Phytomenadione

Adults: Prophylaxis for mild hemorrhage or a tendency toward hemorrhage: in neonates, the usual dose is 2 mg given orally at birth or shortly afterward, followed by a further 2 mg on the 4th to 5th day and another 2 mg on the 28th to 30th day. If the oral route is not suitable, 2 mg may instead be given by IM or IV injection. Children over 1 year of age may be given 5 to 10 mg orally. For children who cannot be relied upon to receive a second oral dose, or breastfed children who cannot be relied upon to receive a third oral dose, a single 1 mg (0.1 ml) dose given by IM injection is recommended. Therapy: an initial dose of 1 mg is given by intravenous injection, with further doses given as needed depending on the clinical picture and coagulation status. Neonates with special risk factors, such as prematurity, birth asphyxia (inadequate oxygen intake during birth), obstructive jaundice, inability to swallow, or maternal use of anticoagulants or anti-epileptics, should receive 1 mg by IM or IV injection at birth or shortly afterward if the oral route is not suitable. In premature infants weighing less than 2.5 kg, IM and IV doses should not exceed 0.4 mg/kg, and the size and frequency of any further doses should be guided by coagulation status. To ensure newborns receive full protection, 3 prophylactic doses of vitamin K should be given orally according to the schedule above.