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
• 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

• 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%).

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

• Blood transfusions
• Dabigatran (Pradaxa) Reversal