when you are using Hemlibra.
  • Other medicines: Hemlibra interacts with some medicines, especially blood products. It may also interact with herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting Hemlibra and before starting any new products.
  • Tell all other healthcare providers you are using Hemlibra: See the patient card you can carry with you in the ‘More information’ section below.
  • Pregnancy and breastfeeding: Tell your doctor if you are pregnant or plan to become pregnant or are breastfeeding.
  • Keep using it regularly: Treatment with Hemlibra is usually long-term to control but not cure haemophilia. You should continue to use it unless you're advised by your healthcare provider to stop. Talk to your healthcare provider before stopping. 
  • Increased bleeding: It’s very important to tell your doctor if you notice an increase in bleeds as the medicine may not be working for you.

Like all medicines, Hemlibra can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine. 

For more information on side effects, see the Medsafe consumer information leaflet in the ‘more information’ section below.

Side effects

What should I do?

  • Pain, discomfort redness, itching or swelling at the injection site
  • This is common and usually settles a few days after the injection.
  • Tell your doctor if this doesn’t settle.
  • Headache
  • Sore muscles and joints
  • These are very common.
  • Tell your doctor if these bother you.
  • Fever
  • Diarrhoea
  • These are common.
  • Tell your doctor if these bother you.
  • Confusion, weakness
  • Swollen arms and legs
  • Yellow colour in skin and eyes
  • This is rare but serious.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of a blood clot, eg, an area feeling hot, numb or swollen anywhere in your face or body
  • This is rare but serious.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of an allergic reaction, eg, skin rash, itches, swelling of the face, lips, mouth and tongue or problems breathing
  • Tell your doctor immediately or ring Healthline 0800 611 116.

Did you know that you can report a medicine side effect to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

The following link has more information about Hemlibra.
Hemlibra useful resources(external link) Roche


(external link)Hemlibra patient card(external link) Roche, 2023
Hemlira patient/carer guide(external link) Roche, 2023


  1. For adults: Emicizumab(external link) New Zealand Formulary
  2. For children: Emicizumab(external link) New Zealand Formulary for Children
  3. Hemlibra(external link) Medsafe Consumer Medicine Information
  4. Hemlibra(external link) Medsafe Data sheet, NZ


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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

Last reviewed: