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Prothrombin time (PT)

Definition

Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot.

A related blood test is partial thromboplastin time (PTT).

Alternative Names

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

How the Test is Performed

A blood sample is needed. If you are taking ant blood-thinning medicines, you will be watched for signs of bleeding.

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.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.

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 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:

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

References

Fink LM, Marlar RA, Miller JL. Antithrombotic therapy. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 42.

Schmaier AH, Miller JL. Coagulation and fibrinolysis. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 39.


Review Date: 1/27/2015
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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