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- Shailendra Prasad, Michael R Wootten, Nichole Kulinski, and Scott A Chapman.
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA. pras0054@umn.edu
- J Fam Pract. 2009 Jul 1; 58 (7): 346-52.
AbstractWarfarin is certainly a lifesaver--but it can also lead to potentially fatal hypocoagulability. Here we recommend best reversal options based on the type of bleed. For patients with an elevated international normalized ratio (INR) with mild or no bleeding, withhold the warfarin and recheck INR in 1 to 2 days; if INR >5, add oral vitamin K supplementation. For major bleeding and elevated INR, hospital admission, vitamin K, fresh frozen plasma, and frequent monitoring are needed. Emergent situations call for hospitalization, clotting factor replacement, and vitamin K administered by slow intravenous infusion.
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