[e-drug] Vitamine K1 (phytomenadione) and K3 (menadione)

["Wilbert Bannenberg" <wjb@wxs.nl>]

E-DRUG: Vitamine K1 (phytomenadione) and K3 (menadione)
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A draft African EML contains both oral and injectable forms of phytomenadione (vit K1) and menadione (vit K3).

WHO/EML14 lists only phytomenadione (K1) injection, 10 mg/ml in 5-ml ampoule and a tablet, 10 mg.
There is no squared box.
Phytomenadione is the naturally occurring vitamine K.

According to the WHO EML database:

"Every sick newborn should receive vitamin K intramuscularly to help prevent haemorrhagic disease. If the newborn is bleeding and does not stop within two hours after the first dose of vitamin K, the dose must be repeated. Every newborn with excessive bleeding should be treated as having possible sepsis.

Administration of vitamin K to the newborn baby by injection or orally depends on country policy. However, the evidence for routine administration of vitamin K to all newborns to prevent the relatively rare haemorrhagic disease of the newborn is still lacking."

Menadione (K3) is a synthetic lipid-soluble vit-K analogue. 

Martindale says "It may be used for the prevention of vitamin-K deficiency in patients with malabsorption syndrome". 

Is this any reason to have this K3 in addition to K1 on an essential drugs list?
If so, should the oral form be enough, or is the injection also needed?

Your comments are appreciated!

regards

Wilbert 

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Dr Wilbert Bannenberg, Public Health Consultant
Mobile +31-6-20873123
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Email: wjb@wxs.nl 
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