Classes
DEA Class; Rx, OTC
Common Brand Names; Drisdol, Calciferol, cholecalciferol, 1,25-Dihydroxycholecalciferol, ergocalciferol
- Vitamins D
- Vitamins, Fat-Soluble
Description
Stimulates calcium and phosphate absorption from small intestine; stimulates phosphate resorption at renal tubule; stimulates secretion of calcium into blood from bone
Like calcium, it keeps your bones strong and helps your nerves carry messages. It also plays a role in fighting germs. Careful time in the sun — 10 to 15 minutes on a clear day, without sunscreen — is the best source. Or you could eat fish such as salmon, tuna, and mackerel. There’s a little in egg yolks, too. You can also get milk and sometimes orange juice with added vitamin D.
Nutrition
Sources: Fish, beef, cod liver oil, egg yolk, liver, chicken breast and cereals.
Indications
Vitamin D is also known as the “sunshine vitamin,” since it is made by the body after being in the sun. Ten to 15 minutes of sunshine 3 times a week is enough to produce the body’s requirement of vitamin D for most people at most latitudes. People who do not live in sunny places may not make enough vitamin D. It is very hard to get enough vitamin D from food sources alone. Vitamin D helps the body absorb calcium. You need calcium for the normal development and maintenance of healthy teeth and bones. It also helps maintain proper blood levels of calcium and phosphorus.
Also Indicated For
- Osteoporosis
- Hypoparathyroidism
- Vitamin D-Resistant Rickets
- Familial Hypophosphatemia
- Nutritional Supplementation
Contraindications
Hypercalcemia
Hypervitaminosis D
Ergocalciferol (oral): Gastrointestinal (GI), liver, or biliary disease associated with malabsorption of vitamin D analogues
Documented hypersensitivity with drugs that could have allergenic crossreactivity with ergocalceferol
Adverse Effects
- Arrhythmias
- Confusion
- Constipation
- Dry mouth
- Headache
- Hypercalcemia
- Lethargy
- Metallic taste
- Muscle or bone pain
- Nausea
- Sluggishness
- Vomiting
Warnings
Ergocalciferol: Use with caution in renal impairment (strong caution), heart disease, kidney stones, arteriosclerosis
Obtain serum calcium twice weekly during titration
Discontinue if patient becomes hypercalcemic
Presence of tartrazine in some products may cause allergic reactions
Vitamin D toxicity may last ≥2 months after therapy is discontinued
Restrict intake in infants with idiopathic hypercalcemia
Concurrent use of cardiac glycosides
Adequate clinical response to vitamin D therapy is dependent on adequate dietary calcium
Maintain normal serum phosphorous concentrations in patients treated for hyperphosphatemia to prevent metastatic calcification
When treating hypoparathyroidism, concomitant treatment with intravenous calcium, parathyroid hormone, and/or dihydrotachysterol may also be required
Adults with a body mass index (BMI) greater than 30 kg/m² are at high risk for vitamin D deficiency due to storage of vitamin D in adipose tissue; doses higher than recommended daily allowance may be required, but must be carefully monitored to avoid toxicity
Metabolism of vitamin D may be altered in patients with chronic kidney disease
In renal impairment, supplementation with ergocalciferol may be necessary; monitor closely
Pregnancy and Lactation
Pregnancy category: C (ergocalciferol)
Lactation: Drug is distributed into breast milk; use with caution
Maximum Dosage
Nutritional Supplementation
Recommended daily allowance (RDA)
19-70 years: 600 IU (15 mcg)/day
Pregnant or lactating women: 600 IU (15 mcg)/day
Osteoporosis
Prophylaxis and treatment
>50 years: 800-1000 IU (20-25 mcg) PO once daily with calcium supplements
Hypoparathyroidism
50,000-200,000 IU (0.625-5 mg) PO once daily with calcium supplements
Vitamin D-Resistant Rickets
12,000-500,000 IU (0.3-12.5 mg) PO once daily
Familial Hypophosphatemia
10,000-60,000 IU (0.25-1.5 mg) PO once daily with phosphate supplements
How supplied
Vitamin D (Calciferol)
1 mcg = 40 international units (IU)
oral solution
- 8000IU/mL (200mcg/mL)
capsule
- 50,000IU (1.25mg)
tablet
- 400IU (10mcg)
- 2000IU (50mcg)