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Reversal of Warfarin
Reversal of Warfarin can be accomplished by administering any of the following:
- Fresh Frozen Plasma (traditional reversal agent)
- Vitamin K (po, sub q, or IV)
- Prothrombin Complex Concentrates (PCC)-not yet available for use in the US (yet)
A few pearls:
- It doesn't take many units of FFP to lower someone's INR
- Don't forget volume considerations if you use FFP
- Vit K is pretty well tolerated but some patients will have an allergic reaction (more common with IV administration)
- These medications in general will be used for life-threatening bleeding (GI, CNS bleeds, retroperitoneal bleeds, etc)
- Prothrombin Complex Concentrates-rich in factors 2,7,9, and 10...perfect drug since Warfarin depletes these factors
- PCC associated with some increased thrombosis