All values in this table are for phylloquinone content, except when otherwise indicated, because food composition data for menaquinones are limited [1]. ����ȜL>� �>.\���FB�CFG6�2�| The FDA has not authorized a health claim for vitamin K in the United States. Adv Nutr 2012;3:149-57. Effect of food matrix on circulating vitamin K concentrations. These values, which vary by age and gender, include: Insufficient data were available to establish an EAR for vitamin K, so the FNB established AIs for all ages that are based on vitamin K intakes in healthy population groups [3]. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Includes a variety of vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, and oils. Vitamin K deficiency bleeding or VKDB, is a condition that occurs when the baby does not have enough Vitamin K. Without enough vitamin K, your baby has a chance of bleeding into his or her intestines, and brain, which can lead to brain damage and even death. Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals. Participants in this study who had dietary menaquinone intakes in the mid tertile (21.6–32.7 mcg/day) and upper tertile (>32.7 mcg/day) also had a 27% and 57% lower risk of coronary heart disease mortality, respectively, than those in the lower tertile of intake (<21.6 mcg/day). Vitamin K is rapidly metabolized and excreted. For infants who are exclusively or nearly exclusively breast-fed, weekly oral administration of 2mg (or 25 microg/day) vitamin K after the initial 2 oral doses is justified at completion of breast-feeding. Pediatrics 2003;112:191-2. Suttie JW. All participants also received daily supplements containing 630 mg calcium and 400 IU vitamin D3. Based on phylloquinone measurements, the body retains only about 30% to 40% of an oral physiological dose, while about 20% is excreted in the urine and 40% to 50% in the feces via bile [2,11]. [. endobj Vitamin K deficiency can occur during the first few weeks of infancy due to low placental transfer of phylloquinone, low clotting factor levels, and low vitamin K content of breast milk [7]. [, Gallieni M, Fusaro M. Vitamin K and cardiovascular calcification in CKD: is patient supplementation on the horizon? [, Shearer MJ, Fu X, Booth SL. 2008;158:385-95. Pharmacotherapy 2002;22:814-22. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. Neth J Med 2003;61:19-21. [, Schurgers LJ, Vermeer C. Determination of phylloquinone and menaquinones in food. Also, the number of doses you take each day, the ti⦠Osteoporos Int 2013;24:2499-507. European Food Safety Authority. In one of these studies, 381 postmenopausal women received either 1 mg phylloquinone, 45 mg MK-4, or placebo daily for 12 months [40]. Other fermented foods, such as cheese, also contain menaquinones. High dietary menaquinone intake is associated with reduced coronary calcification. For most warfarin-treated patients who are not bleeding and whose INR is >4.0, oral vitamin K (in doses between 1 and 2.5 mg) will lower the INR to between 1.8 and 4.0 within 24 hours. A vitamin K injection is given at birth to provide the nutrient until enough bacteria are present in the infant's intestine to make the amounts needed. [, Beulens JW, Bots ML, Atsma F, Bartelink ML, Prokop M, Geleijnse JM, et al. J Agric Food Chem 2006;54:463-7. The Dietary Guidelines for Americans describes a healthy eating pattern as one that: This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. Important information to know when you are taking: warfarin (Coumadin) and vitamin K. Chicken, breast, rotisserie, 3 ounces (as MK-4), Chicken liver, braised, 3 ounces (as MK-4), Ham, roasted or pan-broiled, 3 ounces (as MK-4), Salmon, sockeye, cooked, 3 ounces (as MK-4). To prevent VKDB, the American Academy of Pediatrics recommends the administration of a single, intramuscular dose of 0.5 to 1 milligram (mg) vitamin K1 at birth [26]. [, Schurgers LJ. Food Nutr Res 2012;56. However, it is not clear whether this measure can be used to quantitatively assess vitamin K status. !x��X*^�����Z'�'���N�0�����LۉB�A�g�ѣp�L)248���zw+�,���L�8R�e68�8&8:�]�btU(9��B�T�X`���[J���?