Kcentra
Kcentra is an anticoagulant reversal agent used to reverse the effects of warfarin (Coumadin) in adults. It works by replacing proteins needed to stop bleeding during a major bleed or to prevent a bleed before an urgent surgery or procedure. The medication is given as an infusion into the veins (intravenous, IV), typically as a single dose. Side effects include headache, low blood pressure, nausea, and vomiting.
What is Kcentra?
What is Kcentra used for?
Treatment of a major bleed in people taking warfarin (Coumadin)
Prevention of bleeding in people taking warfarin (Coumadin) who need an urgent surgery or procedure
How Kcentra works
Normally, your body uses vitamin K to make certain proteins needed to form blood clots. But warfarin (Coumadin) prevents blood clots by stopping vitamin K from working. This means people taking warfarin (Coumadin) usually have fewer of these proteins required to form blood clots, which keeps their blood thin.
Kcentra is an anticoagulant reversal agent. It contains a mix of these proteins, and it helps to stop bleeding in someone taking warfarin (Coumadin).
Drug Facts
What are the side effects of Kcentra?
Common Side Effects
- Low blood pressure (7%)
- Headache (7%)
- Nausea or vomiting (6%)
- Anemia (low red blood cell count) (6%)
- Fast heart rate (5%)
- Irregular heart rhythm (5%)
- Difficulty sleeping (5%)
Other Side Effects
- Diarrhea
- Fluid overload
- Skin irritation
- Trouble breathing
Serious Side Effects
- Heart attack: chest pain, pain in the arms or shoulders, pain in the neck or jaw
- Stroke: difficulty speaking, numbness on one side of the body, confusion
- Other blood clots: in the lungs (cough, difficulty breathing, chest pain); in the leg (redness, pain, tenderness, swelling of the skin)
- Serious allergic reaction: difficulty breathing, tightness in the throat, hives, fast heartbeat, dizziness, lightheadedness, swelling in the face or tongue
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Kcentra
Pros
Works quickly to reverse the effects of blood thinners to stop bleeding
Typically given as a single dose
Less likely to lead to too much fluid in your body compared to similar treatments
Cons
Can cause a serious allergic reaction during or after infusion
Made from human blood, so there is a risk of potential infections
Needs to be given as an infusion into the veins
Pharmacist tips for Kcentra
Your provider will order blood tests (e.g., complete blood count and INR) and examine you for signs and symptoms of bleeding after receiving Kcentra to see how well you respond to the medication.
Don't restart warfarin (Coumadin) unless your provider specifically says to do so. Your provider will carefully consider the risks and benefits of bleeding versus clotting for your specific situation and will let you know when it's safe to resume taking your warfarin (Coumadin).
Kcentra is made from human blood products, so there's a rare chance it can contain certain viruses and make you sick. Contact your provider if you start to feel sick or have symptoms, such as fever, chills, feeling confused and anxious, or having trouble maintaining your balance.
Frequently asked questions about Kcentra
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What are the risks and warnings for Kcentra?
Kcentra can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of serious blood clots
Risk factors: Not moving much or on bed rest | History of blood clots | Medical conditions that raise your risk of blood clots | History or risk of heart problems
Kcentra can raise your risk of getting blood clots in various parts of your body. While anyone can get a blood clot during treatment, there are certain factors that can put you at higher risk. Symptoms of a blood clot might be different depending on the location of the clot. They can include swelling, warmth, or tenderness in the legs. But more seriously, clots can lead to breathing problems, heart attack, or stroke and cause chest pain, difficulty breathing, or weakness of the face, legs, or arms. Call 911 if you have any of these symptoms because this is a medical emergency.
Your provider will monitor you closely for blood clot symptoms while you receive Kcentra. If you're at risk for blood clots, your provider might adjust your dose.
Serious allergic reactions
Serious allergic reactions to Kcentra are possible, including life-threatening reactions like anaphylaxis (e.g., closing of the throat). Your care team will monitor you for dizziness, nausea, a choking sensation, difficulty breathing, swelling around your eyes, or swelling of the lips or tongue after using Kcentra.
Risk of infection
Because Kcentra is made from human blood products, there's a risk that it might contain viruses that can make you sick. But your risk of infection is low, since the donors of these blood products are carefully screened. Also, there are high manufacturing standards put into place to make sure the viruses are killed or removed. To prevent serious infections in the rare case that your dose of Kcentra is affected, let your provider know right away if you start to feel sick or have symptoms, such as feeling confused and anxious, or having trouble maintaining your balance.
Kcentra dosage forms
Typical dosing for Kcentra
Kcentra is given as an infusion into the veins. Your provider will calculate your dose based on your INR level and body weight.
Kcentra contraindications
Allergy to Kcentra, heparin, human albumin, or other clotting factors
History of heparin-induced thrombocytopenia (HIT)
What are alternatives to Kcentra?
Treatment of a major bleed in people taking warfarin (Coumadin)
Prevention of bleeding in people taking warfarin (Coumadin) who need an urgent surgery or procedure
Prevention of bleeding in people taking warfarin (Coumadin) who need an urgent surgery or procedure
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References
Best studies we foundAmerican Society of Hematology. (n.d.). Blood clots.
Barmore, W., et al. (2023). Biochemistry, clotting factors. StatPearls.
Barnes, G. D. (2020). ACC consensus on management of anticoagulant-related bleeding. American College of Cardiology.
Baroletti, S. A., et al. (2006). Heparin-induced thrombocytopenia. Circulation.
CSL Behring GmbH. (2023). Kcentra- prothrombin, coagulation factor vii human, coagulation factor ix human, coagulation factor x human, protein c, protein s human, and water kit [package insert]. DailyMed.
Hospira, Inc. (2021). Vitamin K1- phytonadione injection, emulsion [package insert]. DailyMed.
National Heart, Lung, and Blood Institute. (2022). Disseminated intravascular coagulation (DIC).
National Institutes of Health. (2021). Vitamin K: Fact sheet for consumers.
Quinlan, D. J., et al. (2013). Four-factor prothrombin complex concentrate for urgent reversal of vitamin K antagonists in patients with major bleeding. Circulation.
Sarode, R., et al. (2013). Efficacy and safety of a 4-factor prothrombin complex concentrate in patients on vitamin K antagonists presenting with major bleeding. Circulation.
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