植甲萘醌 (維生素K1)
Phytonadione (Vitamin K1)
Phylloquinone (2-methyl-3-phytyl-1,4-naphthoquinone)
別名: 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
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
牛
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
豬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
羊
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
山羊
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
植甲萘醌 (維生素K1) 是一種合成的脂溶性維生素，與天然存在的維生素K1相同。它是獸醫學中關鍵的解毒劑，主要用於逆轉因攝入抗凝血殺鼠劑（如華法林、溴鼠隆等）引起的凝血障礙。
主要臨床應用包括：
- 抗凝血殺鼠劑中毒： 治療的核心。第二代殺鼠劑半衰期極長，通常需要連續補充維生素K1長達3-4週。
- 甜苜蓿中毒： 用於反芻動物，治療因發霉甜苜蓿引起的雙香豆素中毒。
- 肝臟疾病： 作為急性肝衰竭或膽道阻塞（影響維生素K吸收或利用）的輔助治療。
- 磺胺喹噁啉中毒： 逆轉與此抗球蟲藥相關的出血性疾病。
臨床要點： 維生素K1 (植甲萘醌) 對這些中毒有效，而維生素K3 (甲萘醌) 無效且具有較高的毒性風險。植甲萘醌需要6-12小時才能合成新的凝血因子；因此，對於正在出血的病患，必須立即輸注血漿或全血以提供活性凝血因子。
作用機制
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.
安全性與警告
禁忌症
- 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)
不良反應
- 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)
注意事項
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.
藥物相互作用
May decrease the numbers of Vitamin K-producing bacteria in the gut, though chronic therapy usually has no significant effect on phytonadione absorption.
Concomitant oral administration may reduce the GI absorption of oral Vitamin K.
Phytonadione directly antagonizes the anticoagulant effects of these drugs.
May prolong or enhance the effects of anticoagulants, thereby antagonizing some of the therapeutic effects of phytonadione.
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
Antagonizes the effects of vitamin K
May decrease gut flora production of vitamin K, though clinically minor when exogenous K1 is supplemented
May exacerbate bleeding tendencies through platelet inhibition
監測
- Clinical efficacy (resolution or lack of hemorrhage, pale mucous membranes, weakness)
- One-stage prothrombin time (OSPT / PT)
- Proteins Induced by Vitamin K Absence (PIVKA)
- International Normalized Ratio (INR)
- Prothrombin time (PT) is the best method of monitoring therapy
- Prothrombin Time (PT) - typically normalizes within 12-24 hours of starting therapy
- Activated Partial Thromboplastin Time (aPTT)
- PIVKA (Proteins Induced by Vitamin K Absence or Antagonism)
- Clinical signs of bleeding (mucous membranes, heart rate, respiratory rate)
藥物動力學
半衰期
吸收
Absorbed from the GI tract via intestinal lymphatics, requiring bile salts. Oral absorption is significantly enhanced (4-5 times in dogs) when administered with fatty foods. SC or PO doses may be poorly absorbed in hypovolemic animals.
分佈
Concentrates in the liver for a short period but is not appreciably stored in the liver or other tissues. Small amounts cross the placenta. Enters maternal milk.
代謝
Rapidly metabolized in the liver to polar metabolites.
排除
The exact elimination pathways of Vitamin K1 are not completely understood, but metabolites are excreted in bile and urine.
過量
Phytonadione is relatively non-toxic. It is highly unlikely that toxic clinical signs would result after a single overdosage. However, inappropriate routes of administration (like rapid IV injection) can cause severe anaphylactoid reactions regardless of the dose.
可用產品
劑型
- Oral capsules
- Oral chewable tablets
- Aqueous colloidal solution for injection
- Emulsion for injection
- Injectable: 10 mg/ml
- Oral: 50 mg tablets
- Nutraceuticals (containing small amounts)
- Injectable solution (10 mg/ml)
- Oral tablets (10 mg, 25 mg, 50 mg)
獸醫用
- Phytonadione Oral Capsules: 25 mg, 50 mg (K-Caps, Veda-K1, Veta-K1, Vitamin K1 Double Strength)
- Phytonadione Oral Tablets, Chewable: 25 mg, 50 mg (Vitamin K1 Chewable, K-Chews)
- Phytonadione Aqueous Colloidal Solution for Injection: 10 mg/mL (K-Ject, Veda-K1, Vita-Jec)
- Vitamine K1 Laboratoire TVM
- Konakion
- Vitamin K1 Injection (10 mg/ml)
- Vitamin K1 Tablets (10 mg, 50 mg)
人用標示
- Phytonadione Oral Tablets: 5 mg (Mephyton)
- Phytonadione Injection, Emulsion: 2 mg/mL & 10 mg/mL
- Konakion (Phytomenadione) injection (10 mg/ml)
- Konakion tablets (10 mg)
各地核准狀態
Widely approved across EU member states for veterinary use.
Available as authorized veterinary medicines.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Phytonadione is highly sensitive to light and must be protected from light at all times. Store tablets and capsules in well-closed, light-resistant containers. If used as an IV infusion, the container and tubing should be wrapped with an opaque material.
飼主須知
- 嚴格遵守給藥時間表： 因為現代老鼠藥（第二代殺鼠劑）在體內停留的時間非常長，所以必須完整按照指示的療程（通常為3-4週）給藥。提早停藥可能會導致突然且危及生命的內出血。
- 與食物一起餵食： 將口服維生素K1與高脂肪食物（如罐頭食品、少量起司或花生醬）一起餵食，可以顯著提高藥物吸收到血液中的比例。
- 限制活動： 在治療期間，請讓您的寵物保持安靜並嚴格限制活動（僅限牽繩散步，禁止跳躍或激烈玩耍），以盡量減少因輕微碰撞而導致瘀傷或內出血的風險。
- 後續檢測： 您的獸醫通常需要在最後一劑維生素K1給藥後約48小時，重新檢查您寵物的血液凝固時間，以確保毒素已完全排出體外。
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。