Phytomenadione (Vitamin K1)

Indications

Phytomenadione (Vitamin K1) is used for: Vitamin K deficiency, Over-anticoagulation, Vitamin K deficiency bleeding

Adult Dose

Oral Vitamin K deficiency due to drugs or malabsorption Adult: 10-40 mg daily. Over-anticoagulation Adult: Up to 5 mg may be used. Dose depends on INR and degree of haemorrhage. Intravenous Over-anticoagulation Adult: 0.5-5 mg via slow IV inj. Dose depends on INR and degree of haemorrhage.

Child Dose

Intramuscular Prophylaxis of vitamin K deficiency bleeding in neonates Child: Neonate: 0.5-1 mg, given as a single dose via IM inj. Alternatively, 2 mg may be given orally, followed by a 2nd dose of 2 mg after 4-7 days. Parenteral Vitamin K deficiency bleeding in neonates Child: Infant: 1 mg by IV/IM/SC inj, further doses may be given if necessary

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity.

Precautions

Increased risk of severe haemolytic anaemia in neonates after large doses; severe hepatic impairment; pregnancy. Premature neonates weighing <2.5 kg. Lactation: Excreted in breast milk; use caution

Pregnancy-Lactation

Pregnancy The drug formulation contains benzyl alcohol, which has been associated with gasping syndrome in neonates; the preservative benzyl alcohol can cause serious adverse events and death when administered intravenously to neonates and infants; if therapy is needed during pregnancy, consider using a benzyl alcohol-free formulation; published studies with the use of phytonadione during pregnancy have not reported a clear association with phytonadione and adverse developmental outcomes; there are maternal and fetal risks associated with vitamin K deficiency during pregnancy; animal reproduction studies have not been conducted with phytonadione Pregnant women with vitamin K deficiency hypoprothrombinemia may be at an increased risk for bleeding diatheses during pregnancy and hemorrhagic events at delivery; subclinical maternal vitamin K deficiency during pregnancy has been implicated in rare cases of fetal intracranial hemorrhage Lactation The drug formulation contains benzyl alcohol; if available, a Preservative-Free formulation is recommended when therapy is needed during lactation; phytonadione is present in breastmilk; there are no data on effects of therapy on the breastfed child or on milk production; the developmental and health benefits of breastfeeding should be considered along with the clinical need for therapy and any potential adverse effects on breastfed child from the drug or from the underlying maternal condition

Interactions

Decreased effect of oral anticoagulants.

Adverse Effects

Side effects of Phytomenadione (Vitamin K1) : Anaphylaxis, dyspnoea, cyanosis, pain, swelling, phloebitis at the Inj site, diaphoresis, dizziness, hypotension (rare), allergic reactions after SC and IM inj.

Mechanism of Action

Phytomenadione promotes hepatic synthesis of clotting factors. It is a naturally occurring compound that is used to prevent and treat haemorrhages related to vitamin K deficiency.