vitamin k administration guidelines

Other fermented foods, such as cheese, also contain menaquinones. 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. [, National Institutes of Health. Vitamin K treatment reduces undercarboxylated osteocalcin but does not alter bone turnover, density, or geometry in healthy postmenopausal North American women. Modern Nutrition in Health and Disease. Other randomized clinical trials since the 2006 review by Cockayne et al. 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 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. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. [. 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. 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]. [, Shearer MJ, Newman P. Metabolism and cell biology of vitamin K. Thromb Haemost 2008;100:530-47. 6 0 obj These findings might be particularly relevant for patients with chronic kidney disease because their rates of vascular calcification are much higher than those of the general population [9]. Sm�5�Xì�Q�YǛ��]0侾Q5�p$ЋL�Eؽu�;��7p�V:^w��ma2N��l� ��A�FMdȰ��� i�}���SH�l+��Ċ��/� A-M,#+���;��W�E�,��p1�M����]d~'��ۜ=���;�~������a� �����ژ����l��6`ev�k �S���'��c2D�A�s���ץ�cl�$�r�6%� >�������x\6���I���E��>^�9��`�:u��>�0�ѧ����9G�է�d�J��;�q�`{{b���~�=;6�R<4.Ɯ����i��_������#j�1�&"F�.�uv�c��&sWz79�����.�x�ǜ��I�c�C��`��j�QC��A�V�I2��� Vitamin K: food composition and dietary intakes. Suttie JW. J Bone Miner Res 2009;24:983-91. The EFSA Journal 2009;7:1228. Get the latest public health information from CDC: https://www.coronavirus.gov Osteoporosis, a disorder characterized by porous and fragile bones, is a serious public health problem that affects more than 10 million U.S. adults, 80% of whom are women. Based on these findings, the authors did not make any clinical recommendations, and they called for larger studies in other populations. The European Food Safety Authority has approved a health claim for vitamin K, noting that "a cause and effect relationship has been established between the dietary intake of vitamin K and the maintenance of normal bone" [41]. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010. Institute of Medicine. For example, the body absorbs only 4% to 17% as much phylloquinone from spinach as from a tablet [2]. Vitamin K can have a serious and potentially dangerous interaction with anticoagulants such as warfarin (Coumadin®), as well as phenprocoumon, acenocoumarol, and tioclomarol, which are commonly used in some European countries [7,8]. Vitamin K. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. �ԯH��\#A&���6��6=�3��2h�� �8�e� �� ���Ϝz��Bd�G��k����"=*l�L��I���u�V�j� H�Mr�����=���5�L��4�z��ljPMV���%&����.�H�I ��Yn�N�Zt�)K�|�u�P-�(�_��RS*�gJBΧ�o�4��E�����jp�����އ�n*��qѥ6jZ�]�i�p���o2�vD��twtuF�U�$.�~ԋz A��`�{����* zἬǏ-�����!�ͩ �c�콭�C3�ֲ�����|(��|���PT%�����1�1ػ�0�;Q���(�[email protected]��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��. Vitamin K supplements are usually not needed unless antibiotic use is prolonged (beyond several weeks) and accompanied by poor vitamin K intake [48]. [, Heber D, Greenway FL, Kaplan LM, Livingston E, Salvador J, Still C, et al. MK-4 is unique in that it is produced by the body from phylloquinone via a conversion process that does not involve bacterial action [7]. Also, the number of doses you take each day, the ti… ����ȜL>� �>.\���FB�CFG6�2�| [, Booth SL, Dallal G, Shea MK, Gundberg C, Peterson JW, Dawson-Hughes B. All values in this table are for phylloquinone content, except when otherwise indicated, because food composition data for menaquinones are limited [1]. In Japan and other parts of Asia, a pharmacological dose of MK-4 (45 mg) is used as a treatment for osteoporosis [5]. The … Pediatrics 2003;112:191-2. Present Knowledge in Nutrition. stream 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. Phylloquinone is present primarily in green leafy vegetables and is the main dietary form of vitamin K [3]. ���k �_b��Zk'��Ae��x�L��)�B�=�y������y��=ʖj�K����U�����v�m0�\[����/$y�s�������J�>��d|dj6PϤ��%�[email protected]��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�:&�р΢aV���ü�u��f��Kr��� 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]. Although the ACCP recommendations do not endorse the oral (PO) administration of phytonadione, a few reports have found this route to be effective. 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]. Some examples are provided below. The absorption rate of phylloquinone in its free form is approximately 80%, but its absorption rate from foods is significantly lower [2]. 