Administración oral de preparado parenteral de vitamina K en anticoagulación excesiva por warfarina

anticoagulation therapy with warfarin, a common clinical practice, needs to be monitored using protombine time expressed as the international normalized ratio (inr); when safety range is exceeded, vitamin k (vit-k) could be administered with preference orally. in venezuela the specific oral preparation for vit-k is not available. this is a double blinded, randomized, placebo controlled, clinical trial; 20 patients, age 18-60 year with initial inr ≥ 6, ≤10, were randomized to oral vit-k 1.25mg (prepared from intravenous presentation) or placebo plus withholding warfarin. inr < 3.5 at 24 hours of treatment (the primary end point) was achieved by 70% among vit-k, and 20% among placebo patients; given an absolute risk reduction (arr), of 50% (ci95%: 14.4-85.6) ρ = 0.028, nnt 2 (ci95%: 1.3 - 6.9). no adverse events were recorded including inr < 2 at 24 hours of treatment administration. our results are consistent with studies where specific oral presentation of vit-k was used. the results indicate that oral administration of vit-k, prepared from an intravenous vit-k preparation, is safe and more effective to revert excessive anticoagulation than simply withholding warfarin, in places where specific preparation of oral vit-k is not available or too expensive.