Oral Vitamin K for Warfarin-Associated Coagulopathy
Authors: Rick Weideman, Amit P. Patel
Journal: Annals of Internal Medicine (2003)

Letters1 April 2003Oral Vitamin K for Warfarin-Associated CoagulopathyRick Weideman, PharmD, BCPS and Amit P. Patel, PharmDRick Weideman, PharmD, BCPSVeterans Affairs North Texas Health Care System; Dallas, TX 75216 (Weideman)University of Houston College of Pharmacy; Houston, TX 77030 (Patel)Search for more papers by this author and Amit P. Patel, PharmDVeterans Affairs North Texas Health Care System; Dallas, TX 75216 (Weideman)University of Houston College of Pharmacy; Houston, TX 77030 (Patel)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-7-200304010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Crowther and colleagues (1) reported that oral vitamin K results in more rapid and predictable conversion of the international normalized ratio (INR) than subcutaneous vitamin K in patients with warfarin-associated coagulopathy. Although the use of oral vitamin K is appealing, we are concerned that several unconsidered variables in Crowther and colleagues' study could have led to biased results.Both phytonadione and phytomenadione are equally potent on a molar basis (2). However, in Crowther and colleagues' study, both of these formulations were liquid solutions given orally and could have had different absorption and bioavailability characteristics compared with the ...References1. Crowther MA, Douketis JD, Schnurr T, Steidl L, Mera V, Ultori C, et al. . 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. Ann Intern Med. 2002;137:251-4. [PMID: 12186515] LinkGoogle Scholar2. Marcus R, Coulston AM. Fat-soluble vitamins: vitamins A, K, and E.. In: Hardman JG, Limbird LE, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York: McGraw-Hill; 1996:1573-90. Google Scholar3. Raj G, Kumar R, McKinney WP. Time course of reversal of anticoagulant effect of warfarin by intravenous and subcutaneous phytonadione. Arch Intern Med. 1999;159:2721-4. [PMID: 10597763] CrossrefMedlineGoogle Scholar4. Kelly KC, Raj G, Weideman RA. Influence of body weight on response to subcutaneous vitamin K administration in over-anticoagulated patients. Am J Med. 2001;110:623-7. [PMID: 11382370] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Veterans Affairs North Texas Health Care System; Dallas, TX 75216 (Weideman)University of Houston College of Pharmacy; Houston, TX 77030 (Patel) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOral Vitamin K Lowers the International Normalized Ratio More Rapidly Than Subcutaneous Vitamin K in the Treatment of Warfarin-Associated Coagulopathy Mark A. Crowther , James D. Douketis , Terri Schnurr , Luigi Steidl , Valentina Mera , Carolina Ultori , Achille Venco , and Walter Ageno Oral Vitamin K for Warfarin-Associated Coagulopathy Elin Ringstrom and Heather Long Oral Vitamin K for Warfarin-Associated Coagulopathy Mark A. Crowther Metrics 1 April 2003Volume 138, Issue 7Page: 610KeywordsBody weightCoagulopathyDrugsInternational normalized ratioVitamin K ePublished: 1 April 2003 Issue Published: 1 April 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...