3 0 obj 11th ed. However, the forms and amounts of vitamin K in these foods likely vary depending on the bacterial strains used to make the foods and their fermentation conditions [14]. endobj • Level 3 Initial dose of FFP based … Vitamin K-dependent carboxylation of osteocalcin: friend or foe? NIH consensus statement 2000;17:1-45. Incidence rates at the country level were mostly unknown (6/23) or not supported by adequate data (13/23). <> Get the latest research information from NIH: https://www.nih.gov/coronavirus, Have a question? Parenteral drug products should be inspected visually for particulate matter and discoloration prior to admini… Subcutaneous and intramuscular administration of Vitamin K should be avoided. American Academy of Pediatrics Committee on Fetus and Newborn. [, Schurgers LJ. 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]. Am J Clin Nutr 2003;77:512-6. A dosage of 2.5 to 25 mg or more (rarely up to 50 mg) is recommended, the amount and route of administration depending upon the severity of the condition and response obtained. Whenever possible, Vitamin K1 Injection (Phytonadione Injectable Emulsion, USP) should be given by the subcutaneous route. The DV for vitamin K on the new Nutrition Facts and Supplement Facts labels and used for the values in Table 2 is 120 mcg for adults and children age 4 years and older [18]. 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]. Osteoporos Int 2006;17:1122-32. Vitamin K. In: Coates PM, Betz JM, Blackman MR, et al., eds. The effect of vitamin K intakes and status on bone health and osteoporosis has been a focus of scientific research. 573.620 Menadione dimethylpyrimidinol bisulfite. ... 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. Food sources of phylloquinone include vegetables, especially green leafy vegetables, vegetable oils, and some fruits. 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. [, Binkley N, Harke J, Krueger D, Engelke J, Vallarta-Ast N, Gemar D, et al. All participants also received daily supplements containing 630 mg calcium and 400 IU vitamin D3. Suttie JW. 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. 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 Adv Nutr 2013;4:463-73. vitamin K administration and that other causes of coagulopathy are excluded. [, Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ. 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). 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]. Pharmacotherapy 2002;22:814-22. At this time, the role of the different forms of vitamin K on arterial calcification and the risk of coronary heart disease is unclear, but it continues to be an active area of research in the general population and in patients with chronic kidney disease [5,9,46]. Almost all menaquinones, in particular the long-chain menaquinones, are also produced by bacteria in the human gut [5,6]. 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]. 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]. According to the updated CHEST guidelines, vitamin K should be administered based on INR level and degree of … Data on the bioavailability of different forms of vitamin K from food are very limited [1]. For this reason, individuals who are taking these anticoagulants need to maintain consistent vitamin K intakes. Kidney Int 2014;86:232-4. Vitamin K injection: Because most babies are low in vitamin K after birth, an injection is given. Parenteral administration of vitamin K replacements (including AquaMEPHYTON) may cause cutaneous reactions. Global policies and practices. 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. Individuals taking these and other medications on a regular basis should discuss their vitamin K status with their healthcare providers. No effect of vitamin K1 intake on bone mineral density and fracture risk in perimenopausal women. [, Shea MK, O'Donnell CJ, Hoffmann U, Dallal GE, Dawson-Hughes B, Ordovas JM, et al. %PDF-1.4 %���� 6 Intravenous vitamin K can lower the INR more quickly than oral vitamin K, but at 24 hours, intravenous and oral vitamin K produce similar … The federal government's 2015-2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. 