Phytonadione

VITAMIN K1

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Pronunciation: fye-toe-na-DYE-oen

Phytonadione ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Phytonadione ballicule

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.

Phytonadione molecular structure (skeletal formula) — Molecular structure: Phytonadione

FDA-approved for

vitamin K deficiency / warfarin reversal

FDA label

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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

Available strengths

inj 10 mg/mL
tab 5 mg

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

Cost

Phytonadione (VITAMIN K1)

Strength		#/mo	generic $/unit	CostPlus
10 mg/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Phytonadione is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

⚠ BOXED WARNING

Severe reactions including fatalities after intravenous use

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Defining liabilityParenteral anaphylaxis and neonatal preservative toxicity

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