Taylor Rackey, CPM Candidate

Midwifery Practice Documents

Revised April 16th, 2020

Drug Protocol: Vitamin K (ALLOWED PER OREGON LDM LICENSE)

Drug​: Vitamin K [AquaMEPHYTON, Phytonadione, Mephyton, Vit K]

Indication for Use: ​Vitamin K malabsorption, hypoprothrombinemia, prevention of hypoprothrombinemia caused by
oral anticoagulants, prevention of hemorrhagic disease of the newborn.
Mechanism of Action: ​Vitamin K is an essential cofactor for the gamma-carboxylase enzymes which catalyze the
posttranslational gamma-carboxylation of glutamic acid residues in inactive hepatic precursors of coagulation factors II
(prothrombin), VII, IX and X. Supplementing the newborn with Vitamin K results in a relief of vitamin K deficiency
symptoms which include easy bruisability, epistaxis, gastrointestinal bleeding, menorrhagia and hematuria.
Form Dose Route of Administration Administration instructions Treatment notes
Single- 0.5-1 IM (recommended by the Repeat after 2-3 weeks if required. Severe reactions, including
dose vial mg AAP) fatalities have been reported
following IM administration.
*Per the pack -
Typically these severe reactions
“whenever possible,
have resembled hypersensitivity
Vitamin K should be
or anaphylaxis, including shock
given by the
and cardiac and/or respiratory
subcutaneous route (see
arrest.
Box Warning).”

Use benzyl alcohol-free

formulations in neonates and
infants, if available. Serious and
fatal adverse reactions including
“gasping syndrome” can occur in
neonates and infants treated with
benzyl alcohol-preserved drugs,
including Phytonadione.
Contraindications: ​Hypersensitivity to any component of this medication. Lack of parental consent.
Storage:​ Store at 68° to 77°F (20° to 25°C). Degrades rapidly by light, store in packaging away from light.

References:
Drugs.com. (2018, December 1). AquaMEPHYTON - FDA prescribing information, side effects and uses. Retrieved
from https://www.drugs.com/pro/aquamephyton.html#ID_70087e81-33aa-46cf-8e24-0596d2c66c78

Merck & Co., Inc. (2017). INJECTION AquaMEPHYTON® (PHYTONADIONE) Aqueous Colloidal Solution of
Vitamin K1 [package insert] Retrieved from:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2003/012223orig1s039lbl.pdf