Vitamin K (phytonadione) for blood clotting

What is vitamin K (phytonadione)?

Vitamin K, also called phytonadione, is naturally present in many foods. It is used by the body to make blood clots properly. In children who cannot properly absorb vitamin K from foods, vitamin K is given to lower their risk of bleeding. This medicine comes in an injectable liquid that may also be given by mouth.

Before giving vitamin K (phytonadione) to your child

Tell your child’s doctor or pharmacist if your child is:

• allergic to vitamin K (phytonadione) or any other part of the liquid
• taking other medications that affect blood clotting.

Talk with your child’s doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• any blood clotting problems
• liver problems
• kidney problems.

How should you give your child vitamin K (phytonadione)?

• The medicine will be provided to you in a glass container called an ampoule.
• Vitamin K is drawn into a syringe using a filter needle that is specially designed to filter out any tiny glass pieces that may have gotten into the liquid when breaking the glass ampoule.
• The following steps can be used to measure out vitamin K from the ampoule:
• Wash your hands with soap and water before handling the medicine.
• Screw the filter needle tightly into the syringe that you will use to measure out the dose.
• Wrap an alcohol swab around the neck of the ampoule where there is a line marking and snap off the ampoule tip. Break the ampoule facing away from you to avoid injury.
• Place the filter needle with syringe into the opened ampoule and measure out the amount of vitamin K you need by pulling the syringe plunger.
• Do not push any medicine back into the filter needle once it is drawn into the syringe. This is to prevent any tiny glass pieces from getting into the liquid.
• See the section below on how much vitamin K to measure out.
• Re-cap the filter needle off of the syringe.
• The glass ampoule and filter needle should only be used once.
• Dispose of the glass ampoule and any remaining medicine, along with the needle, in a sharps disposal container.
• Make sure you understand and are comfortable with the way to prepare vitamin K and know how to dispose of the needle and syringe.

How much vitamin K should you give your child?

Vitamin K is available in several different strengths. The dosing information below applies to the 10 mg/mL (1 mL) glass ampoules. Please check the label on your vitamin K ampoule and ask your pharmacist if you have any questions about dosing.

1 mL = 10 mg of vitamin K

Your child has been prescribed _______ mg of vitamin K for each dose. This dose is equivalent to _______millilitres (mL) on the syringe that has been provided.

Your child’s doctor may sometimes need to change the dose. If your child’s dose of vitamin K changes, please ask one of the nurses or the pharmacist to complete the dose chart for you.

What should you do if your child misses a dose of vitamin K (phytonadione)?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does vitamin K (phytonadione) take to work?

Vitamin K (phytonadione) starts working in six to 10 hours and reaches maximum effect in 24 to 48 hours (one to two days).

What are the possible side effects of vitamin K (phytonadione)?

Oral vitamin K (phytonadione) is generally well tolerated. Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child’s doctor immediately if your child has:

• signs of a life-threatening reaction, including rash; hives; itching; red, swollen, blistered or peeling skin with or without fever
• wheezing
• tightness in the chest or throat
• trouble breathing or talking
• unusual hoarseness
• swelling of the mouth, face, lips, tongue or throat.

What safety measures should you take when your child is taking vitamin K (phytonadione)?

There are some medicines that should not be taken together with vitamin K (phytonadione). It is important that you tell your child's health-care providers if your child takes any other medications (prescription, over the counter or herbal). The dose of vitamin K or the other medicine may need to be adjusted. These include:

• mineral oil
• cholestyramine
• orlistat
• warfarin

If your child is also taking cholestyramine, it is important that your child does not take any other medicines one hour before, or four to six hours after a dose of cholestyramine, unless your doctor or pharmacist tells you they can be given together.

What other important information should you know about vitamin K (phytonadione)?

• Keep a list of all your child's medications (prescription, natural products, vitamins, over the counter) with you and show this list to your child's doctor or pharmacist.
• Do not share your child’s medicine with others and do not give anyone else’s medicine to your child.
• Make sure you always have enough vitamin K (phytonadione) to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep vitamin K (phytonadione) at room temperature in a cool, dry place away from sunlight, heat or an open flame. Do NOT store it in the bathroom or kitchen.
  
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep vitamin k (phytonadione) out of your child's sight and reach and locked up in a safe place. If your child takes too much vitamin k (phytonadione), call the Ontario Poison Centre at one of these numbers. These calls are free.

• Call 416-813-5900 if you live in Toronto.
• Call 1-800-268-9017 if you live somewhere else in Ontario.
• If you live outside of Ontario, call your local Poison Information Centre.