The present application generally relates to methods to prevent or treat bleeding and/or hypocoagulation in an individual in need thereof, and compositions for use in such methods. The methods comprise administration of FVa, preferably an APC resistant FVa (such as superFVa), alone or in combination with FVIIa, preferably rhFVIIa (such as NovoSeven® or another FVIIa having enhanced activity or half-life). When administered in combination, FVa and FVIIa elicit a synergistic benefit when used to treat or prevent bleeding or hypocoagulation in subjects in need thereof, e.g., subjects with a genetic disorder such as hemophilia or an acquired bleeding disorder or other condition associated with bleeding or hypocoagulation such as hemorrhagic stroke or shock, trauma, surgery or dysmenorrhea or individuals who produce inhibitory antibodies against procoagulants such as FVIII or FIX or who have been administered an overdose of an anticoagulant drug such as a direct Xa or direct thrombin inhibitor or a Novel Oral Anti-Coagulant (NOAC) or demonstrate unexplained bleeding. Also, the invention relates to the use of a superFVa alone or in combination with FVIIa or other procoagulant or prohemostatic agent to prevent, treat or reverse APC-associated bleeding, e.g., as the result of APC overproduction (such as through serious injury and/or hemorrhagic shock) or APC or other anticoagulant therapy, e.g., in the treatment of inflammatory disorders or sepsis disease.