Thromb Haemost 2010; 104(01): 118-121
DOI: 10.1160/TH09-12-0822
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10

Results of a prospective cohort study
Mark A. Crowther
1   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
David Garcia
2   Department of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
,
Walter Ageno
3   Department of Medicine, University of Insubria, Varese, Italy
,
Luqi Wang
1   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Dan M. Witt
4   Clinical Pharmacy Anticoagulation Service, Kaiser Permanente Colorado, Denver, Colorado, USA
,
Nathan P. Clark
4   Clinical Pharmacy Anticoagulation Service, Kaiser Permanente Colorado, Denver, Colorado, USA
,
Mark D. Blostein
5   Department of Medicine, McGill University, Montreal, Quebec, Canada
,
Susan R. Kahn
5   Department of Medicine, McGill University, Montreal, Quebec, Canada
,
Sam Schulman
1   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Michael Kovacs
6   Department of Medicine, University of Western Ontario, London, Ontario, Canada
,
Marc A. Rodger
7   Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
,
Philip Wells
7   Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
,
David Anderson
8   Department of Medicine, Dalhousie, Halifax, Nova Scotia, Canada
,
Jeffrey Ginsberg
1   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Rita Selby
9   Department of Medicine, University of Toronto, Toronto, British Columbia, Canada
,
Sergio Siragusa
10   Division of Hematology, University of Palermo, Palermo, Italy
,
Mauro Silingardi
11   Department of Medicine, Reggio Emilia, Italy
,
MaryBeth B. Dowd
4   Clinical Pharmacy Anticoagulation Service, Kaiser Permanente Colorado, Denver, Colorado, USA
,
Clive Kearon
1   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
› Author Affiliations
Further Information

Publication History

Received: 06 December 2009

Accepted after major revision: 19 February 2010

Publication Date:
23 November 2017 (online)

Summary

Unanticipated elevation of the INR is common in patients receiving warfarin. We performed a prospective cohort study of 107 warfarintreated patients with INR values of more than 10 who received a single 2.5 mg dose of oral vitamin K. During the first week, one patient experienced major bleeding, and one died. In the first 90 days after enrolment four patients had major bleeding (3.7%, 1.0% to 9.3%), eight patients (7.5%, 3.3% to 14.2%) died and two had objectively confirmed thromboembolism. Based on our low rate of observed major bleeding we conclude that 2.5 mg of oral vitamin K is a reasonable treatment for patients with INR values of more than 10 who are not actively bleeding.

 
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