Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
Phytonadione
Indication
- Main use is for the prophylaxis of hemorrhagic disease of the newborn
Pharmacology
- Vitamin K is required for the synthesis of the 4 known vitamin K - dependent coagulation factors, II (prothrombin), VII (proconvertin), IX (plasma thromboplastin) and X (Stuart factor), as well as protein C (an important inhibitor of coagulation)
Side Effects
- Flushing, weakness, cramping pains, swelling at injection site
- Following large doses, severe hemolytic anemia, with indirect hyperbilirubinemia
Dose
- Birth Weight < 1500 g: 0.5 mg IM once
- Birth Weight > 1500 g: 1.0 mg IM once
- Dosage is given only once, on admission, unless ordered otherwise
- Mothers who take drugs that impair vitamin K metabolism (eg. anticonvulsants, rifampin) should be given vitamin K1 20 mg/d orally, for at least 2 weeks before the expected time of delivery
- Infants at high risk for secondary late hemorrhagic disease due to cystic fibrosis, chronic diarrhea etc should be given vitamin K1 50 to 100 ug/day orally or 1 mg IM once a month
Supplied As
- 1 mg/0.5 mL ampoule
References
- McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
- Fetus and Newborn Committee, Canadian Pediatric Society: The use of Vitamin K in the perinatal period, CMAJ 1988; 139:127-130.