Vitamin k antidote for warfarin onset full#

Tsu and colleagues conducted a retrospective analysis of 400 patients who received vitamin K for reversal of warfarin between February 2008 and November 2010 to evaluate the effect of the dose and route on the reduction of the INR. Typical dosing for emergent reversal of warfarin with Vitamin K is 5-10 mg IV but lower doses for non-emergent situations can be utilized as well.

Vitamin k antidote for warfarin onset full#

What dose of vitamin K do the guidelines recommend?Ī full review of all the various organizational guidelines is beyond the scope of this post ( see a great recent review here ). Anaphylaxis, with a reported rate of 3 per 10,000 doses, is thought to be associated with older IV formulations that contain polyethoxylated castor oil compared to the more modern micelle formulations. And yes, as I get this question a lot, IV administration has a connotation with anaphylaxis but this is not a concern when we dilute and administer over 15-30 mins. Intramuscular and subcutaneous administration should be avoided when reversing warfarin due to erratic absorption. 1 Oral vitamin K has a longer onset of action and can take up to 24-36 hours for the full effect to be seen. Administration via the IV route has the shortest onset of action as factors will start to be produced 2-4 hours after administration and full effect seen ~12 hours after administration. Route of administration is also important as this impacts the onset and timing of reversal. The reduction in INR is dose-dependent which we will discuss in a little bit. What we already know about Vitamin K for warfarin reversalĪdministration of vitamin K can bypass or overcome the effect of warfarin on vitamin-K-epoxide reductase, leading to the production of vitamin K dependent clotting factors (II, VII, IX, X).