[2][3][6] Vitamin K can be delivered into the body via the oral, subcutaneous, intramuscular, or intravenous routes of administration.

Specifically, a boxed warning for IV and IM usage dictates the possible occurrence of mortality or severe reactions.

[10] There has been some evidence to suggest that vitamin K could increase insulin sensitivity in diabetic men as well as help keep INR values from fluctuating for individuals on warfarin therapy.

Unpreserved vitamin K should be used in nursing mothers to eliminate the chance of benzyl alcohol exposure via breastmilk.

[1]: 123 [16] Vitamin K reactions can occur on the skin but due to its varying presentation, healthcare providers have a difficult time diagnosing it.

The first is a local reaction of itchiness, eczema-like texture, indurated erythema on the skin at the injection site.

Intravenous vitamin K admission had reports of low blood pressure, shortness of breath, flushing, and other serious allergic reactions.

These type of reactions have been more commonly observed in those that are administered parental vitamin K1 through an IV versus SQ, IM or oral tablets.

More importantly, such cases have been associated with mortality which is why the prescribing guidelines indicate and recommends SQ for parental vitamin K1.

On the other hand, the British Committee for Standards in Haematology as well as the ACCP guidelines discourages SQ and IM because they have variable and unforeseeable absorption.

[6] Vitamin K may be given to children in the case of deficiency, hemorrhagic disease of newborn, malabsorption syndrome, cystic fibrosis, biliary atresia, hepatic failure, and an antidote to warfarin.

[27] Thus, by inhibiting vitamin K, a key element by which the body produces clots, the risk of prolonged bleeding increases.

[26][28] In situations where rapid reversal is necessary for those on warfarin, such as in the case of major hemorrhage or surgery, 4-factor prothrombin complex concentrate (4F-PCC) is used with vitamin K to neutralize the effects of VKAs.

Intravenous vitamin K should only be given in emergencies where benefits outweigh risks when compared to alternative options, as in the case of oral anticoagulant overdose.