Vitamin K Deficiency Bleeding Medication

Updated: May 20, 2019
  • Author: Dharmendra J Nimavat, MD, FAAP; Chief Editor: Santina A Zanelli, MD  more...
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Medication Summary

Vitamin K is the mainstay for prevention of and treatment of vitamin K deficiency bleeding (VKDB). Other coagulation factors are rarely needed. Severe bleeding may warrant the use of fresh frozen plasma. No other drugs or treatments are acceptable substitutes for prompt vitamin K dosing. Subcutaneous administration of vitamin K is preferred over the intramuscular (IM) route in symptomatic infants.



Class Summary

Vitamin K is required to correct the deficiency that defines vitamin K deficiency bleeding. Prophylaxis with IM vitamin K at birth is an effective means of preventing vitamin K deficiency bleeding in the newborn.

Vitamin K1 (phytonadione)

Fat-soluble vitamin that promotes the hepatic synthesis of the following clotting factors: prothrombin (factor II), proconvertin (factor VII), plasma thromboplastin component (factor IX), and Stuart factor (factor X). May not be effective when liver disease is severe. Coagulation factors should increase in 6-12 h after PO dosing and in 1-2 h after parenteral administration. Monitor effectiveness by measuring prothrombin time.

Increased incidence of VKDB observed in countries that have switched to PO prophylaxis. IM preferred route for newborns and is recommended by the American Academy of Pediatrics.

Available as a 2-mg/mL emulsion in 0.5 mL ampul and 10-mg/mL emulsion in 1 mL ampul; also contains dextrose and benzyl alcohol (9 mg/mL). No approved oral formulation in US for infants.