How does Vitamin D 50000 IU affect the body. What are the potential side effects of high-dose Vitamin D. When should you consider taking Vitamin D supplements. How can you prevent Vitamin D toxicity.

Understanding Vitamin D: Essential Nutrient for Health

Vitamin D is a crucial nutrient that plays a vital role in maintaining overall health. It is often referred to as the “sunshine vitamin” because our bodies can produce it when our skin is exposed to sunlight. However, many people don’t get enough sunlight or have difficulty absorbing vitamin D, leading to the need for supplementation.

High-dose vitamin D supplements, such as 50,000 IU formulations, are sometimes prescribed to correct deficiencies or manage certain medical conditions. While these potent doses can be beneficial in specific situations, they also come with potential risks and side effects that users should be aware of.

The Importance of Vitamin D in the Body

Vitamin D serves several critical functions in the human body:

• Promotes calcium absorption for strong bones and teeth
• Supports immune system function
• Aids in cell growth and differentiation
• Helps regulate mood and reduce depression
• May play a role in preventing certain cancers and chronic diseases

Given its wide-ranging impact on health, maintaining adequate vitamin D levels is essential. However, the key lies in finding the right balance, as both deficiency and excess can lead to health problems.

Vitamin D 50000 IU: Uses and Applications

Vitamin D supplements in high doses, such as 50,000 IU, are not typically recommended for regular use without medical supervision. These potent formulations are generally prescribed for specific reasons:

Correcting Severe Vitamin D Deficiency

In cases of severe vitamin D deficiency, healthcare providers may prescribe high-dose supplements to rapidly increase levels in the body. This approach, known as “loading dose” therapy, aims to quickly replenish vitamin D stores.

Managing Certain Medical Conditions

Some medical conditions may warrant high-dose vitamin D supplementation, including:

• Osteoporosis
• Hyperparathyroidism
• Certain autoimmune disorders
• Malabsorption syndromes (e.g., Crohn’s disease, celiac disease)

In these cases, the potential benefits of high-dose vitamin D are weighed against the risks, and patients are closely monitored by healthcare professionals.

Potential Side Effects of Vitamin D 50000 IU

While vitamin D is essential for health, taking extremely high doses can lead to toxicity and adverse effects. The most significant concerns associated with vitamin D 50000 IU side effects are related to hypercalcemia, or excess calcium in the blood.

Hypercalcemia: A Major Concern

Hypercalcemia occurs when blood calcium levels exceed 10.4 mg per deciliter. This condition can result from excessive vitamin D intake, as the nutrient enhances calcium absorption in the intestines and promotes calcium release from bones into the bloodstream.

Symptoms of hypercalcemia may include:

• Loss of appetite
• Nausea and vomiting
• Constipation or diarrhea
• Fatigue and weakness
• Confusion and difficulty concentrating
• Headaches
• Increased thirst and frequent urination
• Muscle and joint pain
• Irregular heartbeat

Is hypercalcemia reversible. In most cases, hypercalcemia caused by vitamin D toxicity can be reversed by discontinuing the supplement and following medical advice. However, severe cases may require additional treatment.

Kidney Damage: A Serious Complication

One of the most severe potential side effects of vitamin D toxicity is kidney damage. Excess calcium in the blood can form crystals that deposit in soft tissues, including the kidneys. This condition, known as nephrocalcinosis, can lead to permanent kidney damage if left untreated.

Symptoms of kidney problems related to vitamin D toxicity may include:

• Severe abdominal or flank pain
• Fever and chills
• Changes in urine output or color
• Swelling in the legs or feet

Can kidney damage from vitamin D toxicity be reversed. Early detection and treatment of vitamin D toxicity can often prevent permanent kidney damage. However, in severe cases, the damage may be irreversible, emphasizing the importance of proper dosing and medical supervision.

Precautions and Interactions with Vitamin D 50000 IU

Given the potency of 50,000 IU vitamin D supplements, it’s crucial to take certain precautions and be aware of potential drug interactions.

Who Should Avoid High-Dose Vitamin D?

Certain individuals should exercise caution or avoid high-dose vitamin D supplements altogether:

• People with a history of kidney stones or calcium metabolism disorders
• Individuals with sarcoidosis or other granulomatous diseases
• Those with high blood calcium levels (hypercalcemia)
• Pregnant or breastfeeding women (without medical supervision)

Drug Interactions

Vitamin D can interact with several medications, potentially affecting their efficacy or increasing the risk of side effects. Some notable interactions include:

1. Cholesterol-lowering medications (statins)
2. Certain blood pressure medications
3. Corticosteroids
4. Weight loss drugs (e.g., orlistat)
5. Seizure medications

How can you minimize the risk of drug interactions with vitamin D. Always inform your healthcare provider about all medications and supplements you’re taking. They can advise on potential interactions and adjust dosages if necessary.

Proper Dosing and Administration of Vitamin D 50000 IU

Proper dosing of high-strength vitamin D supplements is crucial to maximize benefits while minimizing risks. Here are some key considerations:

Frequency of Administration

Vitamin D 50,000 IU is typically prescribed for weekly use rather than daily consumption. This approach helps maintain steady vitamin D levels while reducing the risk of toxicity.

Duration of Treatment

The duration of high-dose vitamin D therapy varies depending on the individual’s needs and response to treatment. Some patients may require short-term supplementation to correct a deficiency, while others with chronic conditions might need ongoing therapy.

Monitoring Vitamin D Levels

Regular blood tests to check vitamin D levels are essential when taking high-dose supplements. These tests help healthcare providers adjust the dosage as needed and ensure that levels remain within a safe and effective range.

How often should vitamin D levels be checked when taking high-dose supplements. The frequency of testing can vary, but many healthcare providers recommend checking levels every 3-6 months during treatment.

Alternatives to High-Dose Vitamin D Supplementation

While high-dose vitamin D supplements can be necessary in some cases, there are alternative approaches to maintaining adequate vitamin D levels:

Sunlight Exposure

Spending time in sunlight is the most natural way to boost vitamin D levels. However, it’s important to balance sun exposure with skin cancer risk. Short periods of unprotected sun exposure (10-30 minutes a few times a week) can be beneficial for many people.

Dietary Sources

Incorporating vitamin D-rich foods into your diet can help maintain healthy levels. Good sources include:

• Fatty fish (salmon, mackerel, sardines)
• Egg yolks
• Fortified dairy products
• Mushrooms exposed to UV light

Lower-Dose Supplements

For many individuals, lower-dose vitamin D supplements (1,000-2,000 IU daily) may be sufficient to maintain adequate levels. These doses are generally considered safe for long-term use without close medical supervision.

Can you get enough vitamin D from diet alone. While it’s possible to obtain vitamin D from food sources, it can be challenging to meet daily requirements through diet alone, especially for those with limited sun exposure or certain health conditions.

Recognizing and Addressing Vitamin D Toxicity

Understanding the signs of vitamin D toxicity and knowing how to address it is crucial for anyone taking high-dose supplements.

Symptoms of Vitamin D Toxicity

The symptoms of vitamin D toxicity often overlap with those of hypercalcemia and may include:

• Persistent nausea and vomiting
• Excessive thirst and frequent urination
• Confusion and disorientation
• Fatigue and weakness
• Bone pain
• Kidney problems

Steps to Take if You Suspect Vitamin D Toxicity

If you experience symptoms that may indicate vitamin D toxicity:

1. Stop taking vitamin D supplements immediately
2. Contact your healthcare provider for guidance
3. Undergo blood tests to check vitamin D and calcium levels
4. Follow your doctor’s recommendations for treatment, which may include reducing calcium intake and increasing fluid consumption

How long does it take for vitamin D levels to normalize after stopping high-dose supplements. The time it takes for vitamin D levels to return to normal can vary depending on the individual and the severity of the toxicity. It may take several weeks to months for levels to fully normalize.

The Future of Vitamin D Research and Supplementation

As our understanding of vitamin D’s role in health continues to evolve, ongoing research is shaping the future of supplementation and treatment strategies.

Personalized Vitamin D Therapy

Emerging research suggests that individual factors such as genetics, body composition, and lifestyle may influence vitamin D metabolism and requirements. This knowledge is paving the way for more personalized approaches to vitamin D supplementation.

Novel Delivery Methods

Scientists are exploring new ways to deliver vitamin D more effectively and safely. These include:

• Transdermal patches
• Nasal sprays
• Slow-release formulations

These innovative approaches may offer alternatives to high-dose oral supplements in the future.

Expanding Applications

Ongoing studies are investigating the potential benefits of vitamin D in various health conditions, including:

• Cancer prevention and treatment
• Autoimmune disorders
• Cardiovascular health
• Cognitive function and neurodegenerative diseases

As research progresses, our understanding of optimal vitamin D levels and supplementation strategies may continue to evolve.

