The Medical Letter on Drugs and Therapeutics
Prothrombin Complex Concentrates to Reverse Warfarin-Related Bleeding
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Warfarin-related bleeding, especially intracranial hemorrhage, can be catastrophic. Several products are available to reverse warfarin’s anticoagulant effect.1

VITAMIN K — The vitamin K-dependent coagulation factors are II, VII, IX and X. Administration of vitamin K can take more than 24 hours to fully restore these factors. In patients with serious or life-threatening warfarin-related bleeding, vitamin K is usually given IV in a dose of 10 mg over about 30 minutes (to reduce the risk of anaphylaxis), and fresh-frozen plasma, recombinant factor VIIa or prothrombin complex concentrate (PCC) may be given in addition.2

FRESH-FROZEN PLASMA — The plasma product most likely to be available in emergency departments to rapidly replace vitamin K-dependent clotting factors is fresh-frozen plasma (FFP). When the speed of replacement ... more      

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Title: Prothrombin Complex Concentrates to Reverse Warfarin-Related Bleeding
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