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Vitamin K
From WikEM
Disambiguation: See ketamine for street name "vitamin K"
Contents
General
- Lasts up to 2 weeks, possibly making anticoagulation post-bleeding risk difficult
- IV form has small risk of anaphylaxis, but risks/benefits must be weighed in serious bleeding
- Type: Vitamin
- Dosage Forms: 100 mcg; 5mg; SC; IM; IV; PO
- Common Trade Names: Generic and Mephyton, K1-1000, Novaplus Vitamin K1
Adult Dosing
Vitamin K deficiency hypoprothrombinemia
- 2.5-25mg PO qd prn
- Max: 25mg/dose
anticoagulant induced hypoprothrombinemia
- 10mg PO x1
- Max: 25mg/dose
warfarin stabilization
- 100 mcg PO qd-bid
Pediatric Dosing
Neonatal deficiency (hemorrhagic disease of the newborn)
- 1mg SC for avoidance of anaphylaxis (IV), hematoma (IM). FFP for serious cases.
Vitamin K deficiency hypoprothrombinemia
- 2.5-5mg PO qd prn
anticoagulant induced hypoprothrombinemia
- 0.5-5mg PO/SC/IM/IV x 1
Special Populations
- Pregnancy Rating: C
- Lactation risk: Safe
- Renal Dosing
- Adult: not defined
- Pediatric: not defined
- Hepatic Dosing
- Adult: adjust dose amount
- Pediatric: adjust dose amount
Contraindications
- Allergy to class/drug
- hereditary hypoprothrombinemia
- overanticoagulation due to heparins
- caution in neonates
Adverse Reactions
Serious
- anticoagulant resistance
- hypersensitivity reaction, severe or life-threatening (SC, IM, or IV use)
- anaphylaxis (SC, IM, or IV use)
- hyperbilirubinemia (neonates)
- hemolytic anemia (neonates)
Common
- taste changes (SC, IM, or IV use)
- flushing (SC, IM, or IV use)
- injection site hematoma
- injection site pain
Pharmacology
- Half-life: unknown
- Metabolism: liver, CYP450: unknown
- Excretion: urine, bile
- Mechanism of Action: Used by liver for synthesis of some coagulation factors (II,VII,IX,X,C,S). Timing in the synthesis of these factors impacts reversal of elevated INR (~4 hours: F-VII, ~24 hours: F-II).