피토나디온 (비타민 K1)

Phytonadione (Vitamin K1)

Phylloquinone (2-methyl-3-phytyl-1,4-naphthoquinone)

해독제, 지용성 비타민POSCIMIV (Not recommended/Extreme caution)개고양이소형 포유류새말소돼지양염소

다른 이름: K-Caps · Veda-K1 · Veta-K1 · K-Chews · K-Ject · Vita-Jec · Aqua-Mephyton · Konakion · Vitamine K1 Laboratoire TVM · Vitamin K1 · K-1 · methylphytylnaphthochinonum · phylloquinone · phytomenadionum · phytomenadione · Phytonadione · Methylphytylnaphthoquinone

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

1-5 mg/kg PO or SC q24hPO, SC· q24h

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
Adjunctive therapy of acute liver failure	1-5 mg/kg PO or SC q24h	PO, SC	q24h	—	🌎 NA
Anticoagulant rodenticide toxicity (exposed but non-bleeding)	1.25-2.5 mg/kg PO twice daily with a fatty meal	PO	q12h	2-4 weeks	🌎 NA
Anticoagulant rodenticide toxicity (bleeding patient)	2.5 mg/kg PO twice daily with a fatty meal	PO	q12h	minimum of 4 weeks	🌎 NA
Anticoagulant rodenticide toxicity (symptomatic)	Loading dose of 2.5-5 mg/kg PO, then 3-5 mg/kg PO divided twice daily	PO	q12h	14 days (1st gen) or at least 30 days (2nd gen/unknown)	🌎 NA
Known 1st generation coumarin toxicity or vitamin K1 deficiency	initially 2.5 mg/kg s.c. in several sites, then 1-2.5 mg/kg in divided doses p.o.	SC/PO	q8-12h	5-7 days	🌍 EU
Known 2nd generation coumarin (brodifacoum) toxicity	initially 5 mg/kg s.c. in several sites, then 2.5 mg/kg p.o.	SC/PO	q12h	3 weeks	🌍 EU
Known inandione (diphacinone) or unknown anticoagulant toxicity	initially 2.5-5 mg/kg s.c. over several sites. Then 2.5 mg/kg p.o. divided	SC/PO	q8-12h	3-4 weeks	🌍 EU
Liver disease (pre-biopsy)	0.5-1.0 mg/kg	SC	q12h	1-2 days	🌍 EU

Anticoagulant rodenticide toxicity (exposed but non-bleeding): Only give SC with starting dose if patient is vomiting or activated charcoal was administered.
Anticoagulant rodenticide toxicity (bleeding patient): Plasma/blood transfusions are a necessity. Re-examine clotting times 2-3 days following cessation of therapy.
Anticoagulant rodenticide toxicity (symptomatic): Check PT or PIVKA 48 hours after stopping therapy; if prolonged, continue for another week.
Known 1st generation coumarin toxicity or vitamin K1 deficiency: Administer SC initially, followed by oral maintenance.
Known 2nd generation coumarin (brodifacoum) toxicity: Restrict activity for 1 week post-treatment. Re-evaluate coagulation status 3 weeks after cessation of treatment.
Known inandione (diphacinone) or unknown anticoagulant toxicity: Re-evaluate coagulation status 2 days after stopping therapy. If PT is elevated, continue therapy for 2 additional weeks. If normal, rest for 1 week.
Liver disease (pre-biopsy): Re-evaluate coagulation time before biopsy. If minimal improvement, fresh frozen plasma may be required.

고양이

적응증	용량	경로	빈도	기간	지역
Adjunctive therapy of acute liver failure	1-5 mg/kg PO or SC q24h	PO, SC	q24h	—	🌎 NA
Anticoagulant rodenticide toxicity (exposed but non-bleeding)	1.25-2.5 mg/kg PO twice daily with a fatty meal	PO	q12h	2-4 weeks	🌎 NA
Anticoagulant rodenticide toxicity (bleeding patient)	2.5 mg/kg PO twice daily with a fatty meal	PO	q12h	minimum of 4 weeks	🌎 NA
Anticoagulant rodenticide toxicity (symptomatic)	Loading dose of 2.5-5 mg/kg PO, then 3-5 mg/kg PO divided twice daily	PO	q12h	14 days (1st gen) or at least 30 days (2nd gen/unknown)	🌎 NA
Known 1st generation coumarin toxicity or vitamin K1 deficiency	initially 2.5 mg/kg s.c. in several sites, then 1-2.5 mg/kg in divided doses p.o.	SC/PO	q8-12h	5-7 days	🌍 EU
Known 2nd generation coumarin (brodifacoum) toxicity	initially 5 mg/kg s.c. in several sites, then 2.5 mg/kg p.o.	SC/PO	q12h	3 weeks	🌍 EU
Known inandione (diphacinone) or unknown anticoagulant toxicity	initially 2.5-5 mg/kg s.c. over several sites. Then 2.5 mg/kg p.o. divided	SC/PO	q8-12h	3-4 weeks	🌍 EU
Liver disease (pre-biopsy)	0.5-1.0 mg/kg	SC	q12h	1-2 days	🌍 EU

