• J. Thromb. Thrombolysis · Feb 2010

    Review

    Warfarin anticoagulation reversal: management of the asymptomatic and bleeding patient.

    • Michael Makris, Joost J van Veen, and Rhona Maclean.
    • Sheffield Haemophilia and Thrombosis Centre, University of Sheffield, Sheffield, UK. m.makris@sheffield.ac.uk
    • J. Thromb. Thrombolysis. 2010 Feb 1; 29 (2): 171-81.

    AbstractThe 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.

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