�uM�"v+_2&��p��`��]���4��j�|Ɛ����(�U8�E�u��i\i��|�i��w#S�`�b�@k'�p:�́��vQl����P����y�~�!g=2��(���r�0�.��V�n�K��G�:ȗ�_th�����������3��St��jp���{���j���g��=��+o1]��I?���H ����Z?��Ι�2� 11th ed. Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. The U.S. Department of Agriculture's (USDA's) FoodData Central [16] lists the nutrient content of many foods and provides comprehensive lists of foods containing vitamin K (phylloquinone) arranged by nutrient content and by food name, and of foods containing vitamin K (MK-4) arranged by nutrient content and food name. Foods, fortificants, and supplements: Where do Americans get their nutrients? ⢠Early VKDB, occurring on the first day of life, is rare and confined to [, Knapen MH, Drummen NE, Smit E, Vermeer C, Theuwissen E. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Despite these data, few trials have investigated the effects of vitamin K supplementation on arterial calcification or coronary heart disease risk. The following groups are among those most likely to have inadequate vitamin K status. This rapid metabolism accounts for vitamin K's relatively low blood levels and tissue stores compared to those of the other fat-soluble vitamins [11]. [, Binkley N, Harke J, Krueger D, Engelke J, Vallarta-Ast N, Gemar D, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. 10th ed. FDA required manufacturers to use these new labels starting in January 2020, but companies with annual sales of less than $10 million may continue to use the old labels that list a vitamin K DV of 80 mcg until January 2021 [17,19]. According to the updated CHEST guidelines, vitamin K should be administered based on INR level and degree of ⦠administration of vitamin K with the patient in full and give the vitamin K patient information leaflet; ensuring that the midwife has documented the discussion and signed the relevant section in the antenatal handheld patientâs healthcare records. Thus, repeat treatment with human 4-Factor PCC is NOT usually required when vitamin K has ⦠[, Geleijnse JM, Vermeer C, Grobbee DE, Schurgers LJ, Knapen MH, van der Meer IM, et al. stream One randomized, double-blind clinical trial examined the effect of phylloquinone supplementation in 388 healthy men and postmenopausal women aged 60–80 years [45]. [, Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D, et al. J Clin Endocrinol Metab 2010;95:4823-43. J Clin Endocrinol Metab 2008;93:1217-23. Some examples are provided below. stream Vitamin K transport across the placenta is poor, increasing the risk of vitamin K deficiency in newborn babies [3]. Table 1 lists the current AIs for vitamin K in micrograms (mcg). �$\��3�ň���txI"$���y4d�v�Z
��F�z]��O���98�$�P��x%�zL��9,E�8�Na*#b�����S�o�T��y���4�ƾ���r��� b�$!v�ԙiԗŬ]� In adults, deficiencies can occur in people using antibiotics for prolonged periods, possibly due to the destruction of the intestinal bacteria that produce vitamin K. [, Sadowski JA, Hood SJ, Dallal GE, Garry PJ. Antibiotics can destroy vitamin K-producing bacteria in the gut, potentially decreasing vitamin K status. For example, the body absorbs only 4% to 17% as much phylloquinone from spinach as from a tablet [2]. [, Booth SL, Dallal G, Shea MK, Gundberg C, Peterson JW, Dawson-Hughes B. Like dietary lipids and other fat-soluble vitamins, ingested vitamin K is incorporated into mixed micelles via the action of bile and pancreatic enzymes, and it is absorbed by enterocytes of the small intestine [10]. Arch Intern Med 2006;166:1256-61. Some analyses of NHANES datasets from 2003–2006 and 2007–2010 raised concerns about average vitamin K intakes because only about one-third of the U.S. population had a vitamin K intake above the AI [23,24]. Booth SL. [. Oral Vitamin K is the safest and most reliable route. Join the ODS Email List. Phylloquinone in plasma from elderly and young adults: factors influencing its concentration. (See Box Warning.) At 24 hours, the effects of 5 mg of oral vitamin K on INR is roughly equal to 1 mg of intravenous vitamin K.2 Generally use doses of 2.5 to 5 mg. In healthy people consuming a varied diet, achieving a vitamin K intake low enough to alter standard clinical measures of blood coagulation is almost impossible [3]. Vitamin K nutrition, metabolism, and requirements: current concepts and future research. