![]() ![]() ![]() Oral vitamin K 1 is absorbed in an energy dependent saturable process in the proximal small intestine, which likely contributes to the variability. Bioavailability varied significantly among patients (10%–65%) for both doses and in individual patients with the 50 mg dose. After oral administration of doses of 10 and 50 mg of vitamin K 1, peak concentrations of 100 to 400 ng/mL and 200 to 2000 ng/mL, respectively, occurred at 3 to 5 hours. 26 In the volunteers and the poisoned patient, a 10 mg IV dose of vitamin K 1 had a half-life of 1.7 hours. 7, 16, 26, 43 One study evaluated the pharmacokinetics of vitamin K 1 in healthy volunteers, brodifacoum anticoagulated rabbits, and a patient poisoned with brodifacoum. There are only a limited number of pharmacokinetic studies of vitamin K 1. Subcutaneous administration should only be considered when a patient is unable to tolerate oral vitamin K therapy and is not clinically compromised enough to necessitate IV vitamin K 1. Because intravenous (IV) administration of vitamin K 1 may be associated with anaphylactoid reactions, it should be avoided unless serious or life-threatening bleeding is present. 1 Oral administration of vitamin K 1 is safe and effective. ![]() The optimal dosage regimen of vitamin K 1 to treat patients who develop an elevated INR while receiving warfarin is given in the 2012 American College of Chest Physicians consensus guidelines. Acquired vitamin K deficiency typically results from the therapeutic administration of warfarin, or following the overdose of warfarin or a long-acting anticoagulant rodenticide (LAARs), such as brodifacoum. Vitamin K 1 ( phytonadione) is the commercial preparation of the natural form of vitamin K (phylloquinone) that is indicated for the reversal of an elevated prothrombin time (PT) or an international normalized ratio (INR) in patients with xenobiotic induced vitamin K deficiency. ![]()
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