V. Pengo et al., REVERSAL OF EXCESSIVE EFFECT OF REGULAR ANTICOAGULATION - LOW ORAL DOSE OF PHYTONADIONE (VITAMIN-K1) COMPARED WITH WARFARIN DISCONTINUATION, Blood coagulation & fibrinolysis, 4(5), 1993, pp. 739-741
To determine the best way to reverse the excessive effect of regular a
nticoagulation in patients with INR > 5 and no bleeding complications,
23 patients with INR > 5 were randomly subdivided into two groups: gr
oup A (n = 12) discontinued warfarin for one day and group B (n = 11)
received 2 mg of vitamin K1 orally in addition to the usual warfarin d
ose. INR was determined after 24 h (day 1), after which both groups co
ntinued with their usual dose of warfarin. After 48 h (day 2), warfari
n dosage was changed according to the INR value. On day 9, INR values
were determined again. Five out of twelve patients in group A had INR
values > 5 on day 1. One patient in group A had an INR value < 5 both
on days 1 and 2. All eleven patients in group B had INR values < 5 on
day 1, and all but one on day 2. On day 9, INR values were acceptable
(INR 2.0-4.5) in ten group A patients and eight group B patients. Thes
e findings suggest that a low oral dose of vitamin K1 is a convenient
treatment for excessive anticoagulation in patients with no bleeding c
omplications.