Can vitamin K (phytonadione) tablets be crushed for administration via a feeding tube?

Administration of Vitamin K (Phytonadione) Through Feeding Tubes

Yes, vitamin K (phytonadione) tablets can be crushed and administered through feeding tubes when necessary, but this must be done following proper preparation techniques to ensure effective delivery and prevent tube occlusion.

Proper Administration Technique

Preparation of Vitamin K for Tube Administration

• Crush vitamin K tablets thoroughly into a fine powder
• Mix the crushed tablet with 15-30mL of water until completely dissolved 1
• Administer immediately after preparation to ensure proper dosing

Administration Process

1. Before administration:

   • Flush the tube with at least 30mL of water 2, 1
   • Temporarily stop enteral feeding if possible (especially if vitamin K interacts with formula components)

2. During administration:

   • Administer the prepared vitamin K solution through the feeding tube
   • Never mix vitamin K with other medications prior to administration 2, 1

3. After administration:

   • Flush the tube with 30mL of water immediately after administration 2
   • Resume enteral feeding as appropriate

Important Considerations

Placement of Feeding Tube

• The site of tube placement affects drug absorption 2
• Vitamin K is best absorbed when delivered to the stomach or proximal small intestine
• Similar to DOACs, bioavailability may be reduced if administered distal to the stomach 2

Alternative Options

• Injectable vitamin K can also be administered orally through feeding tubes when tablets are unavailable or cost-prohibitive 3
• When using injectable vitamin K orally:
  • It can be prepared as an undiluted solution or as a compounded solution
  • Different formulations have different beyond-use dates 3

Precautions

• Always consult with a pharmacist before crushing and administering medications through feeding tubes 1
• Avoid using carbonated beverages or acidic juices to dissolve vitamin K 1
• Do not add vitamin K directly to enteral formula 1
• Ensure vitamin K is completely dissolved before administration to prevent tube occlusion 1

Potential Pitfalls to Avoid

• Failing to flush the tube before and after administration can lead to tube occlusion
• Mixing vitamin K with other medications can cause drug interactions or affect absorption
• Administering crushed vitamin K too far distal in the GI tract may reduce absorption
• Using improper dissolution techniques may lead to incomplete delivery of the medication

Following these guidelines will help ensure effective delivery of vitamin K through feeding tubes while minimizing risks of tube occlusion and maintaining proper medication efficacy.