Prothrombinex use for the reversal of warfarin: is fresh frozen plasma needed?

Julie H Crawford and Bradley M Augustson
Med J Aust 2006; 184 (7): . || doi: 10.5694/j.1326-5377.2006.tb00277.x
Published online: 3 April 2006

To the Editor: Current Australian guidelines for urgent warfarin reversal recommend withholding warfarin, and giving vitamin K as well as factor replacement (Prothrombinex HT; PTX) with or without fresh frozen plasma (FFP).1 PTX administration without FFP is recommended only when FFP is unavailable, as PTX factor VII levels are low and unquantified.2 Transfusion of 25–50 IU/kg PTX and 150–300 mL of FFP is advised. We examined the effectiveness of warfarin reversal using PTX alone or combined with FFP.

  • 1 Department of Haematology, PathWest, Perth, WA.
  • 2 Sir Charles Gairdner Hospital, Perth, WA.


  • 1. Baker RI, Gallus AS, Harper PL, et al. Warfarin reversal: consensus guidelines, on behalf of the Australasian Society of Thrombosis and Haemostasis. Med J Aust 2004; 181: 492-497. <MJA full text>
  • 2. MIMS Australia. Prothrombinex-HT. MIMS annual. Sydney: MediMedia Australia, June 2004: 2-252.
  • 3. Levine M, Raskob G, Landerfeld S, Kearon C. Hemorrhagic complications of anticoagulant treatment. Chest 2001; 119: 108S-121S.


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