Neonatal Drug Therapy Manual

Vitamin K1

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Phytonadione
Classification: 
Vitamin
Original Date: 
March 1992
Revised Date: 
April 2019
Indications: 
  • Prevention/treatment of hemorrhagic disease of the newborn
Administration: 
  • IV direct: rate not to exceed 1 mg/min (undiluted)
  • IV intermittent infusion: over 15 minutes (see below for recipe)
  • IM
  • SC

 

Dosage: 

Prophylaxis:

  • < 1.5 kg: 0.5 mg IM/SC within 6 hours of birth
  • > 1.5 kg: 1 mg IM/SC within 6 hours of birth

Treatment:

  • 1 mg/dose IM/IV
Side Effects: 
  • CVS: flushing and hypotension
  • Local: pain and swelling at injection site
  • Respiratory: dyspnea
Parameters to Monitor: 
  • HR, RR, BP
  • Prothrombin time with repeated doses
Reconstitution and Stability: 

IV intermittent infusion:

  • Vitamin K 1 mg/0.5 mL
    • Take 0.5 mL (1 mg) and add to 0.5 mL D5W
    • Final concentration: 1 mg/mL
Compatibility: 

- Solutions Compatible: dextrose, 0.9 % NaCl, dextose-saline combinations

- Y-site Compatible: calcium gluconate, dobutamine, dopamine, fentanyl, furosemide, heparin, indomethacin, KCl, midazolam, morphine, ranitidine, sodium bicarbonate

Notes: 

Severe reactions resembling anaphylaxis or hypersensitivity have occured rarely during or immediately after IV and IM administration.

References: 

-Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 22nd Edition. Hudson: Lexi-Comp Inc.; 2015

-American Society of Health-System Pharmacists (ASHP). Handbook on Injectable Drugs. 19th Edition. Bethesda: ASHP; 2017

 

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