My INR is 4 from the last report, my family doctor called & I was told to skip my Warfarin tonight, and he will change my pill in 1mg, right now, 3 mg

What can I do to minimize my risk of bleeding?
On average, your risk of serious bleeding can be kept below 2 % per year, if several requirements are met. Your INR blood test should be monitored frequently by a reliable laboratory and dosage adjustments should be made by a clinician who is an experienced expert in this form of therapy. You should take your medication exactly as instructed, and notify your clinician if any of several potential changes occur. Specifically, you should notify your clinician of any changes that may alter your response to warfarin. These changes include changes in your diet, vitamins, food supplements, herbal preparations, other medications (either prescription or those bought "over the counter"), change in your level of exercise, getting sick, smoking, consuming alcohol, or any travel plans (since travel may inadvertently result in a change in diet or physical activity).

In addition to keeping your clinician informed of changes that may alter your response to warfarin, you can also reduce your risk of serious bleeding by monitoring yourself for signs and symptoms of bleeding. The most common "early warning" signs are unusual bruising (bruises that develop without a cause or bruises that tend to grow or expand), nose bleeds, and bleeding gums. Signs (things you may see) that may indicate more serious bleeding include pink or brown urine, red or black stools (bowel movements), coughing up blood, or vomiting blood or "coffee ground" colored material. New symptoms (changes in how you feel) that may suggest serious bleeding is occurring include a severe headache, dizziness, fatigue or weakness. If the "early warning" signs occur, you should contact your clinician immediately. If the indicators of more serious bleeding occur, you should secure medical attention immediately (including going to an emergency department if necessary).