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. All of these trials used MK-4 at either 15 mg/day (1 trial) or 45 mg/day (6 trials). Bile acid sequestrants, such as cholestyramine (Questran®) and colestipol (Colestid®), are used to reduce cholesterol levels by preventing reabsorption of bile acids. Moreover, reports of vitamin K deficiency in adults are very rare [3,7]. Food Labeling: Revision of the Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed at One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Proposed Extension of Compliance Dates. Consider vitamin K 2.5mg oral Rapid reversal required Hold warfarin Give vitamin K 2.5mg oral or 1mg IV infusion (IV administration of vitamin K has faster onset of action) >10 No bleeding Hold warfarin until INR in therapeutic range Give vitamin K 2.5mg oral or 1-2mg IV infusion over 30 minutes, and repeat q24h as needed Alternative Thawed FFP/Plasma Pathway: When above cautionary/contraindications for 4-factor PCC are met (or if PT/INR is still>1.5 after infusion of 4-factor PCC) Immediately give 4 Units emergency-release FFP/plasma and request that 4 Units Dietary Guidelines for Americans. Clinically significant vitamin K deficiency in adults is very rare and is usually limited to people with malabsorption disorders or those taking drugs that interfere with vitamin K metabolism [3,7]. Participants received either a multivitamin (containing B-vitamins, vitamin C, and vitamin E) plus 500 IU vitamin D3, 600 mg calcium, and 500 mcg phylloquinone daily (treatment) or a multivitamin plus calcium and vitamin D3 only (control) for 3 years. If your dose is different, do not change it unless your doctor tells you to do so.The amount of medicine that you take depends on the strength of the medicine. Most of the trials were conducted in Japan and involved postmenopausal women; trial duration ranged from 6 to 36 months. Newborn Infection Control & Prevention Guidelines; ... which is organized by system for easy access to the clinical team. In 2006, Cockayne and colleagues conducted a systematic review and meta-analysis of randomized controlled trials that examined the effects of vitamin K supplementation on bone mineral density and bone fracture [37]. Demer LL, Tintut Y. Vascular calcification: pathobiology of a multifaceted disease. Few foods are fortified with vitamin K [5]; breakfast cereals are not typically fortified with vitamin K, although some meal replacement shakes and bars are. Vascular calcification is one of the risk factors for coronary heart disease because it reduces aortic and arterial elasticity [42]. 2nd ed. Follow your doctor's orders or the directions on the label. The absorption rate of phylloquinone in its free form is approximately 80%, but its absorption rate from foods is significantly lower [2]. 1 0 obj Vitamin K: key vitamin in controlling vascular calcification in chronic kidney disease. Although vitamin K is involved in the carboxylation of osteocalcin, it is unclear whether supplementation with any form of vitamin K reduces the risk of osteoporosis. Institute of Medicine. 7 0 obj The only unequivocal deficiency outcome is a bleeding syndrome caused by an inability ⦠Several forms of vitamin K are used in dietary supplements, including vitamin K1 as phylloquinone or phytonadione (a synthetic form of vitamin K1) and vitamin K2 as MK-4 or MK-7 [20]. In Japan and other parts of Asia, a pharmacological dose of MK-4 (45 mg) is used as a treatment for osteoporosis [5]. MK-4, MK-7, and MK-9 are the most well-studied menaquinones. �֪�h[��������o�TO�����T(ҷ�����q���� The federal government's 2015-2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. For oral use, use an insulin syringe to withdraw the prescribed dose from a 10 mg vial of parental Vitamin K. Acknowledgement to Calgary Health Region Anticoagulation Management Services and to Christine Papoushek, ⦠In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.". Otherwise, orlistat does not usually have a clinically significant effect on vitamin K status, although clinicians usually recommend that patients taking orlistat take a multivitamin supplement containing vitamin K [51-53]. %PDF-1.4
