Four-factor prothrombin complex concentrate (Beriplex® P/N) is superior to three-factor prothrombin complex concentrate for reversal of coumarin anticoagulation

The study was conducted as a head-to-head comparison of a four-factor prothrombin complex concentrate (4F-PCC) and two different three-factor PCCs (3F-PCC) for effective reversal of vitamin K antagonist (VKA)-induced anticoagulation using an established rat model of acute bleeding [ 1 ]. The 4F-PCC (containing the human coagulation factors II, VII, IX and X) is indicated for the urgent reversal of acquired coagulation factor deficiency induced by VKA therapy in adult patients with acute major bleeding. In contrast, the 3F-PCCs (containing factors II, IX, × and only minimal VII) are indicated for the prevention and control of hemorrhagic episodes in hemophilia B patients. Nevertheless, the use of 3F-PCC for correcting hemostasis following warfarin overdose has been discussed but the lack of factor VII in these 3F-PCC products has raised questions about efficacy.