Prothrombin complex concentrates: Difference between revisions
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*Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial | *Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial | ||
*Common Trade Names: Kcentra | *Common Trade Names: Kcentra | ||
*3 factor PCC (Factors II, IX, and X), would need to supplement with factor VII for reversal if using 3 factor PCC | |||
*4 factor PCC (Factors II, VII, IX, and X) | |||
==Adult Dosing== | ==Adult Dosing== | ||
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*[[Anti-platelet agent reversal]] | *[[Anti-platelet agent reversal]] | ||
*[[Blood products]] | *[[Blood products]] | ||
*[[Warfarin reversal]] | |||
==References== | ==References== | ||
Revision as of 18:17, 11 August 2018
General
- Type: Hemostatics, blood components
- Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial
- Common Trade Names: Kcentra
- 3 factor PCC (Factors II, IX, and X), would need to supplement with factor VII for reversal if using 3 factor PCC
- 4 factor PCC (Factors II, VII, IX, and X)
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
- Consider rechecking INR after 15 minutes to determine need for redosing
Pediatric Dosing
- Safety and efficacy not established
Special Populations
- 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
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%).[1]
Common
- Thromboembolic events
- Headache
- Hypotension (4.9%)
- Nausea/vomiting
- Arthralgia
- ICH (2.9%)
- Mental status change
- 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
- Anticoagulant reversal for life-threatening bleeds
- Anti-platelet agent reversal
- Blood products
- Warfarin reversal
References
- ↑ 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