Vitamin K (Phytonadione)
Warfarin reversal, Vitamin K deficiency coagulopathy, Rodenticide (superwarfarin) poisoning
Indications
- Warfarin reversal
- Vitamin K deficiency coagulopathy
- Rodenticide (superwarfarin) poisoning
Adult dosing
- major bleed: dose: 10; unit: mg; route: IV slow push; fixed: true; elevated inr: dose: 2.5; maxDose: 5; unit: mg; route: PO; fixed: true; rodenticide: dose: 25; unit: mg; route: PO; interval: q6h; fixed: true
Pediatric dosing
- reversal: dose: 0.3; unit: mg/kg; maxDose: 10; maxDoseAbsolute: true; route: IV; weightBased: true
Clinical pearls
- IV route can cause anaphylactoid reaction — give slowly over 20-30 min
- Always give with PCC for life-threatening warfarin bleeding
- PO is preferred route when not urgently needed — more predictable
- Superwarfarin (brodifacoum) poisoning requires weeks-months of oral vitamin K
Source and review
- AHA/ASA Guidelines; Chest 2012 ACCP Guidelines. Last reviewed: 2024-11-01