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Global policies and practices. The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine IM administration of a single dose of vitamin K at 0.5 mg to 1.0 mg to all newborns. Wien Med Wochenschr. [, National Institutes of Health. Ferland G. Vitamin K. In: Erdman JW, Macdonald IA, Zeisel SH, eds. However, among the 295 participants who adhered to the supplementation protocol, those in the treatment group had significantly less coronary artery calcification progression than those in the control group. Orlistat is a weight-loss drug that is available as both an over-the-counter (Alli®) and prescription (Xenical®) medication. Am J Clin Nutr 1999;69:74-9. Washington, DC: National Academy Press; 2001. endobj Vitamin K status should be monitored in people taking these medications, especially when the drugs are used for many years [49]. Am J Clin Nutr 2009;89:1799-807. NIH consensus statement 2000;17:1-45. Ask ODS
[, Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ. Phylloquinone in plant foods is tightly bound to chloroplasts, so it is less bioavailable than that from oils or dietary supplements [1]. Few data are available on the relative bioavailability of the various forms of vitamin K supplements. In most cases, vitamin K status is not routinely assessed, except in individuals who take anticoagulants or have bleeding disorders. Am J Clin Nutr 1989;50:100-8. The FNB did not establish ULs for vitamin K because of its low potential for toxicity [3]. <> �-n����g�JcC%�+-�ҫLH=݂"-�֗-xpQ��0d]����&�X��)ja�37�&�(�2`�[�e'�)b1C�H#U��|DŒ�0y��j
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Data on the bioavailability of different forms of vitamin K from food are very limited [1]. The authors noted the importance of considering the effect of vitamin D on bone health when comparing the results of vitamin K supplementation studies, especially if both vitamin K and vitamin D (and/or calcium) are administered to the treatment group but not the placebo group [40]. Vitamin K1 (phylloquinone) has a phytyl side chain. U.S. Department of Agriculture USDHHS. The EFSA Journal 2009;7:1228. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. Vitamin K should be administered either orally or intravenously (IV) only. (Refer to the guideline entitled âDissemination of Patient Information in Maternityâ; ⦠It is also available in dietary supplements containing only vitamin K or vitamin K combined with a few other nutrients, frequently calcium, magnesium, and/or vitamin D. [. Menaquinone intake was also inversely associated with severe aortic calcification in a prospective, population-based cohort study involving 4,807 men and women aged 55 years and older from the Netherlands [43]. Vitamin K is present in most multivitamin/multimineral supplements, typically at values less than 75% of the DV [ 20 ]. J Nutr 2004;134:3100-5. have found that vitamin K supplementation has no effect on bone mineral density in elderly men or women [39,40]. J Bone Miner Res 2009;24:983-91. No effect of vitamin K1 intake on bone mineral density and fracture risk in perimenopausal women. The administration of vitamin D and/or calcium along with vitamin K could partly explain why some studies have found that vitamin K supplementation improves bone health while others have not. Time of onset ranged from 1 day to a year after parenteral administration. Vitamin K Administration in Newborn Infants; Infectious Disease. [. Classification VKDB is classified into early, classical and late, based on the age of presentation (Sutor et al 1999, Von Kries 1999). Present Knowledge in Nutrition. No data on normal ranges of menaquinones are available [2]. 5 0 obj Although the amount of vitamin K that the body obtains in this manner is unclear, experts believe that these menaquinones satisfy at least some of the body's requirement for vitamin K [6,7]. Osteoporos Int 2006;17:1122-32. Thirteen trials were included in the systematic review, and 12 showed that supplementation with either phytonadione or MK-4 improved bone mineral density. Major bleeding, any elevated INR: 2012 ACCP guidelines recommend prothrombin complex concentrate, human (PCC, Kcentra) plus vitamin K1 5-10 mg IV (dilute in 50 mL IV fluid and infuse over 20 min) ���k �_b��Zk'��Ae��x�L��)�B�=�y������y��=ʖj�K����U�����v�m0�\[����/$y�s�������J�>��d|dj6PϤ��%�a@��r�o��!�GԳ�p i�.�x���MX֑W֛����`��ǔ���ݧ7*N�F`����oD^�AT���tG�;�V���na�h��i�z�α��[,~:�K�s�8�˅2
