NAME OF THE MEDICINAL PRODUCT QUALITATIVE AND QUANTITATIVE COMPOSITION
Each soft gelatin capsule contains 1mg phytomenadione. For a full list of excipients, see section 6.1.
PHARMACEUTICAL FORM
Capsule, soft The dark brown soft capsule contains a clear, odourless pale yellow liquid.
CLINICAL PARTICULARS Therapeutic indications
Neokay is indicated for the prevention of vitamin K deficiency bleeding in babies
Posology and method of administration Oral prophylaxis in healthy neonates, including healthy preterm babies: The contents of a single Neokay capsule should be administered by cutting the narrow tubular tip off the capsule and squeezing the liquid into the baby’s mouth. Another dose should be given if the first dose is spat out or the baby is sick within three hours of the dose being given. Unwell babies and babies of mothers taking carbemazepine, phenobarbital, phenytoin, rifampicin or warfarin at the time of delivery: Babies who are not well enough to be fed within a few hours of birth and babies whose mothers are taking any of the above drugs should be treated with an intramuscular formulation of vitamin K at birth. Exclusively breast fed babies: The administration of 1mg Neokay by mouth at birth protects healthy term babies from the risk of bleeding due to vitamin K deficiency in the first week of life. Evidence to date suggests that for babies who are being exclusively breast-fed, a dose of 1mg once weekly for 12 weeks offers the best protection against late vitamin K deficiency bleeding.
Contraindications
Do not give further doses of Neokay to any baby showing evidence of hypersensitivity to any of the constituents.
Special warnings and precautions for use
Take expert advice before giving Neokay to any baby with protein C or protein S deficiency currently on treatment with warfarin.
Interaction with other medicinal products and other forms of interaction
Vitamin K acts as an antidote to the anticoagulant drugs of the coumarin type therefore concomitant use is not recommended except in the treatment of warfarin overdosage. It is not an antidote to heparin.
Pregnancy and lactation Effects on ability to drive and use machines Undesirable effects
No adverse effects have been associated with oral administration
Overdose PHARMACOLOGICAL PROPERTIES Pharmacodynamic properties
Pharmacotherapeutic group: Vitamin K, ATC code: B02 BA01 Vitamin K is an essential co-factor in the hepatic synthesis of prothrombin (factor II) and of several other blood clotting factors (factor VII, IX, X and the coagulation inhibitors protein C and protein S). Low levels at birth may lead to the development of a generalised bleeding tendency (haemorrhagic disease of the new born).
Pharmacokinetic properties
Phytomenadione is a fat soluble vitamin which does not cross the placenta readily. There is relatively little in human milk. Cow’s milk contains more, and infant formula milks are artificially fortified. The half life in plasma is 2-3 hours. Vitamin K is absorbed from the small intestine and taken up by the liver but is only stored in the body for relatively short periods of time. Intra-muscular administration of phytomenadione in an emulsion may aid retention by setting up a “depot” muscle store. Bile salts aid absorption. The mixture of short and medium chain triglycerides contained in the Neokay formulation is readily absorbed, even in the absence of biliary and pancreatic secretions. The drug is metabolised to more polar metabolites and excreted in the urine and bile as glucuronide and sulphate conjugates.
Preclinical safety data PHARMACEUTICAL PARTICULARS List of excipients
Fractionated coconut oil (containing at least 95 percent of saturated 8 and 10 carbon atom fatty acids). The soft capsule shell consists of gelatin, glycerol, iron oxide red (E172), iron oxide black (E172) and purified water
Incompatibilities Shelf life Special precautions for storage
Do not store above 25°C. Do not freeze. Store in the original packaging. Nature and contents of container
Polypropylene plastic bottles with LDP/HDP blend caps. Containers contain soft gelatin capsules with pack sizes of 12 or 100.
Special precautions for disposal MARKETING AUTHORISATION HOLDER
Neoceuticals Limited The Innovation Centre Innovation Way Heslington York YO10 5DG
MARKETING AUTHORISATION NUMBER(S) DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION DATE OF REVISION OF THE TEXT
Depigmentation therapies for normal skin in vitiligouniversalis†Dermatology Department and ‡Vitiligo Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia*Correspondence: K.M. AlGhamdi. E-mail: [email protected] vitiligo involves most of the body, it might be easier to depigment the normal remaining skin rather than to attemptrepigmentation. We reviewed the liter
POST OPERATIVE INSTRUCTIONS 1. You will be sent home with a prescription for narcotic pain relievers. Initially take the narcotic as directed just like “clock work” the 24 to 48 hours. It is easier to stay a head of the pain than try to catch up. You may supplement with ibuprofen (Advil, Motrin) in between the narcotic doses. For example, 400mg (2 pills) ibuprofen then two hours later th