Known 1st generation coumarin toxicity or vitamin K1 deficiency: Administer SC initially, followed by oral maintenance.
Known 2nd generation coumarin (brodifacoum) toxicity: Restrict activity for 1 week post-treatment. Re-evaluate coagulation status 3 weeks after cessation of treatment.
Known inandione (diphacinone) or unknown anticoagulant toxicity: Re-evaluate coagulation status 2 days after stopping therapy. If PT is elevated, continue therapy for 2 additional weeks. If normal, rest for 1 week.
Liver disease (pre-biopsy): Re-evaluate coagulation time before biopsy. If minimal improvement, fresh frozen plasma may be required.

소형 포유류

적응증	용량	경로	빈도	기간	지역
Anticoagulant rodenticide toxicity	5 mg/kg/day divided q8-12h	PO	q8-12h	—	🌎 NA
Anticoagulant rodenticide toxicity (symptomatic)	Loading dose of 2.5-5 mg/kg PO, then 3-5 mg/kg PO divided twice daily	PO	q12h	14-30 days	🌎 NA

Anticoagulant rodenticide toxicity: Give with a fatty meal (e.g., peanut butter). Do not give IV; SC can cause anaphylaxis.
Anticoagulant rodenticide toxicity (symptomatic): Treat pocket pets at the high end of this dosage range.

새

적응증	용량	경로	빈도	기간	지역
Hemorrhagic disorders	0.25-0.5 mL/kg IM of the 10 mg/mL injectable product	IM	—	—	🌎 NA
Hemorrhagic disorders	0.2-2.5 mg/kg IM as needed	IM	as needed	usually only 1-2 injections required	🌎 NA

Hemorrhagic disorders: Commonly used before surgery where hemorrhage is anticipated.
Hemorrhagic disorders: May also be used prophylactically when amprolium and sulfas are administered.

말

적응증	용량	경로	빈도	기간	지역
Warfarin (or related compounds) toxicity	500 mg SC q4-6h	SC	q4-6h	Until OSPT returns to normal	🌎 NA
Warfarin (or related compounds) toxicity	0.5-2.5 mg/kg IM, if IV use is necessary dilute in saline or D5W/saline and give very slowly (not to exceed 5 mg/minute)	IM, IV	—	—	🌎 NA

Warfarin (or related compounds) toxicity: Whole blood or fresh plasma may also be necessary early in treatment.
Warfarin (or related compounds) toxicity: Avoid IV if possible.

소

적응증	용량	경로	빈도	기간	지역
Anticoagulant rodenticide toxicity	Initially 0.5-2.5 mg/kg IV in D5W at a rate of 10 mg/minute. Subsequent doses may be given IM or SC.	IV, IM, SC	—	3-4 weeks for second generation agents	🌎 NA
Anticoagulant rodenticide toxicity	0.5-2.5 mg/kg IM, if IV use is necessary dilute in saline or D5W/saline and give very slowly (not to exceed 5 mg/minute)	IM, IV	—	—	🌎 NA
Acute hypoprothrombinemia with hemorrhage	0.5-2.5 mg/kg IV, not to exceed 10 mg/minute in mature animals and 5 mg/minute in newborn and very young animals	IV	—	—	🌎 NA
Non-acute hypoprothrombinemia	0.5-2.5 mg/kg IM or SC	IM, SC	—	—	🌎 NA
Sweet clover or lespedeza toxicity	1-1.5 mg/kg SC for several days	SC	q24h	several days	🌎 NA

Anticoagulant rodenticide toxicity: Avoid IV if possible.
Sweet clover or lespedeza toxicity: Remove from source, avoid stress/injury.

돼지

적응증	용량	경로	빈도	기간	지역
Warfarin (or related compounds) toxicity	0.5-2.5 mg/kg IM, if IV use is necessary dilute in saline or D5W/saline and give very slowly (not to exceed 5 mg/minute)	IM, IV	—	—	🌎 NA

Warfarin (or related compounds) toxicity: Avoid IV if possible.

양

적응증	용량	경로	빈도	기간	지역
Warfarin (or related compounds) toxicity	0.5-2.5 mg/kg IM, if IV use is necessary dilute in saline or D5W/saline and give very slowly (not to exceed 5 mg/minute)	IM, IV	—	—	🌎 NA

Warfarin (or related compounds) toxicity: Avoid IV if possible.

