Vitamin K to Reverse Excessive VKA Anticoagulation

Beyond holding anticoagulation, adding vitamin K did not reduce mortality, bleeding, or thrombosis risks in nonbleeding patients with elevated INRs.

Labile international normalized ratios (INRs) due to drug interactions, dietary changes, and acute illness increase bleeding risks in patients receiving vitamin K antagonists (VKAs). In 2008, clinical practice guidelines were changed to advise against administration of vitamin K in nonbleeding patients with INR elevation.

To assess the effect of combining vitamin K with VKA cessation to reverse excessive anticoagulation in this setting, investigators conducted a meta-analysis of five randomized, controlled trials involving 1074 nonbleeding adults with INRs between 4.5 to 10.0 requiring temporary cessation of VKAs (warfarin in 3 studies, acenocoumarol in 2). At baseline, patients randomized to vitamin K administration versus placebo or observ…

Reviewing Author

Brady L. Stein, MD, MHS

Disclosures

Leadership Positions in Professional SocietiesAmerican Society of Hematology (Senior Editor, ASH Self-Assessment Program; guideline development)

Brady L. Stein, MD, MHS

Disclosures

Leadership Positions in Professional SocietiesAmerican Society of Hematology (Senior Editor, ASH Self-Assessment Program; guideline development)

Vitamin K to Reverse Excessive VKA Anticoagulation

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Reviewing Author