Having trouble logging in? Sign up for a free account Get unlimited access on Medscape. Hansen KN1, Minousis M, Ebbesen F.Author information1Department of Paediatrics, Viborg-Kjellerup Hospital, Denmark. vsb24knh@vibamt.dkAbstractAIM: To evaluate oral vitamin K prophylaxis at birth by giving 2 mg phytomenadione, followed by weekly oral vitamin K prophylaxis; 1 mg was administered by the parents until 3 mo of age.METHODS: A total of 507850 live babies were born in Denmark during the study period, November 1992 to June 2000. Of these infants, 78% and 22% received oral and intra-muscular prophylaxis, respectively; i.e. about 396000 neonates received oral prophylaxis at birth. Weekly oral prophylaxis was recommended for all infants as long as they were mainly breastfed. A survey of possible cases of vitamin K deficiency bleeding (VKDB) was carried out by repeated questionnaires to all Danish paediatric departments and by checking the National Patient Register.RESULTS: No cases of VKDB were revealed, i.e. the incidence was 0-0.9:100000 (95% CI).
The questionnaires were used to evaluate compliance with the regimen. Parents of 274 infants participated. A dose of vitamin K was regarded as having been given if the infant received a drop of vitamin K or was mostly formula-fed that week, and the prophylaxis was regarded as completed if the infant had received at least 9 doses. Compliance was good, with 94% of the infants completing the course of prophylaxis.CONCLUSION: Weekly oral vitamin K supplementation during the first 3 mo of life was an efficient prophylaxis against VKBD. Parental compliance with the regimen was good.PMID: 12892158 [Indexed for MEDLINE] MeSH termsAntifibrinolytic Agents/therapeutic use*Breast FeedingChild Health Services/organization & administrationDenmark/epidemiologyDrug Administration ScheduleDrug Therapy, CombinationFood, FortifiedHealth PromotionHumansIncidenceInfant WelfareInfant, NewbornPatient Compliance/statistics & numerical dataPreventive Health Services/organization & administrationSurveys and QuestionnairesVitamin K/administration & dosageVitamin K/therapeutic use*Vitamin K 1/administration & dosageVitamin K 1/therapeutic use*Vitamin K Deficiency/epidemiologyVitamin K Deficiency/prevention & control*Vitamin K Deficiency Bleeding/epidemiologyVitamin K Deficiency Bleeding/etiology*Vitamin K Deficiency Bleeding/prevention & control*SubstancesAntifibrinolytic AgentsVitamin KVitamin K 1Full Text SourcesWileyOvid
Technologies, Inc.MedicalVitamin K - MedlinePlus Health InformationMiscellaneousPHYTONADIONE - Hazardous Substances Data BankProper UseDrug information provided by: Micromedex Take this medicine only as directed by your doctor. Do not take more or less of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may cause serious unwanted effects, such as blood clotting problems. The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (tablets): For problems with blood clotting or increased bleeding, or for dietary supplementation: Adults and children—The usual dose is 5 to 10 milligrams (mg) a day. For injection dosage form: Adults and teenagers—The usual dose is 5 to 15 mg, injected into a muscle or under the skin, one or two times a day. Children—The usual dose is 5 to 10 mg, injected into a muscle or under the skin, one or two times a day. For problems with blood clotting or increased bleeding: Adults and teenagers—The usual dose is 2.5 to 25 milligrams (mg), rarely up to 50 mg. The dose may be repeated, if needed. Children—Use is not recommended. Adults and teenagers—The usual dose is 2.5 to 25 mg, rarely up to 50 mg, injected under the skin. For prevention of bleeding in newborns: The usual dose is 0.5 to 1 mg, injected into a muscle or under the skin, right after delivery. The dose may be repeated after six to eight hours, if needed.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Tell your doctor about any doses you miss. Keep out of the reach of children. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not keep outdated medicine or medicine no longer needed. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. The Mayo Clinic Diet OnlineThe Mayo Clinic CookbookMayo Clinic on Alzheimer's DiseaseControlling High Blood PressureMayo Clinic on Digestive Health Other Topics in Patient Care & Health Info Diseases and Conditions A-Z Tests and Procedures A-Z Drugs and Supplements A-Z Patient and Visitor Guide
