Medicines Management & Pharmacy Services (MMPS) …

1 Medicines Management & Pharmacy Services (MMPS) Vitamin K Preparations Information Following the discontinuation of the licensed phytomenadione 10mg tablets, there has been some confusion as to the products available at LTHT. The table below summarises the currently available products. Product Comments Phytomenadione - fat-soluble vitamin K Phytomenadione 10mg tablets (Konakion ) (discontinued) Discontinued by the manufacturer. An unlicensed chewable tablet product is available. Phytomenadione 10mg tablets (unlicensed)

2 Unlicensed product.

3 Can be divided, chewed or crushed. Phytomenadione 10mg capsules (unlicensed) Unlicensed product. Currently not available. Phytomenadione 1mg capsules (Neokay ) Use for small doses and in children unable to take tablets. Snip the end off the capsule and give the liquid contents orally. Phytomenadione 2 ampoules (Konakion MM Paediatric ) Can be given orally, intramuscularly and intravenously. Phytomenadione 10mg/1mL ampoules (Konakion MM ) Can be given intravenously. Can also be given orally, though this is unlicensed. Menadiol - water-soluble vitamin K Menadiol 10mg tablets There have been intermittent supply problems with this product.

4 For alternatives, see table below. A limited number of specialities have previously used menadiol 10mg tablets or the discontinued Konakion phytomenadione 10mg tablets. Agreed alternatives are shown in the table below if there are supply problems with menadiol 10mg tablets. Specialist Area Normal Usage When Menadiol Stocks are Limited Obstetric cholestasis Use menadiol 10mg tablets Use phytomenadione 10mg chewable tablets (unlicensed) Adult Liver Disease Use phytomenadione products Paediatric Liver Disease Use menadiol 10mg tablets. Reserved for this indication when stocks are low or limited, specifically where oral phytomenadione is not absorbed and IV/IM injections would be inappropriate.

5 Cystic Fibrosis Use phytomenadione 10mg chewable tablets (unlicensed) Reversal of Warfarin Depending on clinical situation, administered IV, or phytomenadione 2 or phytomenadione 10mg/1mL ampoules given orally. For patients previously maintained on oral menadiol where a switch to oral phytomenadione is indicated, the conversion would be 1:1 ( 10mg menadiol would be converted to 10mg of phytomenadione). References and Provenance MI Databank Query 139760; 148861; 155762 Date Produced: February 2015; last updated May 2020 Review Date: June 2023 Author: Laura Broad, Specialist Clinical Pharmacist Quality Assurance Check by: Charlotte Daniel, Pharmacist Produced by The Leeds Medicines Advice Service For further information contact ext 65377 This information has been prepared by Leeds Medicines Management and Pharmacy Services for use by health care professionals at Leeds Teaching Hospitals NHS Trust.

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