Prothrombin complex concentrate

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Prothrombin Complex Concentrate (PCC) is a combination of blood clotting factors II, VII, IX and X. It reverses the effect of warfarin (a coumarin anti-coagulant) and is used in cases of significant bleeding in patients with a coagulopathy (INR > 8.0, prolonged prothrombin time, raised d-dimer). For example, gastrointestinal haemorrhage from a gastric or dodenal ulcer.

PCC is extremely effective but expensive and in the UK is prescribed in discussion with a senior haematologist.