Dosing & UsesDosage Forms & Strengths Recommended daily intake (RDA) Males: 120 mcg/day PO Females: 90 mcg/day PO Hypoprothrombinemia Due To Drugs or Factors Limiting Absorption or Synthesismay be increased PRN to 25 mg or, rarely, to 50 mg; may be repeated in 12-48 hours Reversal of Warfarin Effects Omit 1-2 doses, or hold warfarin; monitor INR and adjust warfarin dose accordingly INR 4.5-10, no bleeding: 2012 ACCP guidelines suggest against routine use; 2008 ACCP guidelines suggest considering vitamin K1 (phytonadione) 1-2.5 mg PO once INR >10, no bleeding: 2012 ACCP guidelines recommend vitamin K1 PO (dose not specified); 2008 ACCP guidelines suggest 2.5-5 mg PO once; INR reduction observed within 24-48 hr, monitor INR and give additional vitamin K if needed Minor bleeding, any elevated INR: Consider 2.5-5 mg PO once; may repeat if needed after 24 hr Major bleeding, any elevated INR: 2012 ACCP guidelines recommend prothrombin complex concentrate, human (PCC, Kcentra) plus vitamin K1 5-10 mg IV (dilute in 50 mL IV fluid and infuse over 20 min)
NOTE: High vitamin K doses (ie, 10 mg or more) may cause warfarin resistance for a week or more; consider using heparin, LMWH, or direct thrombin inhibitors to provide adequate thrombosis prophylaxis in clinical conditions requiring chronic anticoagulation therapy (eg, atrial fibrillation) PO dose may be repeated in 12-48 hr and SC/IV/IM dose in 6-8 hr if necessary IV rate not to exceed 1 mg/min Use of high vitamin K doses (10-15 mg) may cause warfarin resistance for ≥1 week Dosage Forms & Strengths 0-6 months: 2 mcg/day 6-12 months: 2.5 mcg/day 1-3 years: 30 mcg/day 4-8 years: 55 mcg/day 9-13 years: 60 mcg/day 14-18 years: 75 mcg/day Hemorrhagic Disease of the Newborn Prophylaxis: 0.5-1 mg IM within 1 hr of birth Treatment: 1 mg/dose/day SC; my require higher doses if mother has been receiving oral anticoagulants InteractionsInteraction CheckerEnter a drug nameNo Results ContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorSeverityName
Anaphylaxis with too-rapid IV administration (has resulted in death) Hyperbilirubinemia (in premature neonates) Severe reactions, including fatalities, have occurred during and immediately after IV administration, even when precautions have been taken with proper dilution and avoidance of rapid infusion Severe reactions also reported after IM administration; typically, these severe reactions involve hypersensitivity or anaphylaxis and include shock and cardiac or respiratory arrest IV/IM reactions may occur with first dose (no prior exposure to phytonadione) Restrict use of IV/IM routes to situations where SC administration is not feasible and serious risk involved is considered justified Rapid IV administration may cause potentially fatal anaphylaxisagent is rapidly degraded Avoid IM route if patients is bleeding or in 3rd trimester of pregnancy Administer phtonadione to quickly lower INR into safe range in patients receiving vitamin K antagonists
Other forms of vitamin K (eg, menadione) are not effective in these settings; only vitamin K1 (ie, phytonadione) should be used Time of onset depends on rate of synthesis of clotting factors Inefective in hereditary hypoprothrombinemia Longer treatment durations (up to months) and much higher doses required in patients exposed to long-acting anticoagulant rodenticide Hemolysis, hyperbilirubinemia, and jaundice reported in newborns treated with larger than recommended doses; Lactation: Excreted in breast milk; Controlled studies in pregnant women show no evidence of fetal risk.Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Promotes hepatic synthesis of clotting factors II, VII, IX, X (exact mechanism is unknown) Onset: 6-10 hr (PO); Peak effect: 24-48 hr (PO); Dilute in preservative-free NS, D5W, or D5NS and infuse slowly; infusion rate not to exceed 1 mg/min IV route should be used only if administration by another route is not feasible Protect injection emulsion from light at all times FormularyAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.pare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only.
Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. This drug is available at the lowest co-pay. commonly, these are generic drugs. This drug is available at a middle level co-pay. commonly, these are "preferred" (on formulary) brand drugs. This drug is available at a higher level co-pay. commonly, these are "non-preferred" brand drugs. commonly, these are "non-preferred" brand drugs or specialty NOT COVERED – Drugs that are not covered by the plan. Prior Authorization Drugs thatThis restriction requires that specific clinical criteria be met prior to the approval of the Quantity Limits Drugs that have quantity limits associated with each prescription. restriction typically limits the quantity of the drug that will Step Therapy Drugs that have step therapy associated with each prescription. typically requires that certain criteria be met prior to