For example, Beriplex is recommended at doses between 25 and 50 IU/kg, which would result in plasma levels of 0.35 to 0.7 IU/ml. In addition, recombinant activated factor VIIa (rFVIIa), an approved potent procoagulant and general hemostatic agent that can initiate hemostasis at sites of bleeding by direct activation of thrombin on the surface of platelets in the absence of tissue factor, 7 may have potential in reversing the anticoagulant effects.Įach CFC was tested over a concentration range that included plasma concentrations typically achieved by patients treated with recommended clinical therapeutic doses, based on Factor IX units specified by the manufacturers. 5 These PCCs have variable composition and include four nonactivated vitamin K–dependent factors II, VII, IX, and X in similar ratios, together with anticoagulant proteins such as protein C and S three-factor concentrates with relatively low amounts of factor VII (less than one third compared with factor IX) 4, 6 and an activated four-factor PCC containing factors II, IX, X, and protein C mainly in nonactivated forms and factor VII mainly in the activated form ( table 1). 5 Several nonactivated PCCs are approved for use, each effective in shortening the time to prothrombin time (PT)/international normalized ratio correction with a low risk of thrombotic adverse events. Prothrombin complex concentrates (PCCs) contain all the vitamin K–dependent coagulation factors and are therefore useful for the rapid reversal of coagulopathy and restoration of normal hemostasis in the setting of overanticoagulation induced by vitamin K antagonists.
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