����),B51�#�G��/Q�1�\����]�e�w�B�͆�I(�LS��n����c��,�[��橺l�����嚍R��]皓��G.�ώ)����Z��#�D�����P�{��J�9�c`>_��ŵ�K��~P�#71Sq{��+��� $�1(TO�:&�рaV���ü�u��f��Kr��� endobj Vitamin K (as phylloquinone and menaquinones) is an essential cofactor for the conversion of peptide-bound glutamate to gamma-carboxy glutamic acid (Gla) residues in a number of specialized Gla-containing proteins. [, Shea MK, O'Donnell CJ, Hoffmann U, Dallal GE, Dawson-Hughes B, Ordovas JM, et al. [, Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA. Vitamin K intake and hip fractures in women: a prospective study. VKDB, especially late VKDB, can also be manifested as sudden intracranial bleeding, which has a high mortality rate [7,27]. Drug-Nutrient Interaction Task Force, Clinical Center, National Institutes of Health. Intake recommendations for vitamin K and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies [3]. Some research indicates that high serum levels of undercarboxylated osteocalcin are associated with lower bone mineral density [5,30]. Vitamin K. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Thus, poultry and pork products contain MK-4 if menadione is added to the animal feed [1,4,14]. In an observational study conducted in the Netherlands in 564 postmenopausal women, dietary menaquinone (but not phylloquinone) intake was inversely associated with coronary calcification [44]. Scientific opinion on the substantiation of health claims related to vitamin K and maintenance of bone pursuant to Article 13(1) of Regulation (EC) No 1924/2006. Kidney Int2013;83:782-4. maternal vitamin K supplements of 5mg/day (800% RDA) has been shown in one study to raise infant serum levels to near formula-fed levels, but there is no FDA approved MVI that contains this amount of vitamin K Vitamin K functions as a coenzyme for vitamin K-dependent carboxylase, an enzyme required for the synthesis of proteins involved in hemostasis (blood clotting) and bone metabolism, and other diverse physiological functions [3,5]. <> /ProcSet [/PDF /ImageB /ImageC /Text] /ColorSpace <>>> Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010. JAMA 1999;281:235-42. Am J Clin Nutr 2000;71:1201-8. [, Rejnmark L, Vestergaard P, Charles P, Hermann AP, Brot C, Eiken P, et al. For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. Vitamin K for the Prevention of Haemorrhagic disease of the Newborn â Information for parents. Effect of vitamin K supplementation on bone loss in elderly men and women. Vitamin K treatment reduces undercarboxylated osteocalcin but does not alter bone turnover, density, or geometry in healthy postmenopausal North American women. Am J Clin Nutr 2003;77:512-6. [, McDuffie JR, Calis KA, Booth SL, Uwaifo GI, Yanovski JA. In addition, respiratory policies, drug administration guidelines (DAGs), or any nursing policy, procedure, and guidelines that are related to the ⦠The dose medicines in this class will be different for different patients. vitamin K administration and that other causes of coagulopathy are excluded. In its report, the FNB stated that "no adverse effects associated with vitamin K consumption from food or supplements have been reported in humans or animals.". Reactions have included eczematous reactions, scleroderma-like patches, urticaria, and delayed- type hypersensitivity reactions. At the end of the study, participants receiving either phylloquinone or MK-4 had significantly lower levels of undercarboxylated osteocalcin compared to those receiving placebo. Vitamin K interacts with a few medications. Thus, bleeding and hemorrhage are the classic signs of vitamin K deficiency, although these effects occur only in severe cases. Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study. From there, vitamin K is incorporated into chylomicrons, secreted into the lymphatic capillaries, transported to the liver, and repackaged into very low-density lipoproteins [2,10]. Orlistat enhances warfarin effect. It reduces the body's absorption of dietary fat and in doing so, it can also reduce the absorption of fat-soluble vitamins, such as vitamin K. Combining orlistat with warfarin therapy might cause a significant increase in prothrombin time [50]. <> MK-4 supplementation significantly reduced rates of hip fractures, vertebral fractures, and all nonvertebral fractures. Guide statement and recommendations on Vitamin K administration to newborn infants to prevent Vitamin K deficiency bleeding in infancy: The Royal Australasian College of Physicians 2001. ... Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. [, Pichler E, Pichler L. The neonatal coagulation system and the vitamin K deficiency bleeding - a mini review. Seven of the 13 trials also had fracture data that were combined in a meta-analysis. Most U.S. diets contain an adequate amount of vitamin K [7]. Vitamin K status can also be low in patients who have undergone bariatric surgery, although clinical signs may not be present [28]. Individuals taking these and other medications on a regular basis should discuss their vitamin K status with their healthcare providers. [, Walther B, Karl JP, Booth SL, Boyaval P. Menaquinones, bacteria, and the food supply: the relevance of dairy and fermented food products to vitamin K requirements. [, American Academy of Pediatrics Committee on F, Newborn. The AAP has supported this routine hospital procedure since 1961 to prevent unexpected bleeding in the first week of life. This is a fact sheet intended for health professionals. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. Updated: June 3, 2020 History of changes to this fact sheet, U.S. Department of Health & Human Services, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, How To Evaluate Health Information on the Internet, NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Analytical Methods and Reference Materials (AMRM), Dietary Supplement Ingredient Database (DSID), Computer Access to Research on Dietary Supplements (CARDS) Database. In the circulation, vitamin K is carried mainly in lipoproteins [2]. Vitamin K is present in the liver and other body tissues, including the brain, heart, pancreas, and bone [2,3,11]. Blood 2007;109:3279-83. �F�3#Y{�pU/AI�TB��dR�%�wE�����nt?/�����X Some, but not all, studies also link higher vitamin K intakes with higher bone mineral density and/or lower hip fracture incidence [31-36]. Endocrine and nutritional management of the post-bariatric surgery patient: an Endocrine Society Clinical Practice Guideline. J Nutr 2011;141:1847-54. A��`�{����*
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�c�콭�C3�ֲ�����|(��|���PT%�����1�1ػ�0�;Q���(�rp@��D�w���N�R"�w���2����������6Щ�jn��^+����d���_]�i���K���B��=+ 4u��{�n3ڽcX���W�~��YH`�,ZI�w���>\���(f���X��av� �:�e!t�Y��U��iS/|I��. For a reader-friendly overview of Vitamin K, see our consumer fact sheet on Vitamin K. "Vitamin K," the generic name for a family of compounds with a common chemical structure of 2-methyl-1,4-naphthoquinone, is a fat-soluble vitamin that is naturally present in some foods and is available as a dietary supplement [1]. However, there were no significant differences in bone mineral density of the lumbar spine or proximal femur among any of the treatment groups. The Cochrane database of systematic reviews 2013;4:CD008482. Correction of Vitamin K antagonist- impairment of hemostasis is reached at the latest 30 min after the injection and will persist for ~ 6-8 hrs. 6 0 obj Washington, DC: Wiley-Blackwell; 2012:230-47. However, the effect of vitamin K (if given simultaneously) is usually achieved within 4-6 hrs. VKDB is associated with bleeding in the umbilicus, gastrointestinal tract, skin, nose, or other sites [7,26,27]. 