Vitamin K to Correct Overanticoagulation
Authors: Mark A. Crowther
Journal: Annals of Internal Medicine (2009)

Letters15 September 2009Vitamin K to Correct OveranticoagulationMark A. Crowther, MD, MSc and David Garcia, MDMark A. Crowther, MD, MScFrom McMaster University, Hamilton, Ontario L8N 4A6, Canada, and University of New Mexico, Albuquerque, NM 87131.Search for more papers by this author and David Garcia, MDFrom McMaster University, Hamilton, Ontario L8N 4A6, Canada, and University of New Mexico, Albuquerque, NM 87131.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-6-200909150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Our study found that low-dose oral vitamin K does not reduce bleeding in asymptomatic patients who present with INR values between 4.5 and 10.0. Thus, one should not recommend vitamin K to patients similar to those we enrolled if the intent is to reduce bleeding.The INR decreased more rapidly in patients who received vitamin K, consistent with the pattern we have observed in previous studies. This INR decrease confirms that the formulation used in our study was effective (1). Similarly, we decided only after extensive discussion that we would not mandate how warfarin was given after study ...References1. Crowther MA, Julian J, McCarty D, Douketis J, Kovacs M, Biagoni L, et al. Treatment of warfarin-associated coagulopathy with oral vitamin K: a randomised controlled trial. Lancet. 2000;356:1551-3. [PMID: 11075768] CrossrefMedlineGoogle Scholar2. Witt DM, Humphries TL. A retrospective evaluation of the management of excessive anticoagulation in an established clinical pharmacy anticoagulation service compared to traditional care. J Thromb Thrombolysis. 2003;15:113-8. [PMID: 14618079] CrossrefMedlineGoogle Scholar3. Garcia DA, Regan S, Crowther M, Hylek EM. The risk of hemorrhage among patients with warfarin-associated coagulopathy. J Am Coll Cardiol. 2006;47:804-8. [PMID: 16487849] CrossrefMedlineGoogle Scholar4. Pengo V, Banzato A, Garelli E, Zasso A, Biasiolo A. Reversal of excessive effect of regular anticoagulation: low oral dose of phytonadione (vitamin K1) compared with warfarin discontinuation. Blood Coagul Fibrinolysis. 1993;4:739-41. [PMID: 8292723] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Mark A. Crowther, MD, MSc; David Garcia, MDAffiliations: From McMaster University, Hamilton, Ontario L8N 4A6, Canada, and University of New Mexico, Albuquerque, NM 87131.Disclosures:Consultancies: M.A. Crowther (Anton Pharmaceuticals). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOral Vitamin K Versus Placebo to Correct Excessive Anticoagulation in Patients Receiving Warfarin Mark A. Crowther , Walter Ageno , David Garcia , Luqi Wang , Dan M. Witt , Nathan P. Clark , Mark D. Blostein , Susan R. Kahn , Sara K. Vesely , Sam Schulman , Michael J. Kovacs , Marc A. Rodger , Phillip Wells , David Anderson , Jeffery Ginsberg , Rita Selby , Sergio Siragusa , Mauro Silingardi , Mary Beth Dowd , and Clive Kearon Vitamin K to Correct Overanticoagulation Mark W. Swaim and B. Gail Macik Vitamin K to Correct Overanticoagulation Vittorio Pengo , Gentian Denas , and Seena Padayattil Jose Vitamin K to Correct Overanticoagulation Robert C. Pendleton and Sara Vazquez Vitamin K to Correct Overanticoagulation Ayad Jindeel Vitamin K to Correct Overanticoagulation P. Dileep Kumar Metrics 15 September 2009Volume 151, Issue 6Page: 435KeywordsBloodConflicts of interestDrug administrationDrugsHemorrhageInternational normalized ratioResearch laboratoriesThrombosisVitamin K ePublished: 15 September 2009 Issue Published: 15 September 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...