• CMAJ · Mar 2004

    Review

    Low-dose oral vitamin K therapy for the management of asymptomatic patients with elevated international normalized ratios: a brief review.

    • Sarah E Wilson, Henry G Watson, and Mark A Crowther.
    • Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
    • CMAJ. 2004 Mar 2; 170 (5): 821-4.

    AbstractAsymptomatic elevation of the international normalized ratio (INR) is a common problem associated with hemorrhage. Evidence from randomized controlled trials supports the use of low-dose oral vitamin K therapy as a treatment that promptly reduces the INR. Vitamin K given orally is more effective than subcutaneous vitamin K injection, and as effective as intravenous administration when INR values are compared 24 hours after administration. A 1.0-mg vitamin K dose is likely most appropriate for patients with INR values between 4.5 and 10. The fear of over-correction of the INR has limited the widespread use of vitamin K; however, our review suggests that this occurs infrequently when small doses are administered orally.

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