netFormulary NHS
Nottinghamshire Area Prescribing Committee
Joint Formulary
 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.06.06  Expand sub section  Vitamin K
Menadiol Sodium Phosphate
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Amber 2

Tablet 10mg  

  • Water soluble preparation of Vitamin K - to be used in patients with hepatic disease or biliary obstruction (including during pregnancy).
  • ~£2.50 per tablet vs phytomenadione ~£1.50 per tablet.
  • Tablets disperse in water if needed. See here for general advice on dispersing tablets. Liquid can be made specially if required - SFH: send patients to KMH pharmacy for supplies
Link  National guidance on vitamin K in obstetric cholestasis: UKMI Q+A
View adult BNF View SPC online View childrens BNF

Tablets 10mg (Phyto-K®) (~£1.50 per tablet vs menadiol ~£2.50 per tablet)

Ampoule 2mg in 0.2ml (Konakion® MM Paediatric)

Injection 10mg in 1ml (Konakion® MM)

Gel filled capsules 1mg (Snip-off-tip)(Neokay®)

Tablets (Vitacon®)  Restricted Restricted 

  • Unlicensed medicine
  • NUH: Only to be used during the supply problem with menadiol 10mg tablets.  For use in patients with Cystic Fibrosis.
Link  NUH: Haemostasis and Thrombosis protocols
Link  SFH: Anticoagulant clinical guidelines
Link  UKMI Q&A: Guidance on the use of vitamin K for obstetric cholestasis
Link  Vitamin K (phytomenadione) pharmacy information
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
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Link to SPCs
Scottish Medicines Consortium
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Controlled Drug
High Cost Medicine
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Cancer Drugs Fund
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Traffic Light Status Information

Status Description


Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.


Medicines which should normally be prescribed by specialists only. eg hospital only.
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

Amber 1

Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.

Amber 2

Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
*Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice

Amber 3

Primary care/ non specialist may initiate as per APC guideline.
The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.


Medicines suitable for routine use within primary care.
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.