For those of us who take the blood thinner warfarin (brand name Coumadin) or similar drugs to prevent prevent clots, one of the scariest of life’s scenarios is an accident or fall. It’s especially scary for patients like me who, because of an acute tendency to clot, must keep their blood extra thin to prevent stroke or heart attack.
In the twelve years I’ve been taking warfarin, I’ve had many bleeding incidents, three of them serious. One, which my doctor feared was approaching the dire “compartment syndrome,” kept me in bed for five weeks.
Now, there’s a new weapon in our battle to keep healthy.
Yesterday, the U.S. Food and Drug Administration approved Kcentra (Prothrombin Complex Concentrate, Human) for the “urgent reversal” of vitamin K antagonists like warfarin in adults with “acute major bleeding.” Plasma is the only other product approved for this use in the United States, the agency said.
Like plasma, Kcentra is used in conjunction with vitamin K to reverse the anticoagulation effect and stop bleeding. The advantage of the new drug is that, unlike plasma, Kcentra does not require blood group typing or thawing, so it can be administered more quickly than frozen plasma. In addition, Kcentra is administered in a significantly lower volume than plasma at recommended doses. This will benefit patients who may not tolerate the volume of plasma required to reverse the anti-coagulation.
So, for someone with a life-threatening bleed, Kcentra may offer a advantage. I’ll be anxious to talk to my doctor to hear his thoughts.
The down side of Kcentra is the possibility of blood clots, even when used properly. That’s a special concern of mine, since the disease that caused my stroke—Antiphosoholipid Syndrome (APS)—is especially prone to clotting under traumatic conditions. Sudden reversal of anti-coagulation could put me at very high risk of another stroke. So my personal strategy, worked out with my doctor, won’t change: watch my blood thinning like a hawk; get my INR (a measure of blood thinning) tested frequently; try to avoid falls or accidents; and in case of bleeding that’s not life-threatening, reduce or stop the warfarin (in close consultation with my doctor) and let my INR drift down gradually.
But for those of us taking Coumadin, life-threatening bleeding is a real possibility. So even though I’ll try hard never to need it, I’m glad for the treatment alternative Kcentra presents.
You can read more about Kcentra here.
have asked myself that question, many times, most recently when I set out for a month of temple climbing in India with my knee swollen and braced a week after suffering a “spontaneous” bleed. Just one of the aggravating hazards of a life on blood thinners. I answered my own question–Why go?– in an essay titled “Why I Still Travel to the Wild,” and wrote about it again yesterday in my travel blog 
September offers an unusual opportunity to hear the latest on developments in diagnosis and treatment of Antiphospholipid Syndrome (APS) at a free one-hour
The world’s gone app-happy. It seems there’s an iPhone/iPad/iPod touch app for just about everything these days, even, I’ve just learned, an app to help patients who take blood thinners keep track of their intake of Vitamin K.
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