Elective Reversal (reversal needed within days)

• Stop 5 days before procedure, check INR 1-2 days pre-op

Urgent Reversal (not bleeding, reversal needed within hours)

• Vitamin K 5-10 mg P.O./I.V.
• 4-factor PCC (Kcentra) prior to procedure if INR ≥1.5, repeat every 6-12 hrs PRN

Urgent Reversal (bleeding, reversal needed immediately)

• HASHTI
• Vitamin K 5-10 mg I.V., Q 12 hrs PRN
• 4-factor PCC or 3-factor PCC + FFP, repeat 6 hrs PRN

**Please refer to the Vitamin K Antagonist Reversal section for details of VKA reversal