Plasma concentrations after intravenous administration of phylloquinone (vitamin K-1) in preterm and sick neonates

Vitamin K prophylaxis usually is administered orally or intramuscularly, bu t in neonatal intensive care oral administration might not be feasible and intramuscular administration is not general practice in very small infants. No data are available about plasma levels after intravenous administration of vitamin It to neonates, Therefore, we investigated plasma levels in 18 infants: 14 preterms with a birthweight of 1785 +/- 648 g and 4 sick newbor ns with a birth-weight of 3167 +/- 510 g after administration of a single d ose of 0.3 +/- 0.1 mg/kg phylloquinone (vitamin K-1) (Konakion MM(R), Roche ) intravenously after birth. Blood was collected 22.9 +/- 18.4 hours after intravenous administration of vitamin K-1. In 10 neonates a second sample w as obtained 111.8 +/- 49.1 hours after the first vitamin K-1 administration . Gas chromatography-mass spectrometry (GC-MS) was used as the method for d etermination of vitamin K-1. The measured plasma concentration after intrav enous administration of vitamin K-1 was 191.3 +/- 102.6 ng vitamin K in the first sample /mL in the first sample and 98.7 +/- 75.2 ng vita min K-1/mL in the second samples. These results are similar to those described in newb orns after oral administration of 3 mg vitamin K-1 and after intramuscular administration of 1.5 mg vitamin K-1. In conclusion, the recommendation of the producer to give 0.4 mg/kg of vitamin K intravenously to neonates, in w hom oral or intramuscular administration is not feasible, seems to be ratio nal. (C) 2000 Elsevier Science Ltd. All rights reserved.