Clotting-factor repletion (4F-PCC)
Replaces the vitamin-K-dependent factors NOW, not in 6 hours
- Directly replaces vitamin-K-dependent clotting factors II, VII, IX and X
- Also supplies proteins C/S
- Immediate vitamin K antagonist reversal — works in minutes, unlike vitamin K
- Beats FFP: 25× smaller volume, no thawing, faster INR correction
- prothrombin complex concentrate, 4-factor (KCENTRA)
- Effect fades as factors are consumed unless vitamin K restores synthesis
- Give IV vitamin K with it
- ↑ thromboembolism risk
- The label carries a boxed thrombosis warning ⚠
Drugs with this mechanism (1)
- Prothrombin complex concentrate (4-factor) — Concentrated clotting-factor replacement for rapid warfarin reversal; thrombosis is the tradeoff.
Self-check
- What should accompany 4F-PCC for warfarin reversal?
IV vitamin K. - Why can 4F-PCC reversal fade without vitamin K?
Replacement factors are consumed without restored synthesis.
All mechanisms · Open Clotting-factor repletion (4F-PCC) in the interactive console ↗