Division of Hematology & Thromboembolism

Clinical Protocols (and Reversals):
Prothrombin Complex Concentrates

Prothrombin Complex Concentrate

Prothrombin Complex Concentrate (PCC) is available through Canadian Blood Services. Two PCCs are currently available, Octaplex and Beriplex; each contains factor II, VII, IX, X, Protein C, Protein S, and small quantities of heparin.

Content
(unit in 500 U of concentrate)

Octaplex ®

from Octapharma

Beriplex ®

from CSL Behring
Factor II (IU)
260-760
380-800
Factor VII (IU)
180-480
200-500
Factor IX (IU)
400-620
400-620
Factor X (IU)
360-600
500-1020
Protein C (IU)
140-620
420-820
Protein S (IU)
140-640
240-680
Heparin (IU)
80-310
8-40
Other components
Sodium citrate

Human antithrombin Human albumin Sodium citrate

 

Indications

Treatment of severe or life-threatening acute bleeding in acquired coagulation defects caused by treatment with vitamin K antagonists (warfarin), or rapid correction (< 6 hours) of the deficiency of vitamin-K dependent factors required for urgent surgical procedures.
Order must be ap proved by the Thrombosis Service in cases of urgent warfarin reversal, except in cases of intracranial hemorrhage (to expedite product release).

Dosage

Dosing for target INR ~ 1.5
INR = 2-3:     20 IU/kg
INR = 3-6:     30 IU/kg
INR > 6:        40 IU/kg
* Add 10 IU/kg for target INR < 1.2
* Also give vitamin K 5-10 mg IV over 30 minutes.
* Under normal circumstances the dose should not exceed 3000 IU with a maximum infusion speed of 8mL/min

Supplied

Human product supplied as a lyophilized powder with 20 mL diluent for reconstitution.
Each vial is approximately 500 IU
Each vial contains a range of factor activity eg. Factor IX -400-620 IU

Contraindications

Patients with heparin-induced thrombocytopenia (HIT) or suspected HIT (product contains heparin)

Theodore E. Warkentin MD, BSc (Med), FRCP(C), FACP
Regional Director, Transfusion Medicine
Hamilton Regional Laboratory Medicine Program
Hematologist, Service of Clinical Hematology

Sam Schulman MD
Professor of Medicine
Thrombosis Service, McMaster Clinic & HHS - General Hospital

Mark Crowther MD, MSc, FRCP(C)
Professor and Chair, Division of Hematology & Thromboembolism, McMaster University
Chief, Laboratory Medicine St Joseph's Healthcare and Hamilton Health Sciences, Hamilton