For an INR greater than 10 without major bleeding, what is the suggested therapy?

In cases of an INR greater than 10 without major bleeding, the recommended approach is to hold warfarin doses and administer vitamin K orally. This is primarily because an INR above 10 indicates a high risk for bleeding but not acute bleeding. Oral vitamin K is effective in reversing the effects of warfarin, allowing for a gradual return of coagulation factors to a safer level without the immediate interventions required in cases of major bleeding.

Administering 10 mg of vitamin K intravenously is usually reserved for patients who have significant bleeding or need rapid reversal of anticoagulation. Lowering the dose of warfarin immediately is not an effective strategy in this scenario, as it does not address the elevated INR that presents a risk of potential bleeding. Although prothrombin complex concentrate can be used for rapid reversal in cases of emergency bleeding, it is not necessary for patients who are not experiencing bleeding and can be managed with oral vitamin K.