Clotting-factor repletion (4F-PCC)
Replaces the vitamin-K-dependent factors NOW, not in 6 hours
- Directly replaces vitamin-K-dependent clotting factors II, VII, IX and X
- Immediate vitamin K antagonist reversal — works in minutes, unlike vitamin K
- Effect fades as factors are consumed unless vitamin K restores synthesis
- ↑ thromboembolism risk
- Concentrated factors II, VII, IX, X (+ proteins C/S) — reverses warfarin in minutes
- Beats FFP: 25× smaller volume, no thawing, faster INR correction
- ➔ prothrombin complex concentrate, 4-factor (KCENTRA)
- Give IV vitamin K with it or the INR rebounds as the factors decay
- Thrombosis is the tradeoff — the label carries that warning boxed ⚠
Drugs with this mechanism (1)
- Prothrombin complex concentrate (4-factor) — Concentrated clotting-factor replacement for rapid warfarin reversal; thrombosis is the tradeoff.
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