Generally supratherapeutic warfarin dosing in low risk patients without bleeding does not require active reversal. Warfarin should be withheld until the target INR is restored or ceased.
Vitamin K should be considered for patients with excessively raised INR or in the groups discussed below in addition to replacement or the inactivated factors.
In clinically significant bleeding or in high risk patients, use of Prothrombinex is reasonable. It is also indicated if reversal is required for planned invasive procedures such as surgery.
In life-threatening or critical organ haemorrhage, FFP should be given.