Low-dose oral vitamin K therapy for the management of asymptomatic patients with elevated international normalized ratios: a brief review.
Asymptomatic elevation of the international normalized ratio (INR) is a common problem associated with hemorrhage. Evidence from randomized controlled trials supports the use of low-dose oral vitamin K therapy as a treatment that promptly reduces the INR. Vitamin K given orally is more effective than subcutaneous vitamin K injection, and as effective as intravenous administration when INR values are compared 24 hours after administration. A 1.0-mg vitamin K dose is likely most appropriate for patients with INR values between 4.5 and 10. The fear of over-correction of the INR has limited the widespread use of vitamin K; however, our review suggests that this occurs infrequently when small doses are administered orally.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sarah E
SE
Wilson
Henry G
HG
Watson
Mark A
MA
Crowther
D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D001777:Blood Coagulation / Q000187:drug effects; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D019934:International Normalized Ratio; D013927:Thrombosis / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D014812:Vitamin K / Q000008:administration & dosage*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D014812:Vitamin K; D014859:Warfarin