Warfarin Reversal in the Emergency Department Despite regular monitoring of the INR, VKA-associated bleeding occasionally occurs and is the primary complication in patients receiving warfarin.10

  • Hemorrhagic complications (acute hemorrhages, laboratory abnormalities, and falls or injuries while taking antiplatelets or anticoagulants) in VKA-treated patients account for >60,000 emergency department visits annually in the US.20
  • Warfarin has been implicated in about one-third of all emergency hospitalizations for adverse drug events in older American adults.21

Gastrointestinal (GI) Bleeding

In one study, GI bleeds accounted for more than 8% of hemorrhages in the first 30 days of warfarin use, and more than 60% of hemorrhages overall during 5 years of follow-up.22

Clinical conditions that increase the risk of hemorrhage also increase the risk of fluid overload23, 24:

  • Advanced age
  • Hypertension
  • Heart disease
  • Renal insufficiency

Urgent reversal of anticoagulation is required in patients experiencing an acute major bleeding event.10

A retrospective study by Goldstein et al (2006) demonstrated that time to initiation of VKA reversal was the most important determinant for normalization of INR. Although there was no difference in morbidity or mortality, every 30-minute delay in plasma infusion reduces the probability of successful INR correction within 24 hours by 20%.25

Home Why Use Kcentra Warfarin Reversal in the ED

Important Safety Information

Kcentra®, Prothrombin Complex Concentrate (Human), is a blood coagulation factor replacement product indicated for the urgent reversal of acquired coagulation factor deficiency induced by Vitamin K antagonist (VKA—eg, warfarin) therapy in adult patients with acute major bleeding or the need for urgent surgery or other invasive procedure. Kcentra is for intravenous use only.


Patients being treated with Vitamin K antagonist therapy have underlying disease states that predispose them to thromboembolic events. Potential benefits of reversing VKA should be weighed against the risk of thromboembolic events, especially in patients with history of such events. Resumption of anticoagulation therapy should be carefully considered once the risk of thromboembolic events outweighs the risk of acute bleeding. Both fatal and nonfatal arterial and venous thromboembolic complications have been reported in clinical trials and postmarketing surveillance. Monitor patients receiving Kcentra, and inform them of signs and symptoms of thromboembolic events. Kcentra was not studied in subjects who had a thromboembolic event, myocardial infarction, disseminated intravascular coagulation, cerebral vascular accident, transient ischemic attack, unstable angina pectoris, or severe peripheral vascular disease within the prior 3 months. Kcentra might not be suitable for patients with thromboembolic events in the prior 3 months.

Kcentra is contraindicated in patients with known anaphylactic or severe systemic reactions to Kcentra or any of its components (including heparin, Factors II, VII, IX, X, Proteins C and S, Antithrombin III and human albumin). Kcentra is also contraindicated in patients with disseminated intravascular coagulation. Because Kcentra contains heparin, it is contraindicated in patients with heparin-induced thrombocytopenia (HIT).

Hypersensitivity reactions to Kcentra may occur. If patient experiences severe allergic or anaphylactic type reactions, discontinue administration and institute appropriate treatment.

In clinical trials, the most frequent (≥2.8%) adverse reactions observed in subjects receiving Kcentra were headache, nausea/vomiting, hypotension, and anemia. The most serious adverse reactions were thromboembolic events, including stroke, pulmonary embolism and deep vein thrombosis.

Kcentra is made from human blood and may carry a risk of transmitting infectious agents, e.g., viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

Please see full prescribing information for Kcentra.

CSL Behring
Kcentra is manufactured by CSL Behring GmbH and distributed by CSL Behring LLC.
Kcentra® and Beriplex® are registered trademarks of CSL Behring GmbH.
Biotherapies for Life® is a registered trademark of CSL Behring LLC
All other products mentioned are trademarks or registered trademarks of their respective companies.
© 2017 CSL Behring. The product information presented on this site is intended for US residents only.
KCT15-11-0051 12/2015