phytomenadione

CLINICAL USE

Vitamin K deficiency Antidote to oral anticoagulants

DOSE IN NORMAL RENAL FUNCTION

Oral:

10 to 20 : mg dailyIV: 5–40 mg daily

PHARMACOKINETICS

Molecular weight :450.7

%Protein binding :90

%Excreted unchanged in urine :

<10 :

Volume of distribution (L/kg) :0.05–0.13

half-life – normal/ESRD (hrs) :1.5–3/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Dialysed. Dose as in normal renal function

CAV/VVHD :Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntagonises effect of coumarins and phenindione

ADMINISTRATION

Reconstition

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Route

IV, IM, oral

Rate of Administration

Konakion ® – very slow injection (1 mg/min)Konakion MM ® – dilute each 10 mg with 55 mL of glucose 5% and give by slow infusion over 15–30 minutes

Comments

Risk of anaphylaxis if IV injected too rapidlyProtect infusion from light Konakion ® should not be diluted (non-micellar)Only Konakion can be given IM

OTHER INFORMATION

recommended for severe haemorrhage

Anticoagulation antidote: re-test prothrombin time 8–12 hours after Konakion, 3 hours after Konakion MM – repeat dose if inadequatePatients with obstructive jaundice requiring oral vitamin K should be prescribed the water-soluble preparation menadiol sodium diphosphate – dosage range is similar

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