Mephyton (Phytonadione) Shortage: What Providers and Prescribers Need to Know in 2026

Clinicians prescribing phytonadione (formerly brand-name Mephyton) are encountering increasing reports from patients who cannot locate the medication at their local pharmacies. This guide provides a current clinical and operational overview so prescribers can counsel patients accurately and prepare appropriate management plans.

Summary: What Has Changed with Mephyton

Brand discontinued: Mephyton (phytonadione) 5 mg oral tablets have been discontinued by Bausch Health Americas. The product is listed in the FDA's Discontinued Drug Product List.

FDA ruling (December 2023): The FDA determined that Mephyton was not withdrawn for safety or efficacy reasons, clearing the way for continued ANDA approvals for generic phytonadione.

No active FDA shortage: As of 2026, phytonadione 5 mg oral tablets are not listed on the FDA Drug Shortages database. Generic versions from multiple manufacturers (Major, Zydus, Amneal) remain available.

Practical availability challenge: Despite no formal shortage, localized stocking gaps exist. Pharmacies with low phytonadione turnover may not routinely keep it on their shelves. Patients searching for 'Mephyton' by brand name may be told it's unavailable even when generic phytonadione is stocked.

Clinical Context: Who Is Most Affected?

Patients most likely to be affected by phytonadione availability challenges include:

Patients on warfarin (Jantoven) with supratherapeutic INR requiring outpatient oral reversal

Patients with vitamin K deficiency secondary to malabsorption syndromes (celiac disease, Crohn's disease, short bowel syndrome)

Patients with obstructive jaundice or biliary disease requiring supplemental vitamin K with concurrent bile salts

Patients on prolonged antibiotic therapy who have depleted intestinal flora-derived vitamin K

Prescribing Guidance: Writing the Prescription Correctly

To minimize pharmacy lookup failures:

Write prescriptions as "phytonadione 5 mg oral tablet" rather than "Mephyton"—generic prescriptions search more successfully in pharmacy databases

Include DAW-0 (generic acceptable) on the prescription to ensure pharmacies don't reject on formulary grounds

Consider calling in advance to confirm the patient's preferred pharmacy stocks it

Clinical Alternatives When Oral Phytonadione Is Unavailable

The clinical decision tree depends on urgency:

Non-urgent / outpatient (e.g., mildly supratherapeutic INR, chronic deficiency): Delay up to 24 hours while pharmacy locates the tablets, or consider subcutaneous phytonadione (injection) in clinic if clinically appropriate.

Moderate urgency (significant INR elevation, no active bleeding): IV phytonadione 1-5 mg via slow infusion in a monitored setting. Research supports IV as a safe alternative when oral is unavailable (Afanasjeva 2017). Rapid INR correction with IV requires monitoring for overcorrection and transient warfarin resistance.

Urgent/emergent (serious or life-threatening bleeding): 4-factor PCC (Kcentra) is the agent of choice per ACCP guidelines, combined with IV phytonadione 10 mg to prevent INR re-elevation. FFP is an acceptable alternative if PCC is unavailable.

Key Safety Reminders for IV Phytonadione

Severe hypersensitivity reactions including anaphylaxis and death have been reported—IV route should only be used when clinical benefit clearly outweighs risks

IV infusion rate must not exceed 1 mg/minute; administer in a monitored clinical setting

Use a filter needle when drawing from glass ampules to avoid glass particle contamination

Preservative-free formulations preferred for use during lactation

Helping Patients Find Phytonadione

Pointing patients toward effective search tools reduces the burden on your practice. medfinder for providers enables patients to submit their prescription details and have local pharmacies called to check for availability—saving time for both the patient and your clinical staff.

For more information on how to guide patients effectively, see our provider's guide to helping patients find phytonadione in stock.