For the direct and fast reversal of VKA therapy Cofact is needed. The dosage of Cofact depends on the INR before treatment, the targeted INR and bodyweight. The targeted INR depends on the severity of the clinical situation. This dosing guide determines the dosage of Cofact for two different situations. These situations acts as a guiding principle: in case of a minor (urgent) surgery of serious overdosing of anticoagulant you aim for a target INR of at least 2.1 (situation A), or you aim for a target INR of at least 1.5 in case of a major or life threatening bleeding/surgery (situation B). Depending on the weight of the patient and the actual INR (before treatment) the dosage of Cofact in ml will be given.
Because of the risk of thrombo-embolic complications, close monitoring should be exercised when administering human prothrombin complex to patients with a history of coronary heart disease, to patients with liver disease, to per- or post-operative patients, to neonates or to patients at risk of thrombo-embolic events or disseminated intravascular coagulation. In each of these situations, the potential benefit of treatment should be weighed against the risks of these complications.