Low-dose oral vitamin K therapy for the management of asymptomatic patients with elevated international normalized ratios: a brief review

Wilson, Sarah E.; Watson, Henry G.; Crowther, Mark A.
March 2004
CMAJ: Canadian Medical Association Journal;3/2/2004, Vol. 170 Issue 5, p821
Academic Journal
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.


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