Can vitamin D supplementation prevent or treat COVID-19. While some studies have suggested a potential link between vitamin D status and COVID-19 outcomes, more research is needed to establish definitive recommendations. Currently, maintaining adequate vitamin D levels is considered part of overall health but is not a specific treatment or prevention strategy for COVID-19.

Weekly-D Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Take vitamin D by mouth as directed. Vitamin D is best absorbed when taken after a meal but may be taken with or without food. Alfacalcidol is usually taken with food. Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

If your doctor has prescribed this medication, take as directed by your doctor. Your dosage is based on your medical condition, amount of sun exposure, diet, age, and response to treatment.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

If you are taking the chewable tablet or wafers, chew the medication thoroughly before swallowing. Do not swallow whole wafers.

If you are taking the rapidly-dissolving tablets, dry your hands before handling the medication. Place each dose on the tongue, allow it to dissolve completely, and then swallow it with saliva or water. You do not need to take this medication with water.

Certain medications (bile acid sequestrants such as cholestyramine/colestipol, mineral oil, orlistat) can decrease the absorption of vitamin D. Take your doses of these medications as far as possible from your doses of vitamin D (at least 2 hours apart, longer if possible). It may be easiest to take vitamin D at bedtime if you are also taking these other medications. Ask your doctor or pharmacist how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day if you are taking it once a day. If you are taking this medication only once a week, remember to take it on the same day each week. It may help to mark your calendar with a reminder.

If your doctor has recommended that you follow a special diet (such as a diet high in calcium), it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.

If you think you may have a serious medical problem, get medical help right away.

Vitamin D: Side effects and risks

Share on PinterestHypercalcemia and kidney damage are possible side effects of vitamin D supplementation.

Doctors tend to consider vitamin D levels to be adequate if there are at least 20 nanograms (ng) of the vitamin per milliliter (mL) of blood. If levels rise above 50 ng/mL, a person may experience adverse side effects.

However, most research indicates that the toxicity threshold for vitamin D is fairly high, around 200–240 ng/mL.

A person with levels of vitamin D in this range usually consumes between 10,000 and 40,000 international units (IUs) of the vitamin per day.

Below are some of the most serious side effects associated with overexposure to vitamin D.

1. Hypercalcemia

Most of the significant side effects associated with vitamin D toxicity are related to hypercalcemia.

Hypercalcemia is an excess of calcium in the blood. This occurs when there are more than 10,4000 ng/mL of calcium in the blood.

Researchers often cite this threshold as 10.4 milligrams (mg) of calcium per deciliter of blood or as 0.104 mg/mL.

There is a strong relationship between vitamin D and calcium. When there are high levels of vitamin D metabolites in the blood, this increases the amount of calcium that the intestines absorb.

High levels of vitamin D metabolites can also promote the release of calcium from the bones into the bloodstream.

Having too much calcium in the blood can lead to a wide range of complications and symptoms. Some of the most serious include:

• a loss of appetite
• diarrhea and constipation
• confusion, disorientation, or trouble thinking
• nausea and vomiting
• joint and muscle pain
• continuous headaches
• irritability and anxiety
• unexplained exhaustion
• muscle weakness
• increased thirst and more frequent urination
• an irregular heartbeat
• reduced reflexes
• a metallic taste in the mouth
• high blood pressure

2.

Kidney damage

Excess calcium in the bloodstream can bind with phosphate and form crystals that deposit in soft body tissues.

These crystals can cause tissue damage and eventually organ damage, depending on their location, number, and size.

The kidney is especially vulnerable to calcium deposits because of its role as a filter and its many small passageways.

When calcium deposits get stuck in kidney tissues, nephrocalcinosis can occur. If this condition is severe, it can cause permanent kidney damage and, eventually, kidney failure.

Symptoms of nephrocalcinosis include:

• nausea and vomiting
• fever and chills
• severe pain in the stomach, the sides of the back, or the groin area, including the testicles in men

Authors of a 2015 review considered the effects of vitamin D3 toxicity.

On average, the people affected had taken a total of 3,600,000 IU of the vitamin in fewer than 3 months. They experienced several side effects, including acute kidney damage.

3. Irregular heartbeat and heart attack

Extreme hypercalcemia can reduce or change the ability of the heart’s cells to function, and people with severe hypercalcemia often experience irregularities in the heartbeat.

A person with severely high levels of calcium or phosphate in the blood may also develop calcium deposits, or plaques, in the arteries or valves of the heart.

In 2012, doctors reported the case of a 70-year-old woman who received calcium injections in the equivalent of 80,000 IU/day over 30 days.

She experienced hypercalcemia and complete heart blockage, which required a permanent pacemaker.

Some signs of heart complications associated with vitamin D toxicity include:

• an irregular heartbeat, which may be temporary or continual
• chest pain
• unexplained exhaustion
• high blood pressure
• pain when exercising
• dizziness
• chest pain

4. Brittle bones and bone pain

When there is too much calcium circulating freely in the bloodstream, the body may not have enough hormones to bind the mineral to the bones effectively.

Vitamin D toxicity can cause hypercalcemia and subsequent problems with the bones. Some symptoms include:

• aching or painful bones
• instability
• an increased rate of falling
• bones that are prone to fracture or break
• severely stooped posture
• severe back or joint pain
• loss of height or length of limb

5. Dehydration

Elevated levels of calcium in the blood can harm the kidney’s ability to concentrate urine.

This can result in a person producing and passing unusually large quantities of urine, which is called polyuria.

Researchers are not entirely sure why this occurs. One theory is that high calcium levels reduce the effects of antidiuretic hormones.

These hormones encourage the kidneys to retain water, and fewer hormones may result in larger quantities of diluted urine.

When a person passes a lot of diluted urine, they lose large quantities of water and electrolytes. For this reason, a person with vitamin D toxicity may be prone to dehydration.

Symptoms of moderate dehydration include:

• a dry mouth and tongue
• restlessness
• irritability
• sunken eyes
• increased thirst
• decreased urinary output
• decreased tear production and dry eyes
• skin that is slow to return to normal after being pinched

Severe dehydration can result in life-threatening conditions. Other signs and symptoms of this condition include:

• a weak or absent pulse
• low blood pressure
• unexplained exhaustion
• very little or no urine output
• unconsciousness

6. Pancreatitis

Hypercalcemia can cause acute pancreatitis, which is the term for inflammation of the pancreas.

In 2017, researchers published a review of the features and treatment of vitamin D toxicity-induced acute kidney injury.

They studied the experiences of 19 people with the toxicity. Each had taken an average of 6,000,000 IU of the vitamin over 1–3 months.

Two of the 19 people experienced acute pancreatitis as a complication.

Signs of pancreatitis include:

• upper stomach pain that extends to the back
• nausea and vomiting
• a rapid pulse
• weight loss
• fever

7. Lung damage

When high levels of calcium and phosphate in the blood bind to form crystals, these deposit in soft tissues.

The crystals are especially likely to deposit in soft-tissue organs that act as filters, such as the lungs.

If many of these calcium salt deposits, or ectopic calcifications, are present in the lungs, they can impair the organ’s function.

Some signs of the resulting lung damage include:

• coughing
• trouble breathing
• chest pain

Vitamin D toxicity: What if you get too much?

Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition that occurs when you have excessive amounts of vitamin D in your body.

Vitamin D toxicity is usually caused by large doses of vitamin D supplements — not by diet or sun exposure. That’s because your body regulates the amount of vitamin D produced by sun exposure, and even fortified foods don’t contain large amounts of vitamin D.

The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause nausea and vomiting, weakness, and frequent urination. Vitamin D toxicity might progress to bone pain and kidney problems, such as the formation of calcium stones.

Treatment includes stopping vitamin D intake and restricting dietary calcium. Your doctor might also prescribe intravenous fluids and medications, such as corticosteroids or bisphosphonates.

Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the U.S. Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day.

Doses higher than the RDA are sometimes used to treat medical problems such as vitamin D deficiency, but these are given only under the care of a doctor for a specified time frame. Blood levels should be monitored while someone is taking high doses of vitamin D.

As always, talk to your doctor before taking vitamin and mineral supplements.

• Vitamin D for babies
• Vitamin D: Can it prevent Alzheimer’s & dementia?

April 17, 2020

Show references

1. Dawson-Hughes B. Vitamin D deficiency in adults: Definition, clinical manifestations, and treatment. https://www.uptodate.com/contents/search. Accessed March 20, 2020.
2. Vitamin D. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed March 20, 2020.
3. Hypercalcemia. Hormone Health Network. https://www.hormone.org/diseases-and-conditions/hypercalcemiaAccessed March 20, 2020.
4. Vitamin D. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed March 20, 2020.
5. Marcinowska-Suchowierska E, et al. Vitamin D toxicity — A clinical perspective. Frontiers in Endocrinology. 2018; doi:10.3389/fendo.2018.00550.

