Prothrombin Complex Concentrates (PCCs)

Prothrombin complex concentrates (PCCs) are (vitamin K–dependent) coagulation factor concentrates containining factors II, VII, IX, and X made from virally inactivated pooled plasma donations from thousands of blood donors. Storage and infusion rates vary with manufacturer recommendations. Formulations include 4-factor PCCs and 3-factor PCCs (these contain factors II, IX, and X but only small amounts of factor VII). Only 4-factor PCCs are available in Canada.

IndicationsTop

Available as lyophilized powders that must be reconstituted, PCCs are most commonly administered for the rapid reversal of warfarin-associated bleeding. PCCs are also used for the reversal of life-threatening bleeding due to anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban. The maximum dose should not be >3000 IU. PCCs carry a prothrombotic risk and should only be administered in situations where the benefit of the therapy outweighs this risk.