Key result
Inadvertent warfarin overdose resulting in a critical INR of 9.9 was successfully managed by withholding warfarin and administering 2 mg of oral vitamin K1, reducing the INR to 4.4 the next day.
Case Report (n=1)
Highlights the risks of warfarin re-initiation and the need for careful management of critical INR values to prevent major bleeding.
dous inter-individual variability in warfarin dosing is apparent, necessitating frequent monitoring via the international normalized ratio (INR). The most feared complication of warfarin therapy is major bleeding, and the risk of this problem increases when the INR exceeds 4.0. 2 Critical INR values (defined in the Edmonton region of Alberta Health Services as an INR > 5.0; the definition may vary by jurisdiction) are reported urgently to clinicians to enable prompt patient management. For ambulatory patients who are not bleeding, strategies to manage critical INRs include withholding warfarin therapy, with the option of admin istering oral vitamin K 1, but guidelines vary and have changed
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Bungard et al. (2015) conducted a case report in Warfarin overdose and critical INR (n=1). Oral vitamin K1 was evaluated on Reduction of critical INR. Inadvertent warfarin overdose resulting in a critical INR of 9.9 was successfully managed by withholding warfarin and administering 2 mg of oral vitamin K1, reducing the INR to 4.4 the next day.
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