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If you’re taking vitamin D, you’re probably taking too much

Vitamins seem like something you can’t have too much of. Like too much ice cream on a sticky summer day—sure, you can technically go overboard, but the limit is so high, and what’s the worst thing that happens anyway? And unlike ice cream, we know that vitamins help keep us healthy.

But just like ice cream, vitamin D can have negative side effects when taken in large doses, the impacts can really sneak up on you, and obesity is a concern. Really.

The tricky thing about “medicines” like vitamin D is that you don’t immediately overdose on them. If you take too much Tylenol, you end up in the hospital pretty fast. That giant vitamin capsule isn’t likely to land you in the ER tomorrow or even a month from now. But vitamin D, unlike many of the other vitamins you may be taking, is fat soluble. That means that if you take too much of it, you won’t just pee it out like you would a water soluble vitamin. Instead of being carried out in your body’s wastewater, the vitamin will cling to your body fat for later use—which can compound the effects of daily overdosing. But it’s easy to think of supplements as harmless when you’re just popping a pill or two in your bathroom each morning.

More and more people are making that mistake. In fact, two vitamin D capsules a day (at 2000 international units each) adds up to 4000 IU—the daily limit. If you’re taking in any vitamin D at all otherwise (and you almost certainly are), you’re already over the safe dosage. And a new study in the Journal of the American Medical Association suggests that 3.2 percent of all Americans are doing just that. If 3. 2 sounds tiny to you, keep in mind that back in 2007-2008 that number was only 0.2 percent.

The increase in vitamin D overdosing is a symptom of the general trend towards taking more vitamin D supplements. About 18 percent of U.S. adults are taking at least 1000 IU a day, which is well above the recommended daily dose of 600 IU. The question is: is that a problem?

With most vitamin-related issues, the answer is that it’s probably not harmful to take them (but that you really don’t need them). There’s no solid evidence that taking multi- or any other kind of vitamin is beneficial to your health unless you’re vitamin-deficient. That goes for prenatal vitamins too, by the way, with the exception of folic acid. Vitamin D is kind of a rare exception, because it’s not uncommon to have a deficiency in it. Studies can’t agree on an exact number, but around 30-40 percent of U.S. adults don’t get enough of the D from their diet and sunlight. Only a few foods contain it at all and those that do, like fatty fish or egg yolks or cheese, may be hard to eat enough of to actually get the benefit. That’s why the U.S. dairy industry started fortifying milk with it. And the trouble with sunlight (which doesn’t give you vitamin D, but does trigger your body’s production of it) is that it’s harmful to get too much of it. It’s better to cover up and avoid skin cancer than it is to go unprotected in an effort to get enough vitamins. Plus, the darker your skin is, the fewer UVB rays get through to produce vitamin D in the first place. Obesity has also been linked to low vitamin D levels, though a 2013 study suggested that it was a shared genetic predisposition to both ailments that caused the link, not obesity prompting a decrease in vitamin D intake.

A severe enough deficiency can give you osteomalacia, which you probably know better by the childhood version’s name: rickets. It’s basically a softening of the bone due to lack of calcium. Vitamin D helps your gut absorb all the calcium you need, so a lack of it causes similar problems to a calcium deficiency. Some people have also linked low vitamin D levels to everything from cancer to diabetes to asthma, but those are still just correlational—it’s not clear that a lack of vitamin D is causing those problems as opposed to just being associated with them. Because of this general association with vitamin D deficiency and poor health, some parents give their kids high-dose supplements to stave off things like the common cold. But a recent study published in the Journal of the American Medical Association shows that it has zero impact. Kids who were assigned to get 2000 IU of vitamin D didn’t get colds any less frequently than those assigned to get a low dose.

Here’s the rub, though: while it’s hard to know whether you’re vitamin D deficient, taking too much could be much worse. High doses have the potential to cause nausea, vomiting, constipation, and weakness. One double-blind clinical trial actually found that vitamin D supplements made elderly patients more likely to fall and fracture a bone, which flies right in the face of everything the supplements were thought to do. And since too much vitamin D can lead to too much calcium, you can also wind up with kidney stones and abnormal heart rhythms.

The flip side is that, unless you’re getting almost no vitamin D, you’re probably fine. There’s a reason that “rickets” sounds like an old-timey disease—because it is. It’s an exceedingly rare problem nowadays, in part because we started fortifying food. So between sun exposure and diet, you probably get enough vitamin D to function properly, even if you should maybe be getting a bit more. You certainly don’t need more than 1000 IU a day. There’s no evidence that taking vitamin D supplements can cure or prevent osteoporosis or bone fractures, improve bone density, or prevent infections. A better solution? Just eat more fish and eggs, and maybe venture outside once in awhile. It’s absolutely possible to get all the vitamin D you need from diet and sunshine. All three options would have multiple beneficial effects on your health and none are likely to make you puke. Win-win.

This post has been updated.

Vitamin D Supplementation: An Update

US Pharm. 2010;35(10):58-76.

An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency. ^1-3 This is mostly attributable to people getting less sun exposure because of climate, lifestyle, and concerns about skin cancer. The 1997 Dietary Reference Intake (DRI) values for vitamin D, initially established to prevent rickets and osteomalacia, are considered too low by many experts.⁴ DRI values are 200 IU for infants, children, adults up to age 50 years, and pregnant and lactating women; 400 IU for adults aged 50 to 70 years; and 600 IU for adults older than 70 years. Current studies suggest that we may need more vitamin D than presently recommended to prevent chronic disease. Emerging research supports the possible role of vitamin D in protecting against cancer, heart disease, fractures and falls, autoimmune diseases, influenza, type 2 diabetes, and depression. Many health care providers have increased their recommendations for vitamin D supplementation to at least 1,000 IU.⁵ As a result, more patients are asking their pharmacists about supplementing with vitamin D.

Pharmacology

Vitamin D is a fat-soluble vitamin that acts as a steroid hormone. The body makes vitamin D from cholesterol through a process triggered by the action of the sun’s ultraviolet B rays on the skin (FIGURE 1). Factors such as skin color, age, amount and time of sun exposure, and geographic location affect how much vitamin D the body makes. Vitamin D influences the bones, intestines, immune and cardiovascular systems, pancreas, muscles, brain, and the control of cell cycles.⁶ Its primary functions are to maintain normal blood concentrations of calcium and phosphorus and to support bone health.

Vitamin D undergoes two hydroxylations in the body for activation. There are several metabolic products or modified versions of vitamin D (TABLE 1). Calcitriol (1,25-dihydroxyvitamin D₃), the active form of vitamin D, has a half-life of about 15 hours, while calcidiol (25-hydroxyvitamin D₃) has a half-life of about 15 days. ⁶ Vitamin D binds to receptors located throughout the body.⁶

Deficiency, Blood Concentrations, and Toxicity

Risk factors for vitamin D deficiency include living in northern latitudes (in the U.S., above the line from San Francisco to Philadelphia), failing to get at least 15 minutes of direct sun exposure daily, being African American or dark-skinned, being elderly, or being overweight or obese.⁵ Rickets and osteomalacia are the well-known diseases of severe vitamin D deficiency. Musculoskeletal pain and periodontal disease may also indicate a significant vitamin D deficiency.⁷ Subtle symptoms of milder deficiency include loss of appetite, diarrhea, insomnia, vision problems, and a burning sensation in the mouth and throat.⁷ Drawing a blood calcidiol concentration is the standard test for vitamin D status, since calcidiol has a longer half-life.⁸

A normal range of vitamin D is 30 to 74 ng/mL, but this can vary among laboratories. ⁸ Most experts agree that a concentration between 35 and 40 ng/mL is reasonable for preventive health. Some suggest that the optimal concentration for protecting against cancer and heart disease is between 50 and 70 ng/mL and up to 100 ng/mL. Side effects or toxicity can occur when blood concentrations reach 88 ng/mL or greater.⁹ Symptoms include nausea, vomiting, constipation, headache, sleepiness, and weakness.⁶ Too much vitamin D can raise blood calcium concentrations, and acute toxicity causes hypercalcemia and hypercalciuria.^6,9

Disease Prevention

Cancer: Vitamin D decreases cell proliferation and increases cell differentiation, stops the growth of new blood vessels, and has significant anti-inflammatory effects. Many studies have suggested a link between low vitamin D levels and an increased risk of cancer, with the strongest evidence for colorectal cancer. A Creighton University study found that postmenopausal women given 1,100 IU of vitamin D₃ (plus calcium) versus placebo were 77% less likely to be diagnosed with cancer over the next 4 years. ¹⁰ In the Health Professionals Follow-up Study (HPFS), subjects with high vitamin D concentrations were half as likely to be diagnosed with colon cancer as those with low concentrations.¹¹

Some studies have shown less positive results, however. The Women’s Health Initiative found that women taking 400 IU of vitamin D₃ (plus calcium) versus placebo did not have a lower risk of breast cancer.¹² Many critics have argued that this dosage of vitamin D is too low to prevent cancer. A 2006 Finnish study of male smokers found that those with higher vitamin D concentrations had a threefold increased risk for pancreatic cancer, with cigarette smoking not found to be a confounding factor.¹³ A 2009 U.S. study of men and women (mostly nonsmokers) did not confirm these results, finding no association between vitamin D concentrations and pancreatic cancer overall, except in subjects with low sun exposure.¹⁴ In this subgroup, higher versus lower vitamin D concentrations had a positive association with pancreatic cancer. ¹⁴ A definitive conclusion cannot yet be made about the association between vitamin D concentration and cancer risk, but results from many studies are promising.

