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How to Mix Factor VIII (Advate ®) at Home

Factor VIII is a medicine used to treat hemophilia A.

There are 3 steps to follow when mixing factor VIII medicine (Advate®):

1. Press: Press firmly and the system will be activated.

2. Swirl: Swirl gently for proper mixing.

3. Flip and Withdraw: Withdraw the medicine from the system.

Below are the steps you must take to make sure the factor is safely mixed and ready to give as an injection through an IV.

Mixing factor

Gather all supplies on a clean surface, wash your hands, and put on gloves. Gloves are optional for home infusion. Check the expiration date, and allow the medicine to warm to room temperature.

Step 1

  • Open the package holding the Baxject III mixing device by peeling away the lid.
  • Place the vial on a flat surface in an upright position with the blue stripe on top. Do not use if it is cloudy or you see particles in the sterile water.
  • Keep the vial upright. Do not lay it down flat.
Advate supplies

Step 2

  • Hold the vial with one hand.
  • With the other hand, press down firmly on the top until it is pushed all the way down and the sterile water (diluent) from the top vial flows into the bottom (Advate) vial.
Advate Step 2

Step 3

  • Gently swirl the vial in a circular motion until the Advate dissolves.
  • Do not shake to mix. If you see powder, continue to gently swirl the vial. This will mix the solution together.
  • The mixture should become clear. If it is not clear, throw it away and use another dose of factor. Then, call the Hematology Clinic at 901-595-5041.
Advate Step 3

Step 4

  • Remove the blue cap from the side of the device.
  • Remove the cap on the syringe (if there is one).
  • Connect the syringe to the side port by twisting it to the right.
  • Do not inject any air.
Advate Step 4

Step 5

  • Turn the vials over so that the blue strip of the Baxject III is now on the bottom.
  • Slowly pull back on the plunger of the syringe and allow the medicine to fill the syringe.
  • If the solution does not go into the syringe, check to make sure that both vials are pressed firmly together.
  • Twist the syringe off the side port. Be sure not to touch the end of the syringe.
  • A small amount of fluid may be left in the vial.


Advate Step 5

Step 6

  • Remove any air from the syringe before giving the medicine.
  • Attach the medicine to the needle set before you infuse.
  • Remember to always place the sticker from the package in your book.
Advate Step 6

To see a video of the process, visit


If you have questions or concerns about giving factor at home through an IV or mixing factor with the Baxject III device, please call the Hematology Clinic at 901-595-5041. If you are calling after hours or on the weekend, dial 901-595-3300 and ask for the nursing care coordinator or the doctor on call. If you are outside the Memphis area, dial toll-free 1-866-278-5833 and press 0 when the call connects.

Reviewed: July 2022