Mephyton

Generic name: Phytonadione

Drug class: Anticoagulant reversal agents, Vitamins

Dosage form: Tablets (5 mg)

Root of administration: Oral

Dose: 2.5 to 10 mg initially; up to 25 mg or 50 mg in severe cases. Repeat doses may be given based on prothrombin time response or clinical condition.

Mechanism of action: Phytonadione is a synthetic form of vitamin K1, essential for the synthesis of clotting factors II, VII, IX, and X in the liver. It promotes the conversion of inactive precursors into active coagulation factors, thereby aiding in blood clot formation.

Drug usage cases:

• Anticoagulant-induced hypoprothrombinemia caused by coumarin or indanedione derivatives
• Hypoprothrombinemia secondary to antibacterial therapy
• Hypoprothrombinemia secondary to obstructive jaundice or biliary fistulas (with concurrent bile salts administration)
• Hypoprothrombinemia secondary to malabsorption syndromes (e.g., celiac disease, cystic fibrosis)
• Other drug-induced hypoprothrombinemia

Drug contraindications:

• Hypersensitivity to phytonadione or any component of the formulation

Side effects:

• Severe hypersensitivity reactions, including anaphylactoid reactions and deaths (more prevalent with intravenous administration)
• Transient “flushing sensations” and “peculiar” sensations of taste
• Dizziness
• Rapid or weak pulse
• Profuse sweating
• Brief hypotension
• Dyspnea
• Cyanosis
• Hyperbilirubinemia (with high doses)

Warnings:

• Does not counteract the effects of heparin
• Use with caution in patients with hepatic disease
• Absorption requires endogenous bile supply; avoid oral administration if bile secretion is impaired
• Use with caution in elderly patients due to potential decreased hepatic, renal, or cardiac function
• Use with caution in premature infants due to risk of hemolysis, jaundice, and hyperbilirubinemia
• Monitor prothrombin time regularly during therapy

Use during pregnancy or breastfeeding:

Phytonadione is present in breast milk. There are no data on the effects of Mephyton on the breastfed child or on milk production. The developmental and health benefits of breastfeeding should be considered along with the clinical need for Mephyton and any potential adverse effects on the breastfed child from Mephyton or from the underlying maternal condition.