Prothrombin complex concentrate transfusion

People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care.

Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Healthcare professionals should follow our general guidelines for people delivering care:

1.12.3

Offer immediate prothrombin complex concentrate transfusions for the emergency reversal of warfarin anticoagulation in people with either:

severe bleeding or
head injury with suspected intracerebral haemorrhage. [2015]

1.12.4

For guidance on reversing anticoagulation treatment in people who have a stroke and a primary intracerebral haemorrhage, see the section on reversal of anticoagulation treatment in people with haemorrhagic stroke in NICE's guideline on stroke and transient ischaemic attack in over 16s. [2015]

1.12.5

Consider immediate prothrombin complex concentrate transfusions to reverse warfarin anticoagulation in people having emergency surgery, depending on the level of anticoagulation and the bleeding risk. [2015]

1.12.6

Monitor the international normalised ratio (INR) to confirm that warfarin anticoagulation has been adequately reversed, and consider further prothrombin complex concentrate.[2015]

For advice on reversing direct-acting oral anticoagulants (DOACs), see the MHRA safety advice on DOACs for a list of reversal agents.