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Phytomenadione oral

Updated 2 Feb 2023 | Vitamin K

Presentation

Oral formulations containing phytomenadione

Drugs List

  • NEOKAY capsules
  • phytomenadione 1mg capsules
  • Therapeutic Indications

    Uses

    Haemorrhagic disease of the newborn - prophylaxis

    Unlicensed Uses

    Neonatal biliary atresia and liver disease

    Dosage

    The capsule should be administered by cutting the narrow tubular tip off the capsule and squeezing the liquid into the baby's mouth.

    Adults

    Not applicable.

    Elderly

    Not applicable.

    Neonates

    Prevention of vitamin K deficiency haemorrhage in healthy neonates, including healthy preterm babies
    One single capsule should be administered at birth. Another dose should be given if the first dose is spat out or the baby is sick within three hours of the dose being given.

    Unwell babies; Babies of mothers taking carbamazepine, phenobarbital, phenytoin, rifampicin or warfarin at the time of delivery
    Babies should be treated with an intramuscular formulation of vitamin K at birth.

    Exclusively breast fed babies
    1mg given at birth, followed by a dose of 1mg once weekly for twelve weeks offers the best protection against late vitamin K deficiency bleeding.

    Neonatal biliary atresia (unlicensed); Liver disease (unlicensed)
    1mg daily.

    Contraindications

    None known

    Precautions and Warnings

    Take expert advice pre giving to babies Protein C/S deficient on warfarin

    Pregnancy and Lactation

    Pregnancy

    There is no relevant data available for these patients.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

    Lactation

    There is no relevant data available for these patients.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

    Side Effects

    None Known

    Overdosage

    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

    Further Information

    Last Full Review Date: April 2015

    Reference Sources

    Summary of Product Characteristics: Neokay 1mg capsules. Neoceuticals Ltd. Revised June 2013.

    NICE Evidence Services Available at: www.nice.org.uk Last accessed: 07 September 2017

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