Heart Disease: Several studies are providing evidence that the protective effect of vitamin D on the heart could be via the renin-angiotensin hormone system, through the suppression of inflammation, or directly on the cells of the heart and blood-vessel walls. In the Framingham Heart Study, patients with low vitamin D concentrations (<15 ng/mL) had a 60% higher risk of heart disease than those with higher concentrations.¹⁵ The HPFS found that subjects with low vitamin D concentrations (<15 ng/mL) were two times more likely to have a heart attack than those with high concentrations (>30 ng/mL).¹⁶ In another study, which followed men and women for 4 years, patients with low vitamin D concentrations (<15 ng/mL) were three times more likely to be diagnosed with hypertension than those with high concentrations (>30 ng/mL). ¹⁷ As is the case with cancer and vitamin D, more studies are needed to determine the role of vitamin D in preventing heart disease, but the evidence thus far is positive.

Fractures and Falls: Vitamin D is known to help the body absorb calcium, and it plays a role in bone health. Also, vitamin D receptors are located on the fast-twitch muscle fibers, which are the first to respond in a fall.¹⁸ It is theorized that vitamin D may increase muscle strength, thereby preventing falls.⁵ Many studies have shown an association between low vitamin D concentrations and an increased risk of fractures and falls in older adults.

A combined analysis of 12 fracture-prevention trials found that supplementation with about 800 IU of vitamin D per day reduced hip and nonspinal fractures by about 20%, and that supplementation with about 400 IU per day showed no benefit.¹⁹ Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University have examined the best trials of vitamin D versus placebo for falls. Their conclusion is that “fall risk reduction begins at 700 IU and increases progressively with higher doses.”¹⁸ Overall, the evidence is strong in support of supplementing with vitamin D to prevent fractures and falls.

Autoimmune Diseases and Influenza: Since vitamin D has a role in regulating the immune system and a strong anti-inflammatory effect, it has been theorized that vitamin D deficiency could contribute to autoimmune diseases such as multiple sclerosis (MS), type 1 diabetes, rheumatoid arthritis, and autoimmune thyroid disease. Scientists have suggested that vitamin D deficiency in the winter months may be the seasonal stimulus that triggers influenza outbreaks in the winter.²⁰ Numerous trials have evaluated the association between vitamin D and immune-system diseases.

A prospective study of white subjects found that those with the highest vitamin D concentrations had a 62% lower risk of developing MS versus those with the lowest concentrations. ²¹ A Finnish study that followed children from birth noted that those given vitamin D supplements during infancy had a nearly 90% lower risk of developing type 1 diabetes compared with children who did not receive supplements.²² In a Japanese randomized, controlled trial, children given a daily vitamin D supplement of 1,200 IU had a 40% lower rate of influenza type A compared with those given placebo; there was no significant difference in rates of influenza type B.²³ More studies of the influence of vitamin D on immunity will be emerging, as this is an area of great interest and it remains unclear whether there is a link.

Type 2 Diabetes and Depression: Some studies have shown that vitamin D may lower the risk of type 2 diabetes, but few studies have examined the effect of vitamin D on depression. A trial of nondiabetic patients aged 65 years and older found that those who received 700 IU of vitamin D (plus calcium) had a smaller rise in fasting plasma glucose over 3 years versus those who received placebo. ²⁴ A Norwegian trial of overweight subjects showed that those receiving a high dose of vitamin D (20,000 or 40,000 IU weekly) had a significant improvement in depressive symptom scale scores after 1 year versus those receiving placebo.²⁵ These results need to be replicated in order to determine a correlation between vitamin D and the risk of diabetes or depression.

Dosing

Only a few foods are a good source of vitamin D. These include fortified dairy products and breakfast cereals, fatty fish, beef liver, and egg yolks. Besides increasing sun exposure, the best way to get additional vitamin D is through supplementation. Traditional multivitamins contain about 400 IU of vitamin D, but many multivitamins now contain 800 to 1,000 IU. A variety of options are available for individual vitamin D supplements, including capsules, chewable tablets, liquids, and drops. Cod liver oil is a good source of vitamin D, but in large doses there is a risk of vitamin A toxicity. ²⁶

The two forms of vitamin D used in supplements are D₂ (ergocalciferol) and D₃ (cholecalciferol). D₃ is the preferred form, as it is chemically similar to the form of vitamin D produced by the body and is more effective than D₂ at raising the blood concentration of vitamin D.²⁷ Since vitamin D is fat soluble, it should be taken with a snack or meal containing fat. In general, 100 IU of vitamin D daily can raise blood concentrations 1 ng/mL after 2 to 3 months (TABLE 2).²⁸ Once the desired blood concentration is achieved, most people can maintain it with 800 to 1,000 IU of vitamin D daily.²⁸ Even though dosages up to 10,000 IU daily do not cause toxicity, it generally is not recommended to take more than 2,000 IU daily in supplement form without the advice of a health care provider.²⁹ Individuals at high risk for deficiency should have a vitamin D blood test first; a dosage of up to 3,000 to 4,000 IU may be required to restore blood concentrations. ²⁹

Drug Interactions

Vitamin D supplements may interact with several types of medications. Corticosteroids can reduce calcium absorption, which results in impaired vitamin D metabolism.⁶ Since vitamin D is fat soluble, orlistat and cholestyramine can reduce its absorption and should be taken several hours apart from it.⁶ Phenobarbital and phenytoin increase the hepatic metabolism of vitamin D to inactive compounds and decrease calcium absorption, which also impairs vitamin D metabolism.⁶

Future Research

While considerable research supports the importance of vitamin D beyond bone health, further trials are required before broad claims can be made about vitamin D and prevention of chronic disease. The Institute of Medicine (IOM) is reviewing the research on vitamin D and plans to report in late 2010 regarding any updates to the DRIs for vitamin D (and calcium).³⁰ Specifically, the IOM will consider the relation of vitamin D to cancer, bone health, and other chronic diseases. ³⁰ An important study, the Vitamin D and Omega-3 Trial, was launched in early 2010 to determine whether 2,000 IU of vitamin D₃ and 1,000 mg of EPA (eicosopentaenoic acid) plus DHA (docosahexaenoic acid) daily can lower the risk of cancer, heart disease, stroke, and other diseases.³¹ This randomized trial, which will enroll about 20,000 healthy men and women, should provide more insight on vitamin D supplementation.

Conclusion

As the number of people with vitamin D deficiency continues to increase, the importance of this hormone in overall health and the prevention of chronic diseases is at the forefront of research. The best evidence for the possible role of vitamin D in protecting against cancer comes from colorectal cancer studies. Evidence also is strong for the potential role of vitamin D in preventing fractures and falls. At this time, further studies are needed to evaluate the role of vitamin D in protecting against heart disease, autoimmune diseases, influenza, diabetes, and depression.

REFERENCES

1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-281.

2. Gordon CM, DePeter KC, Feldman HA, et al. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med. 2004;158:531-537.

3. Lips P, Hosking D, Lippuner K, et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med. 2006;260:245-254.

4. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Chapter 7. Vitamin D. www.nal.usda.gov/fnic/DRI//DRI_Calcium/250-287.pdf. Accessed August 2, 2010.

5. Harvard School of Public Health Nutrition Source. Vitamin D and health. www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamin-d/index.html. Accessed August 30, 2010.

6. NIH Office of Dietary Supplements. Dietary supplement fact sheet: vitamin D. http://ods.od.nih.gov/factsheets/vitamind.asp. Accessed August, 4, 2010.

