Vitamin K Supplementation Guidelines

Standard Daily Recommendations

• The Institute of Medicine recommends 120 μg/day for adult males and 90 μg/day for adult females 1

Context-Specific Supplementation Amounts

• After biliopancreatic diversion, provide 300 μg vitamin K daily as part of routine supplementation due to malabsorption risk 2, 3, 4
• For parenteral nutrition, provide at least 150 μg phylloquinone per day in addition to amounts naturally present in lipid emulsions 5

Treatment of Vitamin K Deficiency

• Initial treatment for documented deficiency is 10 mg intramuscularly or subcutaneously 6, 4
• Maintenance after deficiency correction is 1-2 mg/week parenterally or orally 6, 3, 4
• Oral treatment for deficiency is 1-2 mg daily using menadiol sodium phosphate or phytomenadione 6

Critical Contraindication

• Patients on anticoagulants, such as warfarin, should not receive vitamin K supplements, as this interferes with anticoagulation control, according to the KDOQI guidelines 7, 5

Special Populations

• Patients with fat malabsorption are at high risk for deficiency and may require higher supplementation doses 8, 1

Important Clinical Considerations

• Natural forms of vitamin K have no proven toxicity at typical supplementation doses, and the upper tolerable limit is not established due to lack of toxicity concerns 8
• Plasma vitamin K levels less than 0.15 μg/L indicate deficiency, and undercarboxylated protein measurements can also be used to assess vitamin K status 8