Efficacy and safety of a prothrombin complex concentrate (Octaplex®) for rapid reversal of oral anticoagulation

Pharmacologic interventions for reversing the effects of oral anticoagulants

“…[22][23][24][25][26][27][28] In contrast to three-factor PCC products, four-factor PCC products were effective for reducing the INR when used without FFP. The effect of four-factor PCC products on bleeding was similar to that of FFP.…”

A Rewarding Medical Internship – Documenting the Case of a Colorectal Cancer Patient with Hematochezia and Melena

“…PCC is a combination of blood clotting factors II, VII, IX, X, and protein C and S. 9 It is used in cases of severe hemorrhage (including GI hemorrhage). 9 After 3 days of PCC treatment, patient L's stool returned to a normal medium brown color. Patient L received another 200 mL of blood transfusion.…”

Management of Excessive Anticoagulant Effect Due to Vitamin K Antagonists

“…45 In the first controlled trial, Taberner et al randomized 18 overanticoagulated patients to receive PCC or intravenous vitamin K. 46 Patients randomized to PCC had a more rapid INR correction compared to patients random-ized to vitamin K. Several additional (but small) prospective studies have shown that PCC is effective in reducing INR and achieving rapid hemostasis in patients with major bleeding or who required urgent surgery. 36,47,48 PCCs are likely to produce more rapid and complete INR reversal compared with FFP. In a study conducted on 41 patients who were bleeding because of warfarin overdosage or who required urgent reversal of warfarin therapy, Makris 40,50 However, whether PCC improves clinical outcome when compared with FFP is unknown.…”

“…As with other coagulation factor concentrates there remains a risk of transfusion-transmitted infection; however, this risk is significantly reduced by procedures such as solvent/detergent-treatment and nanofiltration. 47 The optimal dose of PCC is not established, and some experts suggest that should be individualized according to initial INR, target INR and body weight. Furthermore, available data do not allow a direct comparison among different PCCs.…”