For Jackson Only: New Protocol Approved for Emergent Warfarin Reversal Fixed Dose Kcentra (Prothrombin Complex Concentrate - PCC) Vitamin K Antagonist (Warfarin) Reversal

Published on Friday, January 11, 2019

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:

EPIC ordering description of both "Kcentra Fixed Dose for Warfarin Reversal" and "Kcentra for Factor Xa (rivaroxaban, apixaban, edoxaban)."

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.

Below are the contents for the "initial infusion:"