7. Nair S. Symptoms of low vitamin D levels. www.buzzle.com/articles/symptoms-of-low-vitamin-d-levels.html. Accessed September 2, 2010.

8. MedlinePlus. 25-hydroxy vitamin D test. www.nlm.nih.gov/medlineplus/ency/article/003569.htm. Accessed August 4, 2010.

9. Moyad MA. Vitamin D: a rapid review: side effects and toxicity. www.medscape.com/viewarticle/589256_10. Accessed September 2, 2010.

10. Lappe JM, Travers-Gustafson D, Davies KM, et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586-1591.

11. Ahn J, Peters U, Albanes D, et al. Serum vitamin D concentration and prostate cancer risk: a nested case-control study. J Natl Cancer Inst. 2008;100:796-804.

12. Chlebowski RT, Johnson KC, Kooperberg C, et al. Calcium plus vitamin D supplementation and the risk of breast cancer. J Natl Cancer Inst. 2008;100:1581-1591.

13. Stolzenberg-Solomon RZ, Vieth R, Azad A, et al. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Cancer Res. 2006;66:10213-10219.

14. Stolzenberg-Solomon RZ, Hayes RB, Horst RL, et al. Serum vitamin D and risk of pancreatic cancer in the Prostate, Lung, Colorectal, and Ovarian Screening Trial. Cancer Res. 2009;69:1439-1447.

15. Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117:503-511.

16. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174-1180.

17. Forman JP, Giovannucci E, Holmes MD, et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension. 2007;49:1063-1069.

18. Liebman B. From sun & sea: new study puts vitamin D & omega-3s to the test. Nutrition Action Healthletter. November 2009:3-7.

19. Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169:551-561.

20. Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134:1129-1140.

21. Munger KL, Levin LI, Hollis BW, et al. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006;296:2832-2838.

22. Hyppönen E, Läärä E, Reunanen A, et al. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001;358:1500-1503.

23. Urashima M, Segawa T, Okazaki M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;91:1255-1260.

24. Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care. 2007;30:980-986.

25. Jorde R, Sneve M, Figenschau Y, et al. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264:599-609.

26. Cannell JJ, Vieth R, Willett W, et al. Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the vitamin D deficiency epidemic. Ann Otol Rhinol Laryngol. 2008;117:864-870.

27. HealthTree.com. Vitamin D and calcium supplements. www.healthtree.com/articles/vitamin-d/source/supplement. Accessed September 2, 2010.

28. Moyad MA. Vitamin D: a rapid review: dosage of vitamin D needed to achieve 35 to 40 ng/ml (90-100 nmol/L). www.medscape.com. Accessed August 4, 2010.

29. The Nutrition Source. Ask the expert: vitamin D and chronic disease. www.hsph.harvard.edu/nutritionsource. Accessed August 4, 2010.

30. Institute of Medicine. Dietary Reference Intakes for vitamin D and calcium. www.iom.edu/Activities/Nutrition/DRIVitDCalcium.aspx. Accessed August 2, 2010.

31. The Vitamin D and Omega-3 Trial (VITAL). www.vitalstudy.org. Accessed August 2, 2010.

32. Lau AH, How PP. The role of the pharmacist in the identification and management of secondary hyperparathyroidism. US Pharm. 2007;32(7):62-72.

33. Cannell JJ. Vitamin D pharmacology. www.vitamindcouncil.org/vitaminDPharmacology.shtml. Accessed August 30, 2010.

To comment on this article, contact [email protected].

Is 50,000 IU of Vitamin D Per Week Too Much?

Asked by Jerri Koch

Question:

Are 50,000 International Units (IU) Of vitamin D Once A Week Harmful?

My doctor prescribed 50,000 IU of vitamin D, to be taken once a week due to vitamin D deficiency. Is this safe to take? Is there any way it would be toxic?

Answer:

The dose that your physician prescribed is likely safe if used on a short-term basis. The Recommended Daily Allowance (RDA) for vitamin D is 600 IU for adults 18-70 years of age, and 800 IU for adults over 70. Vitamin D supplementation appears to be safe for adults when taken by mouth in doses of 4,000 IU daily (for a total of 28,000 IU per week).

When vitamin D deficiency is present, experts recommend a range of 40-2,000 IU of vitamin D each day depending on the severity of the deficiency. While the upper limit of this recommendation is 2,000 IU per day, research shows that high doses of vitamin D (10,000 to 50,000 IU daily) may be necessary for patients who have a history of malabsorption.

While vitamin D toxicity (also called hypervitaminosis D) is rare, it can have serious side effects. These include allergic skin reactions, a build-up of calcium in the arteries, headaches, muscle pain, kidney or urinary stones, and gastrointestinal problems (such as nausea, vomiting, constipation, and diarrhea).

Your vitamin D levels should be monitored closely during this time of high-dose supplementation. Report any adverse reactions to your doctor immediately.

You should know: The answer above provides general health information that is not intended to replace medical advice or treatment recommendations from a qualified healthcare professional.

You should know: The answer above provides general health information that is not intended to replace medical advice or treatment recommendations from a qualified healthcare professional.

Meet Our Writer

Carmen Roberts, M.S., R.D., L.D.N.

Carmen is a Registered Dietitian. In addition to writing for HealthCentral, she has spent her career working at Johns Hopkins and is also an adjunct faculty instructor for Excelsior College. Carmen has over 20 years of experience in nutritional counseling, education, writing, and program management and is a certified specialist in adult weight management. She enjoys educating her students and clients about how nutrition affects the body and its role in overall health and wellness.

Mega-dosing vitamin D: Doctor-prescribed 50,000 IU vitamin D may be right for some patients

More than 40 percent of the U.S. population is estimated to have a vitamin D deficiency, especially in regions with less year-round sun exposure.

The vitamin, which is vital for the body’s absorption of calcium, is available over-the-counter, with dosages typically from 600 international units to 2,000 IU. For people with a severe vitamin D deficiency confirmed in blood tests, some health care providers are prescribing a mega-dose: 50,000 IU vitamin D taken once a week for six to eight weeks.

After the temporary regimen, patients return to store-bought options. But does that high dose, even short-term, have any health concerns? Medical groups say it’s typically safe, under physician supervision, to get levels back to normal.

“If vitamin D levels are fairly low, that’s a pretty typical regimen we are seeing more and more, because there is more awareness about low vitamin D levels,” said Skye McKennon, an adjunct pharmacy professor in Spokane.

“Humans get vitamin D from two sources, through food or supplements and the other is through the skin via UV light. In the fall and wintertime, particularly when you live somewhere like the Northwest, we’re not getting a lot of UV light, so our natural source of vitamin D is decreased quite a bit. ”

McKennon will teach at Washington State University Spokane this spring on preventative health. She said low vitamin D levels in the body are associated with osteoporosis, increased risk for falls and fractures, depression, impaired immune function, multiple sclerosis and some cancers.

Dr. Gretchen LaSalle, a Spokane MultiCare family physician, agrees that vitamin D deficiency has received more attention in the past 10 years, including how it affects health. But research on the nutrient has gone back and forth, she added.

“If you have a significant deficiency, the recommended approach currently is to use 50,000 IU of vitamin D once a week for six to eight weeks, then re-measure levels, to try to boost those values back up a little more quickly,” LaSalle said.

“That high of a dose shouldn’t be prescribed without blood testing, I would say, because that’s a pretty hefty dose. Vitamin D is a fat-based or oil-based vitamin, so it’s one that can accumulate in body tissues and can become toxic, although it’s very difficult for that to happen. ”

After a high-dose prescription, people with low vitamin D levels need to keep taking an over-the-counter supplement to maintain levels in a normal range, she said. “That’s more typically your 1,000 IU daily dosing.”

McKennon said few foods naturally contain vitamin D, mainly from fatty fish such as salmon and tuna. Small amounts are found in beef liver, cheese and egg yolks, while some grocery items are fortified with it, such as milk, orange juice and cereals. Both vitamin D through diet and skin are converted in the body to biologically active forms by the liver and kidney.

Harvard Medical School articles describe that under ideal circumstances, 10 to 15 minutes of sun on the arms and legs a few times a week can generate nearly all the vitamin D people need. But that’s impacted by season, latitude, age and use of sunscreen.

People at higher risk of low vitamin D levels include older adults, individuals with darker skin and those living at northern latitudes such as Spokane, McKennon said. Other reasons might include when people eat less or have decreased absorption for medical reasons or aging.

For healthy adults, a common recommendation is to take a vitamin D supplement from 600 IU to 1,000 IU. Kids need about 400 units a day, and babies who are breastfed need supplement drops, LaSalle said.

After a short-term, mega-dose supplement, patients often report improved energy and moods.

Vitamin D deficiency is measured through blood testing when levels go below 20 nanograms per milliliter of blood, LaSalle said.

