Fact or Fallacy: Vitamin K Administration in Patients with Elevated INR and Liver Disease
by Johanna Van Epps, PharmD, Jeffrey Fish, PharmD, FCCM, BCCCP
QUESTION: Should vitamin K be given to non-bleeding patients with an elevated international normalized ratio (INR) secondary to liver disease?
Patients with chronic liver disease are at increased risk of both bleeding and thrombosis. The liver is responsible for synthesizing both procoagulant and anticoagulant factors that act together to maintain hemostatic balance. Patients with cirrhosis have a deficiency in vitamin K-dependent clotting factors (II, VII, IX, and X). Meanwhile, these patients also have lower levels of endogenous anticoagulants (protein C and protein S) and increased levels of von Willebrand factor and factor VIII, which increases risk of thrombosis.
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2024 September/October Table of Contents
QUESTION: Should vitamin K be given to non-bleeding patients with an elevated international normalized ratio (INR) secondary to liver disease?
Patients with chronic liver disease are at increased risk of both bleeding and thrombosis. The liver is responsible for synthesizing both procoagulant and anticoagulant factors that act together to maintain hemostatic balance. Patients with cirrhosis have a deficiency in vitamin K-dependent clotting factors (II, VII, IX, and X). Meanwhile, these patients also have lower levels of endogenous anticoagulants (protein C and protein S) and increased levels of von Willebrand factor and factor VIII, which increases risk of thrombosis.
Download PDF
2024 September/October Table of Contents