Effect of interaction is not clear, use caution. Use Caution/Monitor.Īspirin/citric acid/sodium bicarbonate increases and vitamin K1 (phytonadione) decreases anticoagulation. Use of high vitamin K doses (10-15 mg) may cause warfarin resistance for ≥1 weekĪspirin rectal increases and vitamin K1 (phytonadione) decreases anticoagulation. May use IV route in selected nonbleeding patients use IV route in patients with major bleeding due to warfarin associated coagulopathy Oral route more effective than SC route in nonbleeding patients in warfarin associated coagulopathy PO dose may be repeated in 12-48 hr and SC/IV/IM dose in 6-8 hr if necessaryĪvoid IM route increases risk of hematoma formation NOTE: High vitamin K doses (ie, 10 mg or more) may cause warfarin resistance for a week or more consider using heparin, LMWH, or direct thrombin inhibitors to provide adequate thrombosis prophylaxis in clinical conditions requiring chronic anticoagulation therapy (eg, atrial fibrillation) Dosing Considerations 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) Minor bleeding, any elevated INR: Consider 2.5-5 mg PO once may repeat if needed after 24 hr INR >10, no bleeding: 2012 ACCP guidelines recommend vitamin K1 PO (dose not specified) 2008 ACCP guidelines suggest 2.5-5 mg PO once INR reduction observed within 24-48 hr, monitor INR and give additional vitamin K if needed INR 4.5-10, no bleeding: 2012 ACCP guidelines suggest against routine use 2008 ACCP guidelines suggest considering vitamin K1 (phytonadione) 1-2.5 mg PO once Omit 1-2 doses, or hold warfarin monitor INR and adjust warfarin dose accordingly Females: 90 mcg/day PO Hypoprothrombinemia Due To Drugs or Factors Limiting Absorption or SynthesisĢ.5-10 mg PO/SC may be increased PRN to 25 mg or, rarely, to 50 mg may be repeated in 12-48 hours Reversal of Warfarin Effects

Vitamin k antidote for warfarin