Problems can occur if people take too much for too long, perhaps piling on higher over-the-counter 5,000 IU dose over time. Risks include developing kidney stones, confusion, vomiting, muscle weakness and increased calcification in the body, McKennon added.

She said with other types of vitamins that aren’t fat-soluble, such as vitamin C, people “just urinate it out” if there’s excess.

“Vitamin D is not like that. If you take too much and don’t actually need it, you can over time become toxic on it. I’d certainly recommend taking it in conjunction with your health care provider. Some people, I think, buy just over-the-counter and try to take a lot of it to get closer to the 50,000 IU dose, but that’s not recommended.

“That’s when we see people get into trouble.”

LaSalle offers similar cautions to work with a provider.

“In my cupboard, I have 5,000-unit capsules from Costco,” she said. “I think there is even 10,000-unit ones out there. It’s available without a prescription, but people need to know that like with any other supplement form, it’s not always a benign or risk-free thing.

“More is not always better, and if people have questions about how much they should be taking, they should talk it through with their provider.”

Devit-3 (15 ml) 50.000 oral drops

Description

1. COMPOSITION:

Active ingredient: 50,000 IU in each bottle (15 ml) vitamin D3.

Excipients: butylhydroxyanisole, sunflower oil.

2. DESCRIPTION OF THE PREPARATION DEVIT-3

Contains cholecalciferol (vitamin D3) as an active ingredient.

Packing: glass bottles of 15 ml, placed in a cardboard box.

The drug is intended for the prevention and treatment of vitamin D deficiency, due to impaired absorption of vitamin D in the digestive tract, in the treatment of rickets (bone disease that develops due to vitamin D deficiency), osteomalacia (a disease associated with a decrease in minerals in the bones) , decreased bone density (osteoporosis), to support hyperparathyroidism (excess parathyroid hormone production).

3. APPLICATION OF DEVIT-3 PREPARATION

DO NOT use the drug in the following cases:

• If you are allergic to cholecalciferol (vitamin D3) or any of the excipients (hypersensitivity).
• you have severe hypertension.
• you have chronic arterial disease (atherosclerosis).
• If you have active pulmonary tuberculosis, you should not use high doses of this medicine for a long time.
• Hypervitaminosis D (a disease caused by excessive consumption or accumulation of vitamin D). Symptoms include loss of appetite, constipation, blurred vision and muscle weakness.
• Hypercalcemia (increased concentration of calcium in the blood) or hypercalciuria (increased calcium in the urine).
• If you have kidney stones (containing calcium).
• if you are sensitive to calcium.

Use DEVIT-3 (DeVit-3) with caution in the following cases:

• If you move a little.
• You are using benzothiadiazine diuretics.
• If you have had kidney stones.
• If you have sarcoidosis.
• With pseudohypoparathyroidism (a type of parathyroid insufficiency).
• If you have kidney disease.
• If you are taking any other medicines that contain vitamin D and its derivatives.

Vitamin D Therapeutic Index is quite low in infants and children. If hypercalcemia lasts a long time, children may experience a decrease in mental and physical development.Women who are breastfeeding and taking pharmacological doses of vitamin D have a risk that the baby may develop hypercalcemia.

Consult a physician before using this drug.

Use of the drug with food and drinks

There is no known interaction with food and drink.

Pregnancy

Consult a doctor before use.

The drug should not be used unnecessarily during pregnancy.

If during treatment you find that you are pregnant, consult a doctor immediately.

Breastfeeding

Vitamin D passes into breast milk.

Consult a doctor before use.

Effect of the drug on driving a vehicle

There is no information that DEVIT-3 (Devit-3) affects the ability to drive a vehicle.

Important information about some of the ingredients in DEVIT-3 (DeVit-3)

This product contains butyl hydroxyanisole, but it is not expected to have any effect in connection with the route of administration.

Use with other medicinal products

• Vitamin D may be diminished when used with anticonvulsants, hydantoin, barbiturates or pyrimidone (medicines used for epilepsy) and rifampicin (an antibiotic used to treat tuberculosis).
• Concomitant use in the treatment of calcitonin, etidronate, gallium nitrate, pamidronate or pliamycin for hypercalcemia (a disease with high levels of calcium in the blood) may reduce the effect of these drugs.
• When used in combination with high doses of drugs containing calcium or diuretics and thiazide (diuretics), the concentration of calcium in the blood may exceed normal levels (risk of hypercalcemia). Careful monitoring of serum calcium concentration is necessary with long-term treatment.
• Use with other preparations containing vitamin D or its derivatives is not recommended due to the increased likelihood of toxicity.
• Isodiazide (used to treat tuberculosis) may reduce the effectiveness of vitamin D3.
• Patients who are taking cardiac glycosides (medicines used for heart failure) may be susceptible to high calcium levels, so the ECG (heart diagnosis) and calcium levels of these patients should be monitored by a doctor.
• Drugs that reduce the absorption of fat (orlistat – used in the treatment of obesity) and cholestramine can reduce the absorption of vitamin D.

Tell your doctor if you are currently using any prescription or over-the-counter medicines, or if you have recently used them.

4. DOSAGE

Instructions for correct use and dosage

A solution of 1 ml is 25 drops.

Recommended dose based on patient symptoms:

• Treatment of vitamin D deficiency or deficiency: 5-30 drops per day, equivalent to 667-4000 IU
• To avoid vitamin D deficiency due to impaired absorption in the digestive tract: 5-15 drops per day, equivalent to 667-2000 IU
• Treatment of vitamin D deficiency due to poor absorption in the digestive tract: 5-75 drops per day, equivalent to 667-10,000 IU
• Treatment of rickets in children and newborns: Up to 1 year: 25 drops per day, equivalent to 3340 IU. Over 1 year: 45 drops per day, equivalent to 6,000 IU. Maintenance dosage: 5 drops per day, equivalent to 667 IU.
• Treatment of osteomalacia due to vitamin D deficiency: 75 drops per day, equivalent to 10,000 IU. Maintenance dosage: 10-15 drops per day, equivalent to 1330-2000 IU.
• Treatment of bone loss with calcium and specific anti-osteoporotic drugs: 5 drops per day, equivalent to 667 IU.
• In patients with an increased risk of fractures due to bone resorption (in elderly patients and patients with glucocorticoid therapy): 5 drops per day, equivalent to 667 IU.
• Secondary hyperparathyroidism: 10-25 drops per day, equivalent to 1330-3340 IU.
• During pregnancy and breastfeeding, the daily dose is 400-800 IU, but if necessary, it can be increased to 4000 IU / day.

Application:

DEVIT-3 (DeVit-3) is taken orally once a day.

For infants or people who cannot be injected, it is recommended to use the drug orally.

Infants can be given the drug by mixing it with food.

Different age groups:

Use in children:

The drug is used in accordance with the instructions.

Elderly use:

No dose adjustment required.

Special Use:

Renal / hepatic impairment:

No dose adjustment required. Kidney function should be checked in cases where continuous vitamin D3 intake is required.Calcium should not be used in severe renal impairment.

If you have the impression that the effect of DEVIT-3 is too strong or too weak, consult your doctor.

Overdose

If you have used an excessive amount of the drug, you may develop hypercalcemia. Symptoms of hypercalcemia: fatigue, psychiatric symptoms (such as euphoria, dizziness, blurred consciousness), nausea, vomiting, loss of appetite, weight loss, thirst, polyuria (excessive urination), kidney stones, nephrocalcinosis (salt accumulation in the kidneys), renal failure, changes in ECG indicators, heart rhythm disturbances and pancreatitis.

Treatment: Avoid exposure to sunlight. vomiting can be induced when the drug has just been taken.

If you take an excessive dosage of the drug, see your doctor.

If you forget to take the drug on time

Do not take double doses to make up for forgotten doses.

Effects that may occur after discontinuation of the drug

No effect is expected after discontinuation of the drug.Do not stop treatment prematurely unless directed by your doctor.

5. SIDE EFFECTS

As with other drugs, side effects may occur in persons sensitive to the components contained in the drug DEVIT-3 (DeVit-3).

Due to the lack of comprehensive clinical studies, the incidence of side effects is not known.

There is a small chance of side effects if the drug is taken in accordance with the prescribed dosage and duration of treatment.The following side effects can occur with high doses of DEVIT-3 and uncontrolled treatment times:

Metabolism

Elevated urine calcium, elevated blood calcium (hypercalcemia) and elevated residual nitrogen (determined by blood and urine tests).

Stomach and intestinal disorders

Constipation, nausea, abdominal pain, diarrhea.

Diseases of the skin and subcutaneous tissue

Hypersensitivity symptoms such as itching, rash, white or reddish blisters (urticaria) on the skin.

