Journal of Thrombosis and Thrombolysis

, Volume 29, Issue 2, pp 171–181

Warfarin anticoagulation reversal: management of the asymptomatic and bleeding patient

  • Michael Makris
  • Joost J. van Veen
  • Rhona Maclean
Article

Abstract

The management of patients with supra-therapeutic INR in a common clinical problem. The risk of bleeding is influenced by the intensity, variability and duration of anticoagulation, patient age, presence of co-morbidities and concomitant drug therapy. For the asymptomatic patient, warfarin discontinuation is all that is usually required but for individuals at high risk of bleeding and those with INR > 10, oral vitamin K administration is recommended. In the presence of major bleeding, treatment with intravenous vitamin K and prothrombin complex concentrate is the most effective therapy.

Keywords

Anticoagulation reversal Warfarin Hemorrhage Vitamin K Prothrombin complex concentrate Recombinant factor VIIa 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Michael Makris
    • 1
    • 2
  • Joost J. van Veen
    • 1
  • Rhona Maclean
    • 1
  1. 1.Sheffield Haemophilia and Thrombosis CentreUniversity of SheffieldSheffieldUK
  2. 2.Sheffield Haemophilia and Thrombosis CentreRoyal Hallamshire HospitalSheffieldUK

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