For Jackson Only: New Protocol Approved for Emergent Warfarin Reversal Fixed Dose Kcentra (Prothrombin Complex Concentrate - PCC) Vitamin K Antagonist (Warfarin) Reversal
For Jackson Only: New Protocol Approved for Emergent Warfarin Reversal Fixed Dose Kcentra (Prothrombin Complex Concentrate - PCC) Vitamin K Antagonist
In September 2018, the Pharmacy and Therapeutics Committee approved a new protocol for Emergent Vitamin K Antagonist (Warfarin) reversal via fixed dose Kcentra (PCC). We will go live with this protocol on January 22, 2019.
Emergent: The life-threatening factor Xa inhibitor reversal (apixaban, rivaroxaban, edoxaban) will still use standard weight-based dosing protocol for Kcentra (PCC), at 50 units/kg.
The benefits of Fixed dose protocol for warfarin reversal include:
- Reduction in time to infusion (by not waiting for pre-treatment INR to result)
- Studies show similar post-Kcentra (PCC) INR when utilizing fixed-dosing regimens as compared to standard dosing regimens.
- Potential reduction of thromboembolic risk with lower doses via fixed-dose regimens
- Significant cost savings
Evidence Support:
- Practice Guidelines
- American College of Cardiology
- Support for Major bleeds and ICH
- Primary Literature
- Support for Major Bleeds and ICH
Please see the Fixed-Dose Kcentra Protocol below:
![Image: Kcentra Policy](/DIS-Newsletters/images/2019/January/img_kcentra_policy.png)
EPIC ordering description of both "Kcentra Fixed Dose for Warfarin Reversal" and "Kcentra for Factor Xa (rivaroxaban, apixaban, edoxaban)."
![Image: Kcentra 1](/DIS-Newsletters/images/2019/January/img_kcentra_1.jpg)
Contents of panel for "Kcentra Fixed dose for warfarin reversal" once selected. Selection contains "initial order" option as well as "additional order" option if needed.
![Image: Kcentra 2](/DIS-Newsletters/images/2019/January/img_kcentra_2.jpg.png)
Below are the contents for the "initial infusion:"
![Image: Kcentra 3](/DIS-Newsletters/images/2019/January/img_kcentra_3.jpg.png)