View source for Prothrombin complex concentrates

==General==
*Type: Hemostatics, [[blood components]]
*Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial
*Common Trade Names: Kcentra

==Adult Dosing==
*Based on pretreatment INR, units based on factor 9 content
**INR 2-4: 25units/kg, not to exceed 2500 units
**INR 4-6: 35units/kg, not to exceed 3500 units
**INR >6: 50units/kg, not to exceed 5000 units
*Conisder rechecking INR after 15 minutes to determine need for redosing

==Pediatric Dosing==
Safety and efficacy not established

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation: Unknown, breast feeding not advised
*Renal Dosing
**Adult-N/A
**Pediatric-N/A
*Hepatic Dosing
**Adult-N/A
**Pediatric-N/A

==Contraindications==
*Allergy to class/drug
*[[DIC]]
*known [[HIT]] (Heparin induced thrombocytopenia)

===Serious===
*Patients receiving PCC for reversal of a vitamin K antagonist ([[Warfarin]]) due to life-threatening bleeding have a rate of thromboembolism which is similar to the rate in patients who receive [[Fresh frozen plasma]] (7.3% v 7.1%).<ref>Milling, TJ Jr et al. Thromboembolic events after vitamin K antagonist reversal with 4-factor prothrombin complex concentrate: exploratory analyses of two randomized, plasma-controlled studies. Ann Emerg Med. 2016 Jan;67(1):96-105.  PMID: 26094105</ref>

===Common===
*thromboembolic events (8.7%)
*[[headache]] (7.8%)
*[[hypotension]] (4.9%)
*[[nausea/vomiting]]
*arthralgia
*[[ICH]] (2.9%)
*mental status change (2.9%)
*hypertension (2.9%)

==Pharmacology==
*Half-life: 4-60 hours, depending on clotting factor
*Metabolism: 
*Excretion: 
*Mechanism of Action: 4 factor PCC contains factors II, VII, XI, X, protein C and S

==See Also==
*[[Blood transfusions]]
*[[Dabigatran (Pradaxa) Reversal]]

==References==
<references/>
[[Category:Pharmacology]]