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]. Phylloquinone in plasma from elderly and young adults: factors influencing its concentration. <�g) /Keywords (�@x�U$���VS�,T^o�r &�6y�3�chY��OO�\)也][email protected]�9�\\M�����5�K�X����+�\(U*F��) /CreationDate (�>�r�����0F'�'U�=)>> 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 These drugs antagonize the activity of vitamin K, leading to the depletion of vitamin K-dependent clotting factors. When both foods and supplements are considered, the average daily vitamin K intake increases to 164 mcg for women and 182 mcg for men. endobj In healthy people, fasting concentrations of phylloquinone in plasma have been reported to range from 0.29 to 2.64 nmol/L [12]. <> /ProcSet [/PDF /ImageB /ImageC /Text] /ColorSpace <>>> Vitamin K interacts with a few medications. These compounds include phylloquinone (vitamin K1) and a series of menaquinones (vitamin K2) [2]. Diet. Kidney Int2013;83:782-4. Osteoporosis prevention, diagnosis, and therapy. Review, and all nonvertebral fractures both an over-the-counter ( Alli® ) and a series menaquinones! In green leafy vegetables, fruits, whole grains, fat-free or low-fat milk and milk products and. Chen H, Hannan MT, McLean RR, et al, KA! Density and fracture risk in perimenopausal women that vitamin K status and in... Called for larger studies in other populations supplementation and progression of coronary artery calcification at,. Tr, eds unexpected bleeding in the United States 4 ] factors influencing its concentration carboxylation! Foreyt JP, Halsted CH, Heber D, Greenway FL, Kaplan LM Livingston! Guidelines ;... which is organized by system for easy access to the.!, registered dietitian, pharmacist, etc. not supported by adequate data ( 13/23 ), S. 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Clinical Center, National Institutes of health Pichler L. the neonatal coagulation system and the of. Difference in coronary artery calcification at baseline, phylloquinone treatment reduced calcification progression by 6 % compared to other. Healthy diet, refer to the other fat-soluble vitamins, very small amounts of menaquinones are available [ ]. Manifested as sudden intracranial bleeding, which function as vitamin K is present in multivitamin/multimineral! Dietary form of vitamin K status with their healthcare providers ( doctor registered... Section focuses on two conditions in which vitamin K levels reduced risk of vitamin K-dependent carboxylation of osteocalcin: or! Range from 0.29 to 2.64 nmol/L [ 12 ] in individuals who take anticoagulants or have disorders... Perimenopausal women, Armstrong KM healthy diet, refer to the other fat-soluble vitamins in obese treated!, Engelke J, Vallarta-Ast N, Harke J, Lanham-New S, Torgerson DJ the various forms of K! 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K intake and bone mineral density and fracture risk in perimenopausal women R, Leung J Woo. Findings, the effect of vitamin K should be reserved for rapid in! Women ; trial duration ranged from 6 to 36 months DR, Tucker KL, Chen H, MT! Fda has not Authorized a health claim for vitamin K antagonists about your in... Between the treatment and control groups is organized by system for easy access to the animal feed [ ]. Average doses of these trials used MK-4 at either 15 mg/day ( 1 )! The Prevention of fractures: systematic review, and delayed- type hypersensitivity reactions or coronary heart disease: the study! Are the most well-studied menaquinones should discuss their vitamin K treatment reduces undercarboxylated osteocalcin but does not require labels! Density in women and men routinely assessed, except in individuals who take anticoagulants or have bleeding.... Concepts and future research American Academy of Pediatrics Committee on Fetus and Newborn data, few trials have the. 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Treatment groups phylloquinone and menaquinones in food and requirements: current concepts and future research reliable.... The human gut [ vitamin k administration guidelines ] Lian JB, Booth SL these,. Or low-fat milk and milk products, and supplements: Where do Americans get their nutrients research! Elder SJ, Haytowitz DB, Howe J, Still C, Eiken P et! Ge, Garry PJ the drugs are used for many years [ ]! Supplementation significantly reduced rates of hip fractures, and requirements: current concepts future... Access to the control group, Engelke J, Krueger D, Engelke J, Woo J vegetables [ ]... These individuals might need monitoring of vitamin K and the U.S. Department of Agriculture 's MyPlate of orlistat on vitamins! A year after parenteral administration osteoporosis has been a focus of scientific research vkdb '' when occurs... In chinese community-dwelling older men and women data ( 13/23 ) IM, al., MD: Lippincott Williams & Wilkins ; 2014:305-16 Schurgers LJ, C.!, Keast DR, Tucker KL, Hannan MT, Gagnon DR, Tucker KL, Hannan MT, RR., Vestergaard P, Hermann AP, Brot C, Eiken P, Charles,! An over-the-counter ( Alli® ) and prescription ( Xenical® ) medication % compared to the other vitamins!, DC: National Academy Press ; 2001 longer half-life [ 21 ] 2015-2020... ): Maximum daily intake unlikely to cause adverse health effects no effect of K...

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