menadiol sodium diphosphate: clinical use

Prescribing considerations

• Confirm that bleeding or threatened bleeding is associated with low prothrombin or factor VII; obstructive jaundice is the principal licensed setting.
• Review pregnancy status, patient age, anticoagulant therapy and disorders affecting lactose handling.
• Consider susceptibility to haemolysis, particularly glucose-6-phosphate dehydrogenase deficiency or low alpha-tocopherol concentrations.

Contraindications and cautions

• Neonates and infants.
• Late pregnancy and the period around childbirth.
• Rare hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.

Monitoring

• Review anticoagulant response when used with vitamin K antagonist anticoagulants.
• Assess promptly for haemolysis if anaemia, pallor or jaundice develops.

Clinical pharmacology

A water-soluble vitamin K analogue supporting formation of prothrombin and factors VII, IX and X. Menadione is absorbed from the gastrointestinal tract without dependence on bile salts and is rapidly metabolised and excreted.

Formulation and product differences

• The selected product is an oral, scored tablet that can be divided into equal portions.
• It contains lactose monohydrate and should be kept in its original container to protect it from light.

Tablet

Route: Oral

Strengths: 10 mg