Abstract | OBJECTIVE: DATA SOURCES: Articles were retrieved through MEDLINE (1946-February 2012) using the terms vitamin K, vitamin K deficiency bleeding, newborn, neonate, and prophylaxis. Reference citations from publications identified were reviewed. STUDY SELECTION AND DATA EXTRACTION: All articles published in English on the use of prophylactic oral vitamin K in neonates were evaluated. The largest epidemiologic studies discussing the efficacy of continuous oral vitamin K prophylaxis were reviewed. Individual, smaller clinical trials were not reviewed. DATA SYNTHESIS: For prevention of early, classic, and late VKDB, use of intramuscular vitamin K 1 mg is preferred over oral administration because of superior efficacy. Single oral doses protect against early VKDB, but multiple oral doses are needed for late VKDB prophylaxis, especially in exclusively breast-fed neonates. Continuous oral dosing regimens used in the literature vary; European epidemiologic data suggest the lowest rates of late VKDB with oral vitamin K 1 mg at birth followed by 25 μg daily for 13 weeks, or 2 mg at birth followed by 1 mg weekly for 3 months. Limited data describe the use of oral prophylactic vitamin K in high-risk patients (eg, premature neonates, biliary abnormalities). CONCLUSIONS: While there are data supporting effective oral vitamin K dosing regimens for prevention of late VKBD in exclusively breast-fed neonates, lack of an appropriate oral dosage form prevents routine use of this technique in the US. In times of drug shortage, injectable vitamin K preparations should be reserved for use in neonates. If injectable vitamin K is not available, clinicians should choose the most practical method of administering oral vitamin K based on the oral products available.
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Authors | Heather J Ipema |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 46
Issue 6
Pg. 879-83
(Jun 2012)
ISSN: 1542-6270 [Electronic] United States |
PMID | 22619475
(Publication Type: Journal Article, Review)
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Chemical References |
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Topics |
- Administration, Oral
- Humans
- Incidence
- Infant, Newborn
- Injections
- Vitamin K
(administration & dosage)
- Vitamin K Deficiency Bleeding
(epidemiology, prevention & control)
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