A fifth North Korean nuclear test could trigger new sanctions including an effort to choke off hard currency earnings by its workers abroad, the top U.S. diplomat for the Asia-Pacific region said on Tuesday.

"Like a regimen of medicine, the dosage can be upped when the effects fall short of what's required," Assistant Secretary of State for East Asian and Pacific Affairs Danny Russel said.

Russel made clear he was speaking about the possibility of fresh sanctions by the U.N. Security Council, by the United States on its own or in conjunction with a group of like-minded states from the European Union and Southeast Asia.