Comparison of oral versus intravenous phytonadione in patients with excessive anticoagulation
Key, N.
Current Hematology Reports 3(5): 315-316
2004
ISSN/ISBN: 1541-0714 PMID: 15341696 Document Number: 8569
This study supports previous data demonstrating that in terms of rapidity of correction of the INR, the hierarchy appears to be intravenous>oral>subcutaneous vitamin K1. This is important in the patient who is actively bleeding, or where rapid correction of the INR (eg, before surgery) is needed. However, the equivalent efficacy at 24 hours- with a lower risk of overcorrection- favors routine use of oral over intravenous vitamin K1 in asymptomatic patients with INR values in the 6 to 10 range. Conclusions are more guarded when the INR is greater than 10, because of the small numbers of subjects in this category, but here again the oral preparation (at the higher dose) appears to be a reasonable choice. Notably, the 'trigger for intervention in this study was an INR greater than 6, somewhat higher than the trigger used in some other studies. It is also important to note that there are probable differences in efficacy between the same dose of various vitamin K1 preparations, and therefore it may be that the efficacy profile of one preparation cannot necessarily be extrapolated to another brand.
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