Kidney and urinary tract diseases

Excessive urination (polyuria), excessive thirst (polydipsia), inability to urinate (anuria).

General disorders

Burning sensation

6. STORAGE CONDITIONS

Store at room temperature below 25 ° C, away from sunlight, in tightly closed containers, out of reach of children.

Use according to the expiration date.Do not use the drug after the expiration date printed on the package.

If you notice any defects on the packaging of the drug, do not use it.

Manufacturer:

DEVA Holding A.Ş.

Istanbul, Turkey

Similar

6 side effects from an excess of vitamin D

Without vitamin D, it is impossible to imagine the full functioning of the body and the maintenance of good health. Its beneficial properties are manifested already at the cellular level, and then they move on to the work of organs and their systems, ensuring the flow of all biochemical reactions.

Not all people get the required amount of the nutrient, which has already become a common occurrence, but is fraught with side effects and deterioration of health. To make up for the deficiency, many resort to the use of supplements. But if you use such drugs incorrectly and do not follow the instructions, vitamin D can accumulate in the body and even reach the toxic limit.

This is extremely dangerous and requires medical attention to restore normal health to the body.

The following article discusses 6 dangerous side effects of excessive nutrient intake.

What is the danger of a lack and an excess of vitamin D

“Sun” vitamin takes part in the reactions of calcium absorption, increases the immune function of the body and strengthens the skeletal system, as well as muscle tissue and heart. A trace element enters our body with natural food or is produced in some amount independently when we are under the sun – after the rays hit the skin, the vitamin is generated and enters our body.

In addition to being found in fatty fish, vitamin D3 is also found in other nutritious foods. Many people are unable to consume the required amount of nutrients, it is not always possible to walk or work in sunlight.All this provokes a lack of a trace element in the body and even leads to its acute form – a deficiency.

Statistics show that approximately 1 billion people on the planet cannot get enough vitamin D.

The easiest way to fill the gap is to use nutritional supplements. Both forms of the solar vitamin – D3 and D2 – can be obtained from special food preparations. D3 is a form of vitamin that is produced by the interaction of sunlight and human skin, and D2 is a form of a substance that is found in plant products.

Scientists have discovered that vitamin D3 contributes much more to blood saturation with a nutrient than its second form – D2. According to the research results, it was found that every 100 IU of D3 consumed by a person during the day increases the level of vitamin in the blood by about 1 ng / ml, 2.5 nmol / L.

But when taking high doses of a substance for a long period, an accumulation effect arises, which then takes on the character of toxicity and danger to the body. When its content in the blood rises to more than 150 ng / ml, or 375 nmol / l, intoxication occurs.The accumulation of the vitamin is concentrated in body fat, followed by a slow process of its release into the bloodstream. Thus, the toxic effects of an overdose of vitamin D can last for several months and even after you stop taking supplements.

It is noteworthy that this effect is not common and is more common among people who take supplements for a long period, exceeding the doses indicated in the instructions, which does not allow to control the vitamin content in the blood.

It is possible that the daily intake of a nutrient may be unintentionally exceeded when supplements are used, if the composition of the drug itself contains much more than indicated on the label.

If you get the sunshine vitamin only naturally, that is, when you are in the sun or through a balanced diet, there is no risk of excessive accumulation of the substance in the body.

Nutrient tracker helps you find the right Vitamin D

If you want to quickly and easily find out the top products containing vitamin D, or want to know the entire composition of your meal, then try the mobile application PREPRO .

In addition to making meal plans and checking which vitamins and minerals are lacking in your diet, there is a wonderful feature that looks for anything among foods and supplements that, for example, contains vitamin D.

You can get acquainted with the application on the website

6 side effects in case of an overdose of vitamin D and the features of each of them

The level of a substance in the blood rises

If our body gets the right amount of nutrients, it strengthens the immune system and protects against the risks of developing cancer, as well as osteoporosis. However, there is no precise definition of the optimal range for vitamin doses.

It is believed that it is enough for a person to receive an amount of vitamin D in a volume of 30 ng / ml, or 75 nmol / L. However, it is recommended by Council officials to maintain a level of 40-80 ng / ml, or 100-200 nmol / L. Exceeding the normal range of 100 ng / ml, or 250 nmol / l, is already harmful to health.

Now more and more people are starting to use vitamin supplements, and it is simply impossible to meet someone whose blood nutrient content is exceeded.

Recently, a study was conducted with 20 thousand people over a 10-year time period. It was found that in 37 subjects the level was higher than 100 ng / ml, or 250 nmol / L. One participant was diagnosed with true toxicity at a dose of 364 ng / ml, or 899 nmol / L.

Another study made it possible to calculate the volume of vitamin in the blood of a woman at the level of 476 ng / ml, or 1171 nmol / L, as a result of taking the supplement with a dosage of 186,900 IU per day for 60 days. This is 47 times the safe upper limit of 4,000 IU per day.

The woman was hospitalized when she began to show symptoms of weakness, forgetfulness, nausea and vomiting, fatigue, slurred speech.

The level of calcium in the blood rises

With the help of vitamin D3, calcium from consumed foods is well and correctly absorbed. And this is one of the key functions of the nutrient in our body.

But with an excess of the substance entering the body, the level of calcium in the blood also rises, which in this case causes unpleasant sensations, disrupts the functioning of the body and is accompanied by potentially dangerous symptoms.

Suspicion of hypercalcemia (excess of the normal level of a mineral in the blood) manifests itself through:

The normal value for calcium in the blood is 8.5-10.2 mg / dL, or 2.1-2.5 mmol / L.

An elderly man with dementia showed that he consumed 50,000 IU of vitamin D every day for six months, which is why he was often hospitalized with symptoms very similar to or associated with hypercalcemia.

Another case was aimed at examining the health of two men – they were taking improperly labeled supplements, which led to an excess of calcium to the level of 13.2-15 mg / dL, or 3.3-3.7 mmol / L.

Only after a year of rehabilitation procedures and a correct diet, the volume of the mineral in the blood returned to normal.

Symptoms of nausea, vomiting, poor appetite

With an excess of a trace element, most of the symptoms that appear are always associated with an increase in calcium levels. In particular, this manifests itself through nausea, vomiting and loss of appetite.

But not all people with hypercalcemia have the symptoms listed above.

A study conducted on a group of 10 people with elevated calcium levels due to excessive doses of vitamin D showed that four people experienced nausea and vomiting, and three more experienced loss of appetite.

Such reactions of the body to excessive intake of the nutrient have been recorded in various other experiments. After taking the supplement, the woman complained of nausea and weight loss. The drug she was using contained 78 times the required dose of the sunshine vitamin. And it didn’t match the information on the label.

In such cases, when the body reacted to inoculation, the level of calcium in the blood was 12 mg / dL, or 3.0 mmol / L.

Symptoms of abdominal pain, constipation, diarrhea

Phenomena such as abdominal discomfort, constipation or diarrhea are common when there is a digestive disorder or disorder. They can be associated with food intolerances or irritable bowel syndrome (IBS). But in the case of an excess of vitamin D, they also occur.

Such manifestations are characteristic of people who receive too large doses of a trace element to eliminate vitamin D deficiency.Moreover, in each case, everything is individual.

One study made it clear that the boy complained of abdominal pain and constipation after taking an improperly labeled vitamin supplement and taking it asymptomatically, both of whom had an overdose.

Another experiment was conducted on an 18-month-old child who was given 50,000 IU of vitamin B3 for 90 days. As a result, the body protested with diarrhea, abdominal pain and other unpleasant phenomena.When the supplement was finished, the symptoms disappeared immediately.

Decrease in bone mass

Vitamin D is directly related to the reactions of calcium absorption and bone metabolism, so the body needs to receive the correct doses of the substance for all bones in the body to be strong and healthy.

But if the dosage is exceeded, it negatively affects organs and tissues.

Despite the fact that excessive saturation of the body with solar vitamin is always associated with an increased level of the mineral in the blood, according to the researchers, such megadoses can provoke a sharp decrease in the amount of vitamin K2 in the blood.

K2 is necessary to retain calcium in bone tissue and blood, and due to oversaturation of vitamin D, the activity of this nutrient decreases.

To maintain normal bone mass and overall health, you need to monitor your vitamin D supplementation and remember to saturate your body with vitamin K2. The latter is best obtained from natural sources – dairy products and meat.

Manifestation of renal failure

If there is an excess of vitamin D in the body, it negatively affects the functioning of the kidneys.

One case study caused a man to be hospitalized with symptoms of renal failure, hypercalcemia, and other negative symptoms following a vitamin shot. Initially, the patient received such a recommendation from the doctor.

