Medline ® Abstract for Reference 59
of 'Management of warfarin-associated bleeding or supratherapeutic INR'
59
TI
Correction of excessive anticoagulation with low-dose oral vitamin K1.
AU
Weibert RT, Le DT, Kayser SR, Rapaport SI
SO
Ann Intern Med. 1997;126(12):959.
BACKGROUND:
Despite earlier acceptance of oral vitamin K1 (phytonadione) for the treatment of excessive anticoagulation, some recent guidelines do not recommend its use.
OBJECTIVE:
To reevaluate the efficacy of oral vitamin K1 in correcting excessive anticoagulation.
DESIGN:
Case series.
SETTING:
Anticoagulation clinics at two university medical centers.
PATIENTS:
81 outpatients who had an international normalized ratio (INR) greater than 5.0 but did not have significant bleeding.
INTERVENTIONS:
Withholding 1 or 2 doses of warfarin, administering 2.5 mg of oral vitamin K1, measuring the INR after 24 to 48 hours, and adjusting the warfarin dose.
MEASUREMENTS:
INRs were obtained from a portable capillary fingerstick monitor or from an automated photooptical coagulometer.
RESULTS:
In 68 of 71 patients (96%), oral vitamin K1 lowered the INR from between 5.0 and 10.0 to less than 5.0 without inducing resistance to further anticoagulation.
CONCLUSIONS:
Withholding 1 or 2 doses of warfarin and administering 2.5 mg of oral vitamin K1 is a reliable, safe, and inexpensive way to rapidly correct excessive anticoagulation (INR>5.0) in patients who do not have serious bleeding episodes and have an INR of less than 10.0.
AD
University of California, San Diego, USA.
PMID