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Rapid Warfarin Reversal
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A significant proportion of patients who are brought to the emergency room with major or life-threatening hemorrhages are being treated with oral anticoagulants, very commonly warfarin, as prophylaxis to prevent thromboembolic events. Warfarin works by inhibiting the synthesis of the vitamin K-dependent coagulation factors (II [prothrombin], VII, IX and X) in the liver.
Uncontrolled bleeding is the most serious and common side effect of warfarin as a result of acquired deficiency of vitamin K-dependent coagulation factors (II, VII, IX and X). The majority of bleeding incidents are clinically minor and include:
- Nose bleeds (epistaxis)
- Excessive bleeding after minor injury, such as a shaving cut
Major hemorrhages, as a result of warfarin therapy, are reported to occur at a rate of 1–12% per patient per year.
Bleeding events are typically classified as minor, major or fatal.
P/N (in some areas known as Confidex®
) is a prothrombin complex concentrate (PCC) from CSL Behring indicated for the treatment and perioperative prophylaxis of bleeding in acquired deficiency of the vitamin K-dependent coagulation factors caused by treatment with oral anticoagulants (e.g., warfarin), or in case of overdose of oral anticoagulants, when rapid correction of the deficiency is required.
In the U.S., this product is known as
(Prothrombin Complex Concentrate [Human]). Kcentra is the first non-activated 4-factor PCC approved in the U.S. for the urgent reversal of vitamin K antagonist (VKA, e.g., warfarin) therapy in adult patients with acute major bleeding or needing an urgent surgery or other invasive procedure.