Appendix B: Phytonadione (Vitamin K) Dosing Guidelines INR > 9.0, No significant bleeding Repeat INR hold warfarin. Monitor INR every 12-24 hours. Consider oral phytonadione at a dose of 2.5 to 5 mg (INR reduction expected to occur within 24 hours). Resume warfarin at a lower dose when the INR approaches the therapeutic range. Repeat INR hold warfarin.
Vitamin K dosing to reverse warfarin based on INR, route of administration, and home warfarin dose in the acute/critical care setting. Vitamin K dose, route, and initial INR influence subsequent INR values. INR reduction is similar for intravenous vitamin K doses of 2 mg or greater.
An update of consensus guidelines for warfarin reversal …
REVERSAL OF WARFARIN OVER-ANTICOAGULATION: FOCUS ON VITA…, Reversal of Warfarin | Circulation, REVERSAL OF WARFARIN OVER-ANTICOAGULATION: FOCUS ON VITA…, For most warfarin-treated patients who are not bleeding and whose INR is >4.0, oral vitamin K (in doses between 1 and 2.5 mg) will lower the INR to between 1.8 and 4.0 within 24 hours. 6 Intravenous vitamin K can lower the INR more quickly than oral vitamin K, but at 24 hours, intravenous and oral vitamin K produce similar degrees of INR correction. 7 Subcutaneous.
• Hold warfarin if INR > 3.0 • Give oral vitamin K 1 to 2.5 mg if INR > 5.0 • Reassess symptoms and INR until episode resolves Serious or Life-Threatening Bleeding Any Elevation * • Investigate cause of ? INR: infection, heart failure, dosing error • Hold warfarin • Give IV vitamin K 10 mg in D5W 50 mL over 15-30 minutes, 3/4/2013 · Vitamin K 1 can be given to reverse the anticoagulant effect of warfarin . When oral vitamin K 1 is used for this purpose, the injectable formulation, which can be given orally or intravenously, is preferred. For immediate reversal, prothrombin complex concentrates (PCC) are preferred over fresh frozen plasma (FFP).
Vitamin K needs to be given IV if urgent partial correction ( 1 to 10 mg on.
Reversal of warfarin with Vitamin K should be reserved only for the most serious bleeding events or patients who will not be restarted on warfarin. Vitamin K should be administered either orally or intravenously (IV) only. Oral Vitamin K is the safest and most reliable route.
Oral vitamin K 1 was administered as a scored 5 mg tablet. Patients who required reversal of their INR prior to minor surgery or a dental procedure took vitamin K 1 36 h before the procedure and continued their daily dose of warfarin: the aim was to reduce their INR to between 1.5 and 2.0.
Reversal of Warfarin Effects. Omit 1-2 doses, or hold warfarin monitor INR and adjust warfarin dose accordingly. INR 4.5-10, no bleeding: 2012 ACCP.
If surgery is required and warfarin cannot be stopped 3 days beforehand, anticoagulation should be reversed with low-dose vitamin K. The timing for re-instating warfarin treatment depends on the risk of post-operative haemorrhage. In most instances, warfarin treatment can be re-started as soon as the person has an oral intake. For dental procedures:
