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Warfarin Overanticoagulation — RACP Adult Medicine MCQ

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EasyHaematologyWarfarin OveranticoagulationRACP Adult Medicine

A 72-year-old man on warfarin for AF is found to have an INR of 8.5 with no evidence of bleeding. What is the most appropriate management?

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Correct answer: D — Cease warfarin and give oral vitamin K 1–2 mg

For INR 5.0–9.0 without bleeding, eTG and Australian guidelines recommend ceasing warfarin and administering oral vitamin K 1–2 mg. INR should be rechecked in 24 hours. If INR >9.0 without bleeding, give oral vitamin K 2.5–5 mg. IV vitamin K and Prothrombinex-VF are reserved for significant or life-threatening bleeding.

Reference: eTG – 2025 – Haematology; AMH – 2025 – Anticoagulants