The incidence of anaphylaxis following intravenous phytonadione (vitamin K1): a 5-year retrospective review

Riegert–Johnson, Douglas L.; Volcheck, Gerald W.

doi:10.1016/s1081-1206(10)62042-x

Cited by 110 publications

(60 citation statements)

References 32 publications

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“…The reactions were similar between the 2 and were characterized by dyspnea and chest tightness, resolving within 15 minutes after stopping the infusion. 17 Riegert-Johnson and Volcheck 18 conducted a retrospective review of IV vitamin K1 administered at a large academic medical center between March 1995 and December 2000. Their objective was to determine the incidence of anaphylaxis after IV vitamin K1.…”

Section: Retrospective Cohort Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

“…18,21,23,24,26,30,31 Of these, 3 also met the suggestions of the American College of Chest Physicians (ACCP) guidelines with total infusion times of at least 20 minutes. 18,26 Of the 10 reactions detailing previous vitamin K1 exposure, 6 had previously received some form of vitamin K1. 25,26,29,30,32 Two cases reported on patients with prior reactions to other medications formulated with PEO-CO. 19,22 Five cases described rechallenge of the patient with vitamin K1 22,23,25,31,32 , 2 of which resulted in recurrence of the reaction.…”

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confidence: 99%

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Characterizing the Severe Reactions of Parenteral Vitamin K1

Britt

Brown

2016

Clin Appl Thromb Hemost

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Parenteral vitamin K1 (phytonadione) is used for anticoagulant reversal, and a boxed warning exists with intravenous and intramuscular administration due to the possibility of severe reactions, including fatalities. These reactions resemble hypersensitivity or anaphylaxis, including anaphylactoid reaction, and have led to shock and cardiac and/or respiratory arrest. The objective of this review is to summarize the available literature detailing the anaphylactic/anaphylactoid reactions with parenteral vitamin K1 in order to better characterize the reaction and provide a more in-depth understanding of its importance. A comprehensive literature search of MEDLINE (1946 to June 2016) and EMBASE (1947 to June 2016) was conducted using the terms vitamin K1, phytonadione, phytomenadione, vitamin K group, anaphylaxis, polyoxyethylated castor oil, and cremophor. A total of 2 retrospective surveillance studies, 2 retrospective cohort studies, and 17 case reports were identified for inclusion and assessment. Based on a review of the literature, use of parenteral vitamin K1 may result in severe hypotension, bradycardia or tachycardia, dyspnea, bronchospasm, cardiac arrest, and death. These reactions are most consistent with a nonimmune-mediated anaphylactoid mechanism. It appears that intravenous administration is more frequently associated with these reactions and occurs at an incidence of 3 per 10 000 doses of intravenous vitamin K1. The solubilizer may also increase the risk of adverse reactions, which occurred in patients with and without previous exposure to vitamin K1. Although there are known factors that increase the risk of an adverse drug event occurring, reactions have been reported despite all precautions being properly followed.

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Section: Retrospective Cohort Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Characterizing the Severe Reactions of Parenteral Vitamin K1

Britt

Brown

2016

Clin Appl Thromb Hemost

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“…18,19 There is a small risk of an allergic reaction in the form of an anaphylactoid reaction (3 in 10,000), but this should not preclude this route of administration, particularly in the bleeding or surgical population. 20,21 Many of the allergic reactions associated with vitamin K in the past may well have been better attributed to the use of polyethoxylated castor oil preservative (cremophor) and the rate of administration (intravenous push). Vitamin K should be administered as a slow infusion over 30 min, where possible.…”

Section: Monitoringmentioning

confidence: 99%

Reversal of vitamin K antagonists prior to urgent surgery

Grobler

Callum

McCluskey

2010

Can J Anesth/J Can Anesth

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Purpose The purpose of this article is to review the effective options for the reversal of vitamin K antagonists (warfarin and it coumarin analogues) and to help identify the option best suited for the patient requiring urgent surgery. Principal findings Vitamin K antagonists, the mainstay in long-term anticoagulation therapy, can be reversed with the administration of vitamin K, frozen plasma (FP), recombinant factor VIIa (rFVIIa), or the recently approved four-factor prothrombin complex concentrate (PCC), OctaplexÒ. While there is little evidence to suggest a superiority of PCC over FP, the availability of PCC in Canada is an important therapeutic addition requiring a thorough understanding of its pharmacology and risk benefit profile for the reversal of vitamin K antagonists. The use of PCC in the management of microvascular bleeding should be limited to very specific indications and should not be indicated in the routine management of massive blood loss. Conclusions In order to limit the blood loss associated with surgery and the management of uncontrolled bleeding, PCC is an important addition to our therapeutic armamentarium in the reversal of vitamin K antagonists.

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“…17,18 However, it has unpredictable effects on the INR; 19,20 we and others have recommended that intravenous vitamin K is preferred to subcutaneous vitamin K if rapid deceases in the INR are desired.…”

Section: Management Of the Non-bleeding Patient With High Inrmentioning

confidence: 99%

Management of Excessive Anticoagulant Effect Due to Vitamin K Antagonists

Dentali

Crowther²

2008

Hematology

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Coagulation factor replacement is required given the need to urgently correct the INR; however, vitamin K should not be forgotten since it is required to antagonize the effect of warfarin, preventing "rebound" anticoagulation after transfused coagulation factors are consumed. This paper will review the evidence supporting various treatment modalities and will provide suggestions for treatment. Future advances in this area will likely focus on evaluations of the relative merits of FFP and PCCs.

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The incidence of anaphylaxis following intravenous phytonadione (vitamin K1): a 5-year retrospective review

Cited by 110 publications

References 32 publications

Characterizing the Severe Reactions of Parenteral Vitamin K1

Characterizing the Severe Reactions of Parenteral Vitamin K1

Reversal of vitamin K antagonists prior to urgent surgery

Management of Excessive Anticoagulant Effect Due to Vitamin K Antagonists

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