Parenteral Manual


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Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
December 2019
  • Management of coagulation disorders when caused by vitamin K deficiency or interference with vitamin K activity
  • Hemorrhagic disease of the newborn
  • Hemorrhagic situations due to overdose of oral anticoagulants
Reconstitution and Stability: 
  • Available as 2 mg/mL and 10 mg/mL ampoules. Store at room temperature
  • Protect from light 
  • Use immediately after dilution - discard unused portions
  • Compatible for 24 hours in TPN

- Solutions Compatible: D5W, NS, ringer's solution, ringer's lactate

- Additive/buretrol Compatible: TPN (amino acids/dextrose)

- Y-site Compatible: heparin, KCl (up to 40 mmol/L)

- Incompatible: no information


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC YES, preferred route
Usual dilution: undiluted
IV Direct

YES, in emergencies
Usual dilution: undiluted or diluted in 10 mL of compatible solution
Infusion rate: do not exceed 1 mg/minute

IV Intermittent Infusion YES, only if other routes are not feasible
Usual dilution: 0.5 mg/mL
Infusion time: 15-30 minutes
Infusion rate: do not exceed 1 mg/minute
IV Continuous Infusion YES, TPN only (daily dose of phytonadione may be added to TPN)

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

- Hemorrhagic disease of the newborn: 

  • Prophylaxis: 0.5-1 mg SC/IM within 1hour of birth; may repeat if necessary 6-8 hours later
  • Treatment: 1-2 mg/dose/day SC/IM

- Oral anticoagulant overdose: 

  • No bleeding, future need for anticoagulant : 0.5-2 mg SC/IV
  • No bleeding, no future need for anticoagulant OR Significant bleeding, not life-threatening: 2-5 mg SC/IV
  • Significant bleeding, life-threatening: 5 mg IV

- Vitamin K deficiency: (due to drugs, malabsorption, decreased synthesis of vitamin K)

  • 1-2 mg/dose IM/IV/SC as a single dose

- Oral anticoagulant overdose: 

  • 2.5-10 mg/dose SC/IV; may repeat in 6-8 hours
  • Maximum: 25-50 mg has been used

- Vitamin K deficiency: (due to drugs, malabsorption, decreased synthesis of vitamin K)

  • 10 mg/dose IM/IV/SC as a single dose

- The IV & IM route should be restricted to those situations where SC/oral routes are not feasible

Potential hazards of parenteral administration: 
  • IV and IM administration may produce severe reactions including shock and cardiac or respiratory arrest    
  • Possibility of allergic sensitivity and anaphylaxis after IV or IM administration
  • Hypotension, bronchospasm, cyanosis, tachycardia, peripheral vascular collapse       
  • Flushing, sweating,
  • Pain, swelling, tenderness at injection site                                               
  • Monitor PT
  • Injectable form may be given orally
  • Blood coagulation factors increase within 1-2 hours following parenteral administration;  prothrombin time may become normal after 12-14 hours
  • Ineffective in hereditary hypoprothrombinemia and hypoprothrombinemia caused by severe liver disease
  • Contains benzyl alcohol

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