Hold warfarin.
Vitamin K 5 - 10 mg PO.
Monitor INR closely.
If INR were 5 - 9 (measurable, but high), omit 1 - 2 doses and resume warfarin at lower dose; OR omit 1 dose and give 1 - 2 mg of vitamin K PO before resuming lower dose.
Source
Winshall, J. and Lederman, R. Tarascon Internal Medicine and Critical Care Pocketbook. 4th ed.
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