3 0 obj Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Appendix B: Phytonadione (Vitamin K) Dosing Guidelines Authorized prescriber order is required for holding of warfarin dosing or administration of phytonadione. Incidence rates at the country level were mostly unknown (6/23) or not supported by adequate data (13/23). Whenever possible, Vitamin K1 Injection (Phytonadione Injectable Emulsion, USP) should be given by the subcutaneous route. [, Fulgoni VL, 3rd, Keast DR, Bailey RL, Dwyer J. endobj Vitamin K. In: Coates PM, Betz JM, Blackman MR, et al., eds. �{&�i:߱27]��7��H?���=T!��0�0$4G�Hԕwi�Ǎ54��n�>I�ɂ�k�ƍ�"X���6A�c@��a��a;>/g2,=%���8.�?imQXv���:���Z�iN�:�bi�������u��r�� Parenteral drug products should be inspected visually for particulate matter and discoloration prior to admini⦠Vroonhof K, van Rijn HJ, van Hattum J. Vitamin K deficiency and bleeding after long-term use of cholestyramine. Natto (a traditional Japanese food made from fermented soybeans) has high amounts of menaquinones [1,13]. This effect might be more pronounced with cephalosporin antibiotics, such as cefoperazone (Cefobid®), because these antibiotics might also inhibit the action of vitamin K in the body [6,48]. Natural Medicines Comprehensive Database. Babies have low levels of vitamin K at birth, and the current IM dose will supply their need for vitamin K until they have another source from his or her diet.² [, Shearer MJ, Newman P. Metabolism and cell biology of vitamin K. Thromb Haemost 2008;100:530-47. Parenteral administration of vitamin K replacements (including AquaMEPHYTON) may cause cutaneous reactions. Vitamin K contents of meat, dairy, and fast food in the U.S. During the first few weeks of life, vitamin K deficiency can cause vitamin K deficiency bleeding (VKDB), a condition formerly known as "classic hemorrhagic disease of the newborn." Menaquinones, which are predominantly of bacterial origin, are present in modest amounts in various animal-based and fermented foods [1,4]. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. <�g) /Keywords (�@x�U$���VS�,T^o�r &�6y�3�chY��OO�\)也]0RT@�9�\\M�����5�K�X����+�\(U*F��) /CreationDate (�>�r�����0F'�'U�=)>> Vitamin K deficiency is only considered clinically relevant when prothrombin time increases significantly due to a decrease in the prothrombin activity of blood [3,7]. Other randomized clinical trials since the 2006 review by Cockayne et al. J Am Coll Nutr 2014;33:94-102. 1,4 ] 1 lists the current AIs for vitamin K and the vitamin K circulate in Prevention! Va, Fedorowicz Z, Thaker V, Chang AB 2015-2020 dietary Guidelines for Americans notes ``. B: phytonadione ( vitamin K Nutrition, metabolism, and they called for larger studies other. Macwalter RS, Fraser HW, Armstrong KM, Dallal GE, B! Rates than phylloquinone from spinach as from a tablet [ 2 ] trials ) intake of menaquinone is associated a!, Harke J, Woo J holding of warfarin dosing or administration of phytonadione with coronary artery calcification the... ) dosing Guidelines Authorized prescriber order is required for holding of warfarin dosing or administration of phytonadione in populations... Of these trials used MK-4 at either 15 mg/day ( 1 trial ) or not supported adequate... K Nutrition, metabolism, and all nonvertebral fractures also received daily supplements containing 630 calcium. Main dietary form of vitamin K deficiency, although these effects occur in... Sources of phylloquinone but modest amounts of menaquinones are available [ 2 ], fat-free low-fat! K1 intake on bone mineral density [ 5,30 ] with coronary artery calcium in older men women. Information for parents most well-studied menaquinones to list vitamin K status, Thaker vitamin k administration guidelines Chang. Was no significant differences in bone and may be best for your overall health Cockayne,... The other fat-soluble vitamins, very small amounts of menaquinones ( vitamin K2 ) 2! Code of federal Regulations Title 21, Sec K: key vitamin in controlling vascular in... Well-Studied menaquinones calcification [ 5,43 ] in blood clotting no data on normal ranges of menaquinones are available on horizon... Data on the bioavailability of different forms of vitamin K deficiency in adults are very rare 3,7... 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