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All About Bleeding

Guidelines for Anticoagulant Reversal

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Emergency Reversal of Warfarin

Emergency reversal of warfarin ISTH Ravi Sarode, ISTH satellite symposium (video)

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Kcentra® Phase III Data Published in the Lancet

Study Finds Kcentra® is Superior to Plasma in Patients Needing Warfarin Reversal for Urgent Surgical or Invasive Procedures

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Reversal of oral anticoagulation/warfarin is considered for:

  • Bleeding anticoagulated patients
  • Treatment is guided by the patient's clinical situation and INR value, and the speed with which the INR must be reduced.14 Table 1 summarizes UK15, France16 and US17 guidelines for warfarin-induced bleeding.

  • Non-bleeding anticoagulated patients with an INR above the target range
  • Anticoagulated patients undergoing elective or emergency surgery
Table 1. Country guidelines for treating serious warfarin induced bleeding
UK guidelines French guidelines US guidelines
Major bleeding
1. Stop warfarin
2. Administer prothrombin complex concentrate (PCC) (50 IU/kg) in preference to fresh frozen plasma (FFP) (15 ml/kg)*
3. Vitamin K (5–10 mg intravenously)
Serious bleeding
1. If INR is not available, one dose of PCC (25 IU/kg factor IX equivalent)
2. Administration of vitamin K (10 mg orally) or slow intravenous administration
3. Monitor INR
Serious bleeding at any elevation of INR
1. For patients with VKA-associated major bleeding, suggest rapid reversal of anticoagulation with prothrombin complex concentrate rather than with plasma. (Grade 2C)
2. Suggest the additional use of vitamin K 5 to 10 mg administered by slow IV injection rather than reversal with coagulation factors alone (Grade 2C).

CSL Behring Products

Package Inserts

CSL Behring's freeze-dried prothrombin complex concentrate (PCC) product is known in various countries as:

Product Websites

Beriplex.co.uk (United Kingdom)
Kcentra.com (United States)

Not all products are available in every country. To learn what products are available in your country, visit your CSL Behring country site.


Last Updated: 2/26/2015 11:11 AM
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