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Ann Intern Med. 2002 Aug 20;137(4):251-4.

Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy. A randomized, controlled trial.

Author information

1
St. Joseph's Hospital, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada. crowthrm@mcmaster.ca

Abstract

BACKGROUND:

Excessive anticoagulation due to warfarin use is associated with hemorrhage. Subcutaneously administered vitamin K has not been evaluated for the treatment of warfarin-associated coagulopathy, yet it is widely used.

OBJECTIVE:

To show that oral vitamin K is more effective than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy.

DESIGN:

Randomized, controlled trial.

SETTING:

Two teaching hospitals.

PATIENTS:

Patients with an international normalized ratio (INR) between 4.5 and 10.0.

INTERVENTION:

Warfarin therapy was withheld, and 1 mg of vitamin K was given orally or subcutaneously.

MEASUREMENTS:

The primary outcome measure was the INR on the day after administration of vitamin K. Secondary outcome measures were hemorrhage and thrombosis during a 1-month follow-up period.

RESULTS:

15 of 26 patients receiving oral vitamin K and 6 of 25 patients receiving subcutaneous vitamin K had therapeutic INRs on the day after study drug administration (P = 0.015; odds ratio, 4.32 [95% CI, 1.13 to 17.44]).

CONCLUSION:

Oral vitamin K lowers INR more rapidly than subcutaneous vitamin K in asymptomatic patients who have supratherapeutic INR values while receiving warfarin.

[Indexed for MEDLINE]

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