http://www.fpnotebook.com/

Vitamin K

Indication
1. Reversal of excessive Anticoagulation with Coumadin
Dosing (See Coumadin Protocol)
1. INR 4 to 10
  1. Give Vitamin K 1-2 mg PO
  2. Dilute parenteral Vitamin K 1-2 mg in flavored drink
  3. Administer Vitamin K 0.5-1 mg IV if not able orally
2. INR over 10 without bleeding complications
  1. Vitamin K 3 mg SC or slow IV infusion
  2. Check INR at 6 hours
  3. Consider repeating Vitamin K at 6 hours if unchanged
3. Serious bleeding complication at any elevated INR
  1. Replace Clotting Factors
    1. Vitamin K 10 mg SC or slow IV infusion
    2. Fresh Frozen Plasma (FFP) 15 ml/kg
    3. Prothrombin Complex Concentrate (PCC) 50 U/kg
  2. Check INR at 6 hours
Research: Guideline Studies (See Coumadin Protocol)
1. Consensus Conference (Dalen) advocates giving
  1. Vitamin K SC/IV for INR > 6
  2. Dalen (1995) Chest 108(sppl):225S
2. Retrospective study of 51 Arizona Patients with INR >6
  1. No Vitamin K given in 48 patients, Coumadin stopped
  2. No adverse outcomes or major bleeding
  3. Glover (1995) Chest 108:987
3. Oral Vitamin K 1 mg acts faster than subcutaneous
  1. Crowther (2002) Ann Intern Med 137:251

Navigation Tree

Please see the Terms and Conditions. Please also see the privacy statement regarding advertising on this page. Although access to this page is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians.

This page was written by Scott Moses, MD. This page was last revised on 4/25/2008 1:10:37 PM. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.