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Vitamin Kis usually needed for a patient with anINR over 9 or has serious bleeding. It's usually NOT needed for INRs under 5.

However it is controversial when INR isbetween5 and 9 and when there is no bleeding. becaise vitamin K can bring the INR down faster than just holding warfarin, but it doesn't seem to decrease bleeding risk.

For most of these patients, the suggestion isholding warfarin for a dose or two and then adjusting it to get the INR in the appropriate range.But for patients with an INR between 5 and 9 on top ofa high risk of bleeding, the suggestion is giving 1 to 2.5 mg vitamin K.

About1 mg is often enough to lower the INR into the therapeutic range in these patients. But this dose is hard to give because the Rx vitamin K tablets only come in 5 mg.

Therefore,therecommendation isgiving one-half or one-quarter of a 5 mg tab, because vitamin K tablets are easy to cut with a pill cutter.

Another option is givinginjectable vitamin K orally, by dispensing it in an oral syringe and have patients mix it with juice to improve taste.

It is discouraged togive vitamin K subcutaneously, because the absorption of vitamin K is less predictable.In addition, only give it IV (intravenously) for patients with very high INRs or serious bleeding due to possible anaphylaxis (allergic reaction).

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15y ago
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14y ago

Vitamin K

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12y ago

coumindin

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