REVIEW

Warfarin reversal

J P Hanley

Correspondence to:
Correspondence to:
Dr J P Hanley
Department of Haematology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK; john.hanley{at}nuth.northy.nhs.uk

Warfarin is the most commonly used oral anticoagulant in the UK. It is associated with few side effects apart from haemorrhage. The most appropriate way to reverse the anticoagulant effect of warfarin depends on the clinical circumstances. In serious bleeding, rapid reversal is required, whereas in minor bleeding or asymptomatic over anticoagulation, a more leisurely approach is usually appropriate. This review discusses the current approaches to warfarin reversal in clinical practice. The development of a uniform approach to warfarin reversal in the Northern Region is described.

Abbreviations: FFP, fresh frozen plasma; ICH, intracranial haemorrhage; INR, international normalised ratio; IV, intravenous; NRHG, Northern Region Haematologists’ Group; PCC, prothrombin complex concentrate; rFVIIa, recombinant activated factor VII

Keywords: haemorrhage; prothrombin complex concentrate; vitamin K; warfarin

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Crowther, M. A., Warkentin, T. E. (2008). Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agents. Blood 111: 4871-4879 [Abstract] [Full Text]  
• Rosovsky, R. P., Crowther, M. A. (2008). What Is the Evidence for the Off-label Use of Recombinant Factor VIIa (rFVIIa) in the Acute Reversal of Warfarin?. ASH Education Book 2008: 36-38 [Abstract] [Full Text]  
• Dentali, F., Crowther, M. A. (2008). Management of Excessive Anticoagulant Effect Due to Vitamin K Antagonists. ASH Education Book 2008: 266-270 [Abstract] [Full Text]  
• Flaherty, M. L., Kissela, B., Woo, D., Kleindorfer, D., Alwell, K., Sekar, P., Moomaw, C. J., Haverbusch, M., Broderick, J. P. (2007). The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology 68: 116-121 [Abstract] [Full Text]  
• Lee, S. B., Manno, E. M., Layton, K. F., Wijdicks, E. F.M. (2006). Progression of warfarin-associated intracerebral hemorrhage after INR normalization with FFP.. Neurology 67: 1272-1274 [Abstract] [Full Text]  
• Huttner, H. B., Schellinger, P. D., Hartmann, M., Kohrmann, M., Juettler, E., Wikner, J., Mueller, S., Meyding-Lamade, U., Strobl, R., Mansmann, U., Schwab, S., Steiner, T. (2006). Hematoma Growth and Outcome in Treated Neurocritical Care Patients With Intracerebral Hemorrhage Related to Oral Anticoagulant Therapy: Comparison of Acute Treatment Strategies Using Vitamin K, Fresh Frozen Plasma, and Prothrombin Complex Concentrates. Stroke 37: 1465-1470 [Abstract] [Full Text]  
• Hemphill, J. C. III (2006). Treating Warfarin-Related Intracerebral Hemorrhage: Is Fresh Frozen Plasma Enough?. Stroke 37: 6-7 [Full Text]  
• Steiner, T., Rosand, J., Diringer, M. (2006). Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy: Current Practices and Unresolved Questions. Stroke 37: 256-262 [Abstract] [Full Text]