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Beriplex 💊
- 💉 Beriplex is a 4-factor prothrombin complex concentrate (PCC) used for rapid reversal of Warfarin and, in some cases, DOACs in major/life-threatening bleeding. Always check the BNF link here.
- ⚠️ Access usually requires haematology approval due to cost, monitoring, and risks.
💊 Dosing – Beriplex (max dose 5,000 units)
| INR | Dose |
|---|---|
| 2.0 – 3.9 | 25 units/kg (≈ 1 mL/kg) |
| 4.0 – 6.0 | 35 units/kg (≈ 1.4 mL/kg) |
| ≥ 6.0 | 50 units/kg (≈ 2 mL/kg) |
📝 Notes
- 💊 For DOAC reversal (apixaban, rivaroxaban, dabigatran): 50 units/kg is often used (off-label; specialist advice required).
- 🧾 Record the batch number in the patient’s notes (mandatory for traceability, due to small viral transmission risk).
- 💉 Administer by slow IV injection, max rate = 200 units/min.
- 🚫 Avoid blood reflux into the syringe – clots may form.
- 🔄 Must not be mixed with other drugs/blood products; use a separate IV line flushed with water for injection.
⚠️ Contraindications
- Known allergy to Beriplex components (incl. heparin, proteins C & S).
- History of Heparin-induced thrombocytopenia (HIT).
- Active disseminated intravascular coagulation (DIC).
- Pregnancy and breastfeeding – use only if benefit outweighs risk (discuss with haematology).
- Severe uncontrolled hypertension or recent arterial/venous thrombosis → risk of re-thrombosis.
💥 Side Effects
- 🩸 Thrombosis (DVT, PE, MI, stroke) – due to replacement of procoagulant factors.
- 🤧 Allergic / anaphylactic reactions (rash, urticaria, bronchospasm, angio-oedema).
- 💉 Heparin-related reactions → thrombocytopenia or HIT-like fall in platelets.
- 🌡️ Pyrexia, chills.
- 🦠 Rare: risk of viral/parvovirus B19 transmission (plasma-derived product, though screened).
- 🫀 Circulatory overload if given rapidly in large volume.
- 🧬 Antibody formation to clotting factors (rare, can reduce efficacy).
📊 Monitoring
- 🔬 Check INR before and 6 h after administration (may need repeat dosing).
- 🩸 Monitor for thrombotic events and platelet count (HIT risk).
- 👀 Observe closely during infusion for allergic or hypotensive reactions.
📑 References
- BNF: Prothrombin Complex Concentrate
- Resuscitation Council UK – Anticoagulant Reversal Guidance
- Specialist Haematology Protocols (local trust guidance)
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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