염소

적응증	용량	경로	빈도	기간	지역
Warfarin (or related compounds) toxicity	0.5-2.5 mg/kg IM, if IV use is necessary dilute in saline or D5W/saline and give very slowly (not to exceed 5 mg/minute)	IM, IV	—	—	🌎 NA

Warfarin (or related compounds) toxicity: Avoid IV if possible.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

진료 중이신가요? VetSheet의 AI가 약물, 용량, 투여 기간을 구조화된 진료 기록에 바로 기입합니다.VetSheet 작동 방식 보기

개요

피토나디온(비타민 K1)은 천연 비타민 K1과 동일한 합성 지용성 비타민입니다. 수의학에서 매우 중요한 해독제로, 주로 항응고성 살서제(예: 와파린, 브로디파쿰, 브로마디올론) 섭취로 인한 응고 장애를 역전시키는 데 사용됩니다.

주요 임상 적용:

항응고성 살서제 중독: 치료의 핵심입니다. 2세대 살서제는 반감기가 매우 길어 종종 3~4주간의 지속적인 비타민 K1 보충이 필요합니다.
스위트 클로버 중독: 반추동물에서 곰팡이가 핀 스위트 클로버로 인한 디쿠마롤 중독을 치료하는 데 사용됩니다.
간 질환: 비타민 K의 흡수나 이용이 손상된 급성 간부전 또는 담도 폐쇄 시 보조 요법으로 사용됩니다.
설파퀴녹살린 중독: 이 항콕시듐제와 관련된 출혈성 질환을 역전시킵니다.

임상 요점: 비타민 K1(피토나디온)은 이러한 중독에 효과적이지만, 비타민 K3(메나디온)는 효과가 없고 독성 위험이 더 높습니다. 피토나디온이 새로운 응고 인자를 합성하는 데는 6~12시간이 걸립니다. 따라서 활동성 출혈이 있는 환자는 활성 응고 인자를 공급하기 위해 즉각적인 혈장 또는 전혈 수혈이 필요합니다.

작용 기전

Phytonadione is essential for the hepatic synthesis of Vitamin K-dependent coagulation factors (Factors II, VII, IX, and X).

Mechanism: In the liver, inactive precursors of these factors require γ-carboxylation of their glutamic acid residues to become functional. This carboxylation is catalyzed by the enzyme γ-glutamyl carboxylase, which requires the reduced form of Vitamin K (Vitamin K hydroquinone) as a cofactor.
The Vitamin K Cycle: During carboxylation, Vitamin K is oxidized to Vitamin K epoxide. The enzyme Vitamin K epoxide reductase (VKOR) recycles the epoxide back to the active hydroquinone form.
Anticoagulant Rodenticides → inhibit VKOR, depleting active Vitamin K and halting the production of functional clotting factors. Exogenous phytonadione bypasses this blockade, providing the necessary substrate to resume factor synthesis.

안전성·주의사항

금기사항

Known hypersensitivity to phytonadione or its components
Hypoprothrombinemia due to hepatocellular damage (Vitamin K cannot correct this if the liver cannot synthesize the protein precursors)
Intravenous administration (relative contraindication due to anaphylaxis risk)
Known hypersensitivity to phytomenadione
Intramuscular administration in severely coagulopathic patients (risk of severe hematoma)

부작용

Anaphylactoid reactions (especially following IV administration)
Acute bleeding from the injection site (IM administration during early stages of treatment)
Slow or poor absorption from SC or PO routes in hypovolemic patients
Anaphylactic reactions (following IV administration)
Haemolytic anaemia (in cats when overdosed)
Anaphylaxis (primarily with IV administration)
Injection site reactions (pain, swelling)
Hematoma formation at injection sites (due to underlying coagulopathy)

주의

Intravenous Administration Warning: The FDA-CVM warns against administering phytonadione IV due to a significant risk of severe anaphylactoid reactions. If IV use is absolutely necessary (e.g., severe bleeding with very high INR in large animals), it must be diluted and given extremely slowly.

Injection Site Bleeding: IM injections can cause acute bleeding at the site in coagulopathic patients. Use small-gauge needles for SC or IM injections.

Delayed Onset: It takes 6-12 hours for new clotting factors to be synthesized. Emergency needs for clotting factors in actively bleeding patients MUST be met with blood products (fresh frozen plasma or whole blood).

Absorption: SC or PO doses may be poorly absorbed in hypovolemic animals. Oral absorption requires bile salts and is significantly enhanced (4-5x) by administering with a fatty meal.

약물 상호작용

Oral Antibiotics

May decrease the numbers of Vitamin K-producing bacteria in the gut, though chronic therapy usually has no significant effect on phytonadione absorption.

Mineral OilModerate

Concomitant oral administration may reduce the GI absorption of oral Vitamin K.

Warfarin (and other coumarin/indanedione anticoagulants)

Phytonadione directly antagonizes the anticoagulant effects of these drugs.

Phenylbutazone, Aspirin, Chloramphenicol, Sulfonamides, Diazoxide, Allopurinol, Cimetidine, Metronidazole, Anabolic Steroids, Erythromycin, Ketoconazole, Propranolol, Thyroid Drugs

May prolong or enhance the effects of anticoagulants, thereby antagonizing some of the therapeutic effects of phytonadione.

AspirinModerate