Clinical experience reversing factor Xa inhibitors with four-factor prothrombin complex concentrate in a community hospital

Abstract

Introduction
In 2013, the United States Food and Drug Administration (FDA) approved Kcentra® (CSL Behring GmbH, Kankakee, IL, USA), for the urgent reversal of acquired coagulation factor deficiency induced by vitamin K antagonist therapy (e.g. warfarin) in adult patients with acute major bleeding or need for urgent surgery/invasive procedure. This four-factor prothrombin complex concentrate (4F-PCC) contains coagulation factors II, VII, IX, and X, proteins C and S, antithrombin III and human albumin. The dose is expressed as units of factor IX activity. When used to reverse the anticoagulant effects of warfarin, an individualised dose should be determined based on body weight and degree of anticoagulation determined by the current international normalised ratio (INR). [...]