Prothrombin complex concentrate
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Prothrombin Complex Concentrate (PCC) (trade name Beriplex or Octaplex[1]) is a combination of blood clotting factors II, VII, IX and X, as well as protein C and S.[1] It reverses the effect of warfarin (a coumarin anti-coagulant) and is used in cases of significant bleeding in patients with a coagulopathy (INR > 8.0, prolonged prothrombin time, raised d-dimer). Examples include gastrointestinal haemorrhage or intracranial haemorrhage.
Several guidelines, including American College of Chest Physicians, now recommend PCC for warfarin reversal in patients with serious bleed (2-4).
PCC is effective but expensive. In the UK is prescribed in discussion with a senior haematologist.
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- ^ a b FASS.se (Farmaceutiska Specialiteter i Sverige - the Swedish official drug catalog) > Ocplex Last updated: 2009–09–03
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2. Haemostasis and Thrombosis Task Force for the British Committee for Standards in Haematology. Guidelines on oral anticoagulation: 3rd edition. Br J Haematol. 1998;101:374-387.
3. Baker R, Coughlin P, Gallus A, et al. Warfarin Reversal: consensus guidelines on behalf of the Australasian Society of Thrombosis and Haemostasis. Med J Aust. 2004;181:492-497.
4. Italian Federation of Anticoagulation Clinics. A guide to oral anticoagulant therapy. Haemostasis. 1998;28(suppl 2):1-46.
