Phytonadione
VITAMIN K1
What it isVitamin K1 cofactor restoring gamma-carboxylation of clotting factors; deficiency and warfarin reversal.
Why this oneUnlike factor replacement, it restores sustained clotting-factor production but does not act immediately.
What limits it⚑ IV administration can trigger severe hypersensitivity; urgent bleeding also needs clotting-factor replacement because vitamin K takes hours.
FDA-approved for
- vitamin K deficiency / warfarin reversal
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Anticoagulant-induced prothrombin deficiency | Adult | 2.5-10 mg | up to 25 mg | |
| Hypoprothrombinemia due to other causes | Adult | 2.5-25 mg or more |
Renal Undefined
Hepatic Undefined
Will not counteract heparin; effect is not immediate (INR improvement 1-8 h).
Instructions
- Give with bile salts when endogenous bile supply to the GI tract is deficient
- Avoid the oral route when the disorder prevents proper absorption
- Coagulant effect is not immediate; INR improvement may take 1-8 h (use whole blood/components if bleeding severe)
- Keep dose as low as possible
Cautions
- Severe hypersensitivity/anaphylactoid reactions and deaths reported (mainly with parenteral IV use)
- Overzealous therapy may restore thromboembolic risk
- Hyperbilirubinemia in newborns with excessive doses
Adverse reactions
- Transient flushing sensations, altered taste
- Dizziness, rapid/weak pulse, sweating, brief hypotension, dyspnea, cyanosis (parenteral)
- Severe hypersensitivity/anaphylactoid reactions (parenteral)
Pregnancy No clear association with adverse developmental outcomes; untreated vitamin K deficiency carries maternal/fetal bleeding risk.
Lactation Undefined
⚠ BOXED WARNING
- Severe reactions including fatalities after intravenous use
Classes and tags
Clinical profile
Mechanism of action: Phytonadione ballicule
