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Vitamin K lowered the international normalised ratio into the therapeutic range in patients receiving warfarin

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 QUESTION: In patients who are receiving warfarin and have an international normalised ratio (INR) value between 4.5 and 10.0, does low dose vitamin K lower the INR better than placebo?

Design

Randomised (allocation concealed*), blinded {patients, clinicians, and outcome assessors},* placebo controlled trial with 3 months of follow up.

Setting

5 thromboembolism services at teaching hospitals in London and Hamilton, Ontario, Canada.

Patients

92 patients (mean age 65 y, 53% women) who were receiving warfarin and had an INR value between 4.5 and 10.0. Exclusion criteria were INR determined >12 hours before screening, life expectancy <10 days, need for immediate normalisation of INR, severe liver disease, major bleeding in the previous month, allergy to vitamin K, bleeding diathesis or thrombolytic treatment within 48 hours …

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