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Healthcare providers are guided to complete bracketed fields, then print and sign the letter so it remains with the patient during travel. The template includes prescribing and safety information for HEMLIBRA, emphasizing thrombotic microangiopathy and thromboembolism risks with aPCC, immunogenicity monitoring, and laboratory test interference guidance.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/hemophilia-a-patient-travel-letter-instructions-travel-letter-template-for-hemlibra-safety/279759/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/hemophilia-a-patient-travel-letter-instructions-travel-letter-template-for-hemlibra-safety/279759.png","ImageObject",442,249,{"name":88,"@type":89},"Ophelia","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-19","2026-09-16",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What information must the doctor include in the Hemophilia A patient travel letter?","Question",{"text":109,"@type":110},"The letter should describe the patient’s bleeding disorder, the medicines they take, and their emergency treatment plan.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How should healthcare providers finalize the travel letter for the patient?",{"text":114,"@type":110},"Providers should fill in the bracketed fields for the patient’s condition and treatment plan, then print and sign the completed letter.",{"name":116,"@type":107,"acceptedAnswer":117},"What is the key safety concern when aPCC is used with HEMLIBRA?",{"text":118,"@type":110},"Thrombotic microangiopathy and thrombotic events have been reported, so patients should be monitored and aPCC should be discontinued and HEMLIBRA dosing suspended if symptoms occur.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},279759,1790327659,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":136,"language":137,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":61,"update_tm":141,"read_time":8},7971461741311,"https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826","Hemophilia A Patient Travel Letter Instructions  \nA travel letter is a document written by a patient's doctor that describes the patient's bleeding disorder, medicine they take, and their emergency treatment plan. It's important that your patient with hemophilia A carries this letter completed by their doctor while traveling in case of emergency.  \nHealthcare providers should fill in bracketed content within the letter to customize it to each patient’s condition and treatment plan. Once the letter is filled out with all the necessary information, healthcare providers should then print it and sign it. Then, the letter should remain with the patient for them to carry while they travel, in case of emergency.  \nThis form was prepared by Genentech and is not a substitute for your clinical judgment or that of any healthcare provider. By using this resource, you agree to the following:  \nThis form is being provided “AS IS” and is intended for use only by qualified healthcare providers. Confirm all information is accurate for each individual patient. Genentech makes no claims as to the accuracy of the information contained herein. Neither Genentech, nor any other party involved in preparation of this form, shall be liable to you or others for any decisions made or actions taken by you or others in reliance on this information.  \nHemophilia A Patient Travel Letter  \nThis template was prepared by Genentech. This letter is not a substitute for the clinical judgment of healthcare providers and must not be relied upon alone in making treatment decisions.  \n[Insert date]  \n[Insert instructions/specific information regarding treatment of breakthrough bleeds]  \nHemophilia A Patient Travel Letter  \nThis template was prepared by Genentech. This letter is not a substitute for the clinical judgment of healthcare providers and must not be relied upon alone in making treatment decisions.  \nIndication  \nHEMLIBRA is indicated for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients ages newborn and older with hemophilia A with or without factor VIII inhibitors.  \nImportant Safety Information  \nBoxed WARNING: THROMBOTIC MICROANGIOPATHY and THROMBOEMBOLISM  \nCases of thrombotic microangiopathy and thrombotic events were reported when on average a cumulative amount of >100 U/kg/24 hours of activated prothrombin complex concentrate (aPCC) was administered for 24 hours or more to patients receiving HEMLIBRA prophylaxis. Monitor for the development of thrombotic microangiopathy and thrombotic events if aPCC is administered. Discontinue aPCC and suspend dosing of HEMLIBRA if symptoms occur.  \nWarnings and Precautions  \nThrombotic Microangiopathy (TMA) and Thromboembolism Associated With HEMLIBRA and aPCC  \nIn clinical trials, TMA was reported in 0.8% of patients (3/391) and thrombotic events were reported in 0.5% of patients (2/391) . In patients who received at least one dose of aPCC, TMA was reported in 8. 1% of patients (3/37) and thrombotic events were reported in 5.4% of patients (2/37) . Patients with TMA presented with thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury, without severe deficiencies in ADAMTS13 .  \nConsider the benefits and risks if aPCC must be used in a patient receiving HEMLIBRA prophylaxis. Due to the long half-life of HEMLIBRA, the potential for an interaction with aPCC may persist for up to 6 months after the last dose. Monitor for the development of TMA and/or thromboembolism when administering aPCC. Immediately discontinue aPCC and interrupt HEMLIBRA prophylaxis if clinical symptoms, imaging, or laboratory findings consistent with TMA and/orthromboembolism occur, and manage as clinically indicated. Consider the benefits and risks of resuming HEMLIBRA prophylaxis following complete resolution of TMA and/or thrombotic events on a case-by-case basis.  \nImmunogenicity  \nTreatment with HEMLIBRA may induce anti-drug antibodies. Anti-emicizumab-kxwh antib","cbCaiuEX7V0CR0R8","https://ap.wps.com/l/cbCaiuEX7V0CR0R8","pdf",651998,31,"English","# Hemophilia A Patient Travel Letter Instructions\n## Purpose of the travel letter\n## How to complete, print, and sign\n## Hemophilia A Patient Travel Letter\n## Indication\n## Important Safety Information\n## Boxed Warning: Thrombotic microangiopathy and Thromboembolism\n## Warnings and Precautions\n## Immunogenicity\n## Laboratory Coagulation Test Interference","[{\"question\":\"What information must the doctor include in the Hemophilia A patient travel letter?\",\"answer\":\"The letter should describe the patient’s bleeding disorder, the medicines they take, and their emergency treatment plan.\"},{\"question\":\"How should healthcare providers finalize the travel letter for the patient?\",\"answer\":\"Providers should fill in the bracketed fields for the patient’s condition and treatment plan, then print and sign the completed letter.\"},{\"question\":\"What is the key safety concern when aPCC is used with HEMLIBRA?\",\"answer\":\"Thrombotic microangiopathy and thrombotic events have been reported, so patients should be monitored and aPCC should be discontinued and HEMLIBRA dosing suspended if symptoms occur.\"}]","Hemophilia A Patient Travel Letter Instructions - Travel letter template for HEMLIBRA safety | PDF",1789526860]