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פותח על ידי קלירמאש פתרונות בע"מ -
Comparison of Oral vs Intravenous Phytonadione (Vitamin K1) in Patients With Excessive Anticoagulation: A Prospective Randomized Controlled Study
Year:
2003
Source of publication :
Archives of Internal Medicine
Authors :
עזרא, דוד
;
.
Volume :
163
Co-Authors:
Lubetsky, A., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel
Yonath, H., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel
Olchovsky, D., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel
Loebstein, R., Division of Clinical Pharmacology, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Halkin, H., Division of Clinical Pharmacology, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Ezra, D., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel, Department of Medicine A, Sheba Medical Center, Tel-Hashomer 52621, Israel
Facilitators :
From page:
2469
To page:
2473
(
Total pages:
5
)
Abstract:
Background: Treatment of patients with excessive anticoagulation is routinely done by intravenous phytonadione (vitamin K1). Oral administration of phytonadione has been shown to be an effective alternative to the intravenous route, but these methods have never been compared directly. Our objective was to compare efficacy and safety of intravenous vs oral phytonadione treatment in patients with excessive anticoagulation without bleeding. Methods: The study was a prospective randomized controlled trial of consecutive patients presenting with excessive anticoagulation without major bleeding. Patients with a baseline international normalized ratio (INR) of 6 to 10 (n = 44, 47 episodes) received either intravenous or oral phytonadione (0.5 mg or 2.5 mg, respectively), and patients with an INR greater than 10 (n = 17, 19 episodes) received 1 mg or 5 mg, respectively. Efficacy and safety end points were sequential INR changes and the proportion of patients achieving therapeutic range (INR, 2-4), overcorrection (INR<2.0), or undercorrection (INR>4.0) INR values. Results: Sixty-six episodes of excessive anticoagulation were studied. In patients with baseline INR 6-10 the response to intravenous phytonadione was more rapid than in the oral group, and the proportion of patients reaching therapeutic range INR at 6 hours (11/24 vs 0/23) and at 12 hours (16/24 vs 8/23) was significantly higher. However, mean±SD INR values were similar for both groups at 24 hours (2.9±0.8 vs 2.6.±0.8). Patients in the intravenous group tended to be more often (7/24 vs 2/23) overcorrected (INR<2). In patients with baseline INR values greater than 10 efficacy and safety were comparable for both routes of administration. Conclusion: Oral administration of phytonadione had similar efficacy and safety as intravenously administered phytonadione and may be suitable for treatment of patients with excessive anticoagulation.
Note:
Related Files :
adult
anticoagulation
controlled clinical trial
Drug Safety
Female
Hemorrhage
International Normalized Ratio
Male
עוד תגיות
תוכן קשור
More details
DOI :
10.1001/archinte.163.20.2469
Article number:
Affiliations:
Database:
סקופוס
Publication Type:
מאמר
;
.
Language:
אנגלית
Editors' remarks:
ID:
23274
Last updated date:
02/03/2022 17:27
Creation date:
16/04/2018 23:58
You may also be interested in
Scientific Publication
Comparison of Oral vs Intravenous Phytonadione (Vitamin K1) in Patients With Excessive Anticoagulation: A Prospective Randomized Controlled Study
163
Lubetsky, A., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel
Yonath, H., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel
Olchovsky, D., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel
Loebstein, R., Division of Clinical Pharmacology, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Halkin, H., Division of Clinical Pharmacology, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Ezra, D., Department of Medicine, Anticoagulation Clinic, Sheba Medical Center, Tel-Hashomer, Israel, Department of Medicine A, Sheba Medical Center, Tel-Hashomer 52621, Israel
Comparison of Oral vs Intravenous Phytonadione (Vitamin K1) in Patients With Excessive Anticoagulation: A Prospective Randomized Controlled Study
Background: Treatment of patients with excessive anticoagulation is routinely done by intravenous phytonadione (vitamin K1). Oral administration of phytonadione has been shown to be an effective alternative to the intravenous route, but these methods have never been compared directly. Our objective was to compare efficacy and safety of intravenous vs oral phytonadione treatment in patients with excessive anticoagulation without bleeding. Methods: The study was a prospective randomized controlled trial of consecutive patients presenting with excessive anticoagulation without major bleeding. Patients with a baseline international normalized ratio (INR) of 6 to 10 (n = 44, 47 episodes) received either intravenous or oral phytonadione (0.5 mg or 2.5 mg, respectively), and patients with an INR greater than 10 (n = 17, 19 episodes) received 1 mg or 5 mg, respectively. Efficacy and safety end points were sequential INR changes and the proportion of patients achieving therapeutic range (INR, 2-4), overcorrection (INR<2.0), or undercorrection (INR>4.0) INR values. Results: Sixty-six episodes of excessive anticoagulation were studied. In patients with baseline INR 6-10 the response to intravenous phytonadione was more rapid than in the oral group, and the proportion of patients reaching therapeutic range INR at 6 hours (11/24 vs 0/23) and at 12 hours (16/24 vs 8/23) was significantly higher. However, mean±SD INR values were similar for both groups at 24 hours (2.9±0.8 vs 2.6.±0.8). Patients in the intravenous group tended to be more often (7/24 vs 2/23) overcorrected (INR<2). In patients with baseline INR values greater than 10 efficacy and safety were comparable for both routes of administration. Conclusion: Oral administration of phytonadione had similar efficacy and safety as intravenously administered phytonadione and may be suitable for treatment of patients with excessive anticoagulation.
Scientific Publication
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