A prothrombin time (PT) test measures the amount of time it takes for your blood plasma to clot.

Prothrombin, also known as factor II, is just one of many plasma proteins involved in the clotting
process.

Why Is a Prothrombin Time Test Performed?

When you get a cut and your blood vessel ruptures, blood platelets collect at the site of the wound. They
create a temporary plug to stop the bleeding. In order to produce a strong blood clot, a series of 12 plasma
proteins, or coagulation factors act together to make a substance called fibrin, which seals the wound.

A bleeding disorder known as hemophilia could cause your body to create certain coagulation factor
incorrectly, or not at all. Some medications, liver disease, or vitamin K deficiency may cause abnormal
clot formation.

Symptoms of a bleeding disorder include:

easy bruising
bleeding that wont stop, even after applying pressure to the wound
heavy menstrual periods
blood in the urine
swollen or painful joints
nosebleeds

If your doctor suspects you have a bleeding disorder, they may order a PT test to help make a
diagnosis. Even if you have no symptoms of a bleeding disorder, your doctor may order a PT
test to make sure your blood is clotting normally before you undergo major surgery.

If youre taking the blood-thinning medication warfarin, your doctor will order regular PT tests to
ensure youre not taking too much medication. Taking too much warfarin can cause excessive
bleeding.
Liver disease or vitamin K deficiency can cause a bleeding disorder. A PT can check how your
blood clots if you have one of these conditions.
 How Is a Prothrombin Time Test Performed?

Blood-thinning medication can affect the results of the test. Tell your doctor about all medications and
supplements youre taking. Theyll advise you whether to stop taking them before the test. You will not
need to fast before a PT.

Youll need to have your blood drawn for a PT test. This is an outpatient procedure usually performed at a
diagnostic lab. It takes only a few minutes and causes little to no pain.

A nurse or phlebotomist (a person specially trained in drawing blood) will use a small needle to draw
blood from a vein (usually in your arm or hand). A laboratory specialist will add chemicals to the blood to
see how long it takes for a clot to form.

How to Prepare for the Test

Certain medicines can change blood test results.

Your health care provider will tell you if you need to stop taking any medicines before you have
this test. This may include aspirin, heparin, antihistamines, and vitamin C.

DO NOT stop or change your medicines without talking to your doctor first.

Why the Test is Performed

The most common reason to perform this test is to monitor your levels when you are taking a
blood-thinning medicine called warfarin. You are likely taking this medicine to prevent blood
clots.

Your provider will check your PT regularly.

You may also need this test to:

Find the cause of abnormal bleeding or bruising

Check how well your liver is working

Look for signs of a blood clotting or bleeding disorder

Normal Results
 PT is measured in seconds. Most of the time, results are given as what is called INR
(international normalized ratio).

If you are not taking blood thinning medicines, such as warfarin, the normal range for your PT
results is:

11 to 13.5 seconds

INR of 0.8 to 1.1

If you are taking warfarin to prevent blood clots, your doctor will most likely choose to keep
your INR between 2.0 and 3.0.

Ask your doctor what result is right for you.

Normal value ranges may vary slightly among different laboratories. Some labs use different
measurements or test different samples. Talk to your doctor about the meaning of your specific
test results

What Risks Are Associated with a Prothrombin Time Test?

Very few risks are associated with having your blood drawn for a PT test. However, if you have a
bleeding disorder, youre at a slightly higher risk for excessive bleeding and hematoma (blood that
accumulates under the skin).

Theres a very small risk of infection at the puncture site. You may feel slightly faint or feel some
soreness or pain at the site where your blood was drawn. You should alert the person administering the
test if you begin to feel dizzy or faint.

What Do the Test Results Mean?

Blood plasma normally takes between 11 and 13.5 seconds to clot if youre not taking blood-thinning
medication. PT results often are reported as aninternational normalized ratio (INR) thats expressed as a
number. A typical range for a person not taking blood thinner medication is 0.9 to about 1.1. For someone
taking warfarin, the planned INR is usually between 2 and 3.5.
 If your blood clots within the normal amount of time, you probably dont have a bleeding disorder. If
you are taking a blood thinner type of medication, a clot will take longer to form. Your doctor will
determine your goal clotting time.
If your blood doesnt clot in the normal amount of time, you may:

be on the wrong dose of warfarin

have liver disease
have vitamin K deficiency
have a bleeding disorder such as factor II deficiency.
If you have a bleeding disorder, your doctor may recommend factor replacement therapy or a transfusion
of blood platelets or fresh frozen plasma.

What Abnormal Results Mean

If you are not taking blood thinning medicines, such as warfarin, an INR result above 1.1 means
your blood is clotting more slowly than normal. This may be due to:
Bleeding disorders, a group of conditions in which there is a problem with the body's blood clotting
process.
Disorder in which the proteins that control blood clotting become over active (disseminated intravascular
coagulation)
Liver disease

Low level of vitamin K

If you are taking warfarin to prevent clots your doctor will most likely choose to keep your INR
between 2.0 and 3.0:
Depending on why you are taking the blood thinner, the desired level may be different.

Even when your INR stays between 2.0 and 3.0, you are more likely to have bleeding problems.

INR results higher than 3.0 may put you at even higher risk for bleeding.

INR results lower than 2.0 may put you at risk for developing a blood clot.

A PT result that is too high or too low in someone who is taking warfarin (Coumadin) may be
due to:

The wrong dose of medicine

Drinking alcohol
 Taking certain over-the-counter (OTC) medicines, vitamins, supplements, cold medicines, antibiotics, or
other medicines

Eating food that changes the way the blood-thinning medicine works in your body

Your provider will teach you about taking warfarin (Coumadin) the proper way.
Risks
This test is often done on people who may have bleeding problems. Their risk of bleeding is
slightly higher than for people without bleeding problems.

Other slight risks can include:

Fainting or feeling lightheaded

Hematoma (blood accumulating under the skin)

Infection (a slight risk any time the skin is broken)

Multiple punctures to locate veins

Interpretation
Various conditions may prolong or shorten prothrombin time.

Causes of prolonged PT include the following:

Warfarin use
Vitamin K deficiency from malnutrition, biliary obstruction, malabsorption syndromes, or use of antibiotics
Liver disease, due to diminished synthesis of clotting factors
Deficiency or presence of an inhibitor to factors VII, X, II/prothrombin, V, or fibrinogen
Disseminated intravascular coagulopathy (DIC)
Fibrinogen abnormality (eg, hypofibrinogenemia, afibrinogenemia, dysfibrinogenemia)
After bolus administration of heparin (PT may be transiently elevated)
Massive blood transfusion due to dilution of plasma clotting proteins
Hypothermia, as it causes inhibition of a series of enzymatic reactions of the coagulation cascade [1]

Alternative Names
PT; Pro-time; Anticoagulant-prothrombin time; Clotting time: protime; INR; International
normalized ratio