The Medical Letter on Drugs and Therapeutics
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Kcentra: A 4-Factor Prothrombin Complex Concentrate for Reversal of Warfarin Anticoagulation

The FDA has approved use of Kcentra (CSL Behring), a human-derived 4-factor prothrombin complex concentrate (PCC), for urgent reversal of warfarin anticoagulation in adults with acute major bleeding. It is the only 4-factor PCC available in the US.

PROTHROMBIN COMPLEX CONCENTRATES — The vitamin K-dependent coagulation factors are II, VII, IX and X. The composition of PCC products is variable. Three-factor PCC products include clotting factors II, IX and X, but contain little or no factor VII. Four-factor PCCs, which have been available in Europe and Canada for many years, include significant amounts of factor VII.1

REVERSING WARFARIN — Warfarin-related bleeding can be catastrophic, but it is reversible.2 Vitamin K can take more than 24 hours to fully restore vitamin K-dependent coagulation factors. Fresh-frozen ... more      

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