Hemolytic anemia menadione toxicity

As the above mentioned studies with high supplementation dosages exemplarily show, there is no known toxicity for phylloquinone (vitamin Kl), although allergic reactions are possible. This is NOT true for menadione (vitamin K3) that can interfere with glutathione, a natural antioxidant, resulting in oxidative stress and cell membrane damage. Injections of menadione in infants led to jaundice and hemolytic anemia and therefore should not be used for the treatment of vitamin K deficiency. 

Menadione and its water-soluble derivatives are potentially toxic in excess and have been reported to cause hemolytic anemia, hyperbilirubinemia, central nervous system toxicity, and methemoglobinemia in the newborn. 

The toxicity associated with excessive amounts of vitamin K in humans has not been unequivocally defined, although it has been suggested that excessive doses of one of its forms, menadione, can contribute to the occurrence of hemolytic anemia, jaundice, kemicterus, and hyperbilirubinemia (Worthington-Roberts, 1988). 

Toxicity. The major problem (Table 5) with therapeutic vitamin K administration is anaphylactoid reactions (Barash, 1978). Menadione and vitamin K in large doses have resulted in hematologic and circulatory effects. Hemolytic anemia, methemoglobinuria, polycythemia, and organ dysfunction have been noted. The effect on the hemopoietic system seems directly related to damage of the circulating red cells and by action of the quinone radical (Richards and Shapiro, 1945). 

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See also in sourсe #XX -- [ ]

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