see: [Dunn's clotting factor replacement](x-devonthink-item://1BC22B6F-8634-47D6-8C7E-BE2827AD7DC9), [[FFP]], [[cryoprecipitate]] > [!treatment] ProthrombineX dose for Warfarin reversal in major bleeding > - INR 2-4: 25 u/kg max 2500 units > - INR 4-6: 35 u/kg max 2500 > - INR >6: 50 u/kg max 5000 > 4FCC 50 u/kg cap 5000 *beriplex* also for apixaban - freeze dried, heat treated factors II, IX, and X - only low levels of factor VII - also give 1 unit of [[FFP]] for [[Warfarin, DOAC, heparin reversal]] - PCC and FFP reverses warfarin-induced anticoagulation more quickly (~15 minutes) than either agent alone - draw up and give 1 vial at a time (500 units) when time critical haemorrhage is present **Advantages over FFP** - small volume - administration can start in minutes (although drawing up a full dose can take 10-15 min) - Rapid administration - INR reversal within 15 minutes - does not need to be thawed - no reports of viral transmission since product launch in 1993 - ==blood grouping not required== **contraindications** - active thrombosis - DIC