What is the intramuscular (IM) equivalent dose of Vitamin K (phylloquinone) for a 10 milligram (mg) intravenous (IV) dose?

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Vitamin K Intramuscular Equivalent Dose for 10 mg IV

For an intravenous (IV) dose of 10 mg vitamin K (phylloquinone), the equivalent intramuscular (IM) dose is also 10 mg. The bioavailability of vitamin K is comparable between IV and IM routes, making the doses equivalent 1.

Dosing Considerations for Vitamin K Administration

Route of Administration Equivalence

  • Vitamin K (phylloquinone) has similar bioavailability when administered via IM or IV routes, so the dose remains the same at 10 mg for both routes 1
  • The choice between IM and IV administration is typically based on clinical context rather than dose adjustment requirements 1

Clinical Applications for 10 mg Vitamin K

  • 10 mg of vitamin K (IV or IM) is recommended for urgent reversal of vitamin K antagonist (e.g., warfarin) anticoagulation in patients with major bleeding or requiring emergency procedures 1
  • This dose is typically administered alongside other reversal agents such as prothrombin complex concentrates (PCCs) in life-threatening bleeding scenarios 1

Onset of Action Differences

  • IV administration provides more rapid onset but carries a small risk of anaphylaxis (3 in 100,000 patients) 1
  • IM administration has a slightly slower onset but avoids the risk of anaphylactic reactions associated with IV administration 1
  • When administered IV, vitamin K should be infused slowly to minimize the risk of adverse reactions 1

Special Population Considerations

  • For pediatric patients, dosing is weight-based (10 μg/kg/day for infants up to 12 months, 200 μg/day for older children) rather than using adult fixed dosing 1
  • In patients with liver disease, vitamin K administration alone typically has only a minor impact on prothrombin time and may take >12 hours to start correcting hemostatic defects 1

Common Pitfalls and Caveats

  • Subcutaneous (SC) administration of vitamin K should be avoided as it results in significantly lower bioavailability compared to IM or IV routes 1
  • In one study comparing SC vs IV administration, vitamin K 0.5 mg IV led to INR <5 in 95% of patients vs only 45% with SC administration at 24 hours 1
  • When treating anticoagulant-related bleeding, vitamin K alone is insufficient for immediate reversal and should be combined with prothrombin complex concentrates or fresh frozen plasma in emergency situations 1
  • The full effect of vitamin K administration takes more than 12 hours, making it unsuitable as a sole agent for emergency reversal of anticoagulation 1

In conclusion, when converting from IV to IM administration of vitamin K, maintain the same 10 mg dose, but be aware of the slightly different onset of action profiles between the two routes 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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