There are many studies that report moderate or severe impairment of renal function in people who suffer from oversaturation of the body with the solar vitamin.

An experiment involving 62 people who received high-dose injections of vitamin D demonstrated that each participant experienced kidney failure.And this did not depend on whether he had initially healthy kidneys or already had other diseases with the organ.

Treatment of this pathology is carried out by using oral or intravenous hydration and special medications.

Summarize

Vitamin D is an important trace element for maintaining the full health of our body. Eating a healthy and balanced diet does not rule out the possibility that you may need to take supplements to help normalize the nutrient levels in your blood.

But too much vitamin is also bad. It is important to avoid overdosing. The maximum allowable daily allowance is 4000 IU, which is quite safe if blood counts are monitored.

When buying food vitamin supplements, it is important to choose products from trusted manufacturers, otherwise the risk of overdose due to incorrect labeling increases.

If you experience the strange symptoms or negative feelings described in this article while using vitamin D supplements, seek immediate medical attention.

Nephrologists have described the consequences of an overdose of vitamin D – Rossiyskaya Gazeta

An overdose of vitamin D, which is also known as the “sunshine vitamin”, threatens kidney failure. A team of Canadian scientists led by Born L. Auguste studied the medical history of a 54-year-old patient and published the results of the study in the Canadian Medical Association Journal.

In a nephrology clinic, where the patient was urgently referred by the attending physician with suspicion of acute kidney damage, it turned out that the man had been taking vitamin D in high concentration for several months. And shortly before the sharp deterioration of his condition, he returned from Southeast Asia, where for 2 weeks he was in the sun for 6-8 hours a day.

Scientists warn: uncontrolled intake of vitamin D can pose a serious risk to the health of patients who are not informed about the threat of the drug to the body.

Vitamin D is not actually a vitamin, but a hormone precursor. When the sun hits the skin, active vitamin D is formed in the liver and kidneys – almost 90% of the substance is produced by the body’s own body.The remaining 10% is absorbed by fatty fish in the diet. The body stops its own production of vitamin D as soon as it makes up for it. Vitamin D regulates calcium and phosphate metabolism and strengthens muscles. If the body is deficient in vitamin D, calcium levels decrease. Severe vitamin D deficiency can cause rickets in children and softening of bones in adults.

Doctors prescribe artificial supplements for those who are deficient in vitamin D, especially during the winter months when there is a lack of sunlight. The dose is determined using a test. Anyone who takes the supplement on their own runs the risk of exceeding the concentration of vitamin D in the body. At best, overdose can cause nausea, hypotension, and heart palpitations. In the worst case, lead to heavy urination and kidney problems.

This is exactly what happened to the Canadian, whose calcium levels were found by doctors to be too high. The man reported that, as a patient of a naturopath, he took vitamin D on his recommendation without undergoing a deficiency test.For two and a half years, he consumed drops with a total dose of 8,000 to 12,000 international units. By comparison, over-the-counter vitamin D supplements contain 800 to 1,000 units.

According to doctors, an overdose of vitamin D is quite rare, however, they warn of the risk of uncontrolled intake of the drug. They recommend not taking more than 1000 IU per day.

Devit-3® (Devit-3®) drops

Drops Devit-3® (Devit-3®) from other manufacturers and dosage forms:

Instructions for use

Active ingredient:

Colecalciferol * (Colecalciferol *)

ATX

A11CC05 Colecalciferol

Pharmacological group

• Vitamins and vitamin-like products

Nosological classification (ICD-10)

• E55. 0 Rickets active
• E83.5 Disorders of calcium metabolism
• M83 Osteomalacia in adults

Composition and form of release

in 10 ml dark glass dropper bottles; in a cardboard box 1 bottle.

Pharmacological action

Pharmacological action – regulating calcium-phosphorus metabolism.

Increases the permeability of the cellular and mitochondrial membranes of the intestinal epithelium, facilitating the transmembrane transport of calcium and other bivalent cations, activates the secondary absorption of phosphates, increases the capture of these ions by bone tissue, and enhances the ossification process.

Indications of the drug Vigantol

^®

Rickets, spasmophilia, osteomalacia.

Contraindications

Hypersensitivity, hypercalcemia, hypercalciuria, the presence of renal calcareous stones, sarcoidosis, immobilization.

Side effects

Hypercalcemia, hypercalciuria, arrhythmia, nausea, vomiting, disturbances of consciousness and psyche, weight loss, urolithiasis, calcium deposits in soft tissues, decreased appetite, thirst, polyuria.

Interaction

Thiazide diuretics increase the risk of hypercalcemia.

Method of administration and dosage

Inside, in a spoonful of milk or other liquid.

Prevention of rickets: to full-term healthy children, Vigantol is prescribed from the second month of life, 1 drop (about 500 IU of vitamin D ₃ ) daily (take 5 days, then a break of 2 days) during the first and second years of life, excluding summer months. Premature babies are prescribed 2 drops (about 1000 IU of vitamin D ₃ ) per day from the 10th day of life (take 5 days, then a break for 2 days), excluding the summer months.

For the treatment of rickets from the 10th day of life, 2–8 drops of Vigantol (about 1000–5000 IU of vitamin D ₃ ) are prescribed per day. During the first two months of life, as well as the 5th and 9th months of life, in the second year – 1-2 courses during the winter-spring period.

Prevention of the risk of diseases associated with vitamin D deficiency _Z : 1-2 drops of Vigantol (about 500-1000 IU of vitamin D ₃ ) per day (take 5 days, then a break for 2 days).

Prevention of vitamin D deficiency ₃ with malabsorption syndrome: 4-8 drops of Vigantol (about 3000-5000 IU vitamin D ₃ ) per day.

Treatment of osteomalacia caused by vitamin D deficiency _Z : 2-8 drops of Vigantol (about 1000-5000 IU vitamin D ₃ ) per day. Treatment should be continued for 1 year.

Maintenance therapy for osteoporosis: 2-4 drops of Vigantol (about 1000-3000 IU vitamin D ₃ ) per day.

Treatment of hypoparathyroidism and pseudohypoparathyroidism: , depending on the concentration in the plasma of calcium, 15-30 drops of Vigantol (about 10,000-20,000 IU of vitamin D ₃ ) are prescribed per day. If a higher dose is required, then a higher dosage is recommended. Calcium levels in blood and urine should be checked for 4-6 weeks, then every 3-6 months and the dose should be adjusted in accordance with normal blood calcium levels.

Precautions

Use with extreme caution in patients receiving thiazide drugs and suffering from sarcoidosis.

Storage conditions of the drug Vigantol

^®

In the dark place at a temperature of 15-25 ° C.

Keep out of reach of children.

The drug Drops Devit-3® (Devit-3®) to buy in Moscow, to buy in St. Petersburg and other cities of Russia is problematic. We are ready to help you find and buy Devit-3® Drops (Devit-3®) at an affordable price with delivery as soon as possible.

Before you buy Devit-3® Drops (Devit-3®), be sure to consult your doctor!

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Calcium and Vitamin D | Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ^® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Cal-Citrate Plus Vitamin D [OTC]; Calcet Petites [OTC]; Calcitrate [OTC] [DSC]; Calcium 500 / D [OTC] [DSC]; Calcium 600 + D [OTC]; Calcium 600-D [OTC] [DSC]; Calcium Citrate + D3 Maximum [OTC]; Calcium High Potency / Vitamin D [OTC]; Calcium Plus Vitamin D [OTC]; Calcium + D3 [OTC]; Caltrate 600 + D3 Soft [OTC]; Caltrate 600 + D3 [OTC]; Caltrate Gummy Bites [OTC]; Citrus Calcium + D [OTC] [DSC]; Liquid Calcium with D3 [OTC]; Liquid Calcium / Vitamin D [OTC]; Os-Cal Calcium + D3 [OTC]; Os-Cal Extra D3 [OTC]; Os-Cal [OTC]; Oysco 500 + D [OTC]; Oyster Calcium + D [OTC]; Oyster Shell Calcium + D [OTC]; Oyster Shell Calcium + D3 [OTC]; Oyster Shell Calcium 250 + D [OTC]; Oyster Shell Calcium 500 + D [OTC]; Oyster Shell Calcium 500 + D [OTC]; Oyster Shell Calcium Plus D [OTC]; Pronutrients Calcium + D3 [OTC]; Vita-Calcium [OTC] [DSC]

What is this drug used for?

• Used to improve growth and development.
• This medication is used to treat a condition that causes bone softening and fragility (osteoporosis).
• Used to treat and prevent low calcium levels.
• This medicinal product can also be used for other indications. Consult your doctor.

What should I tell my doctor BEFORE taking this drug?

• In case of an individual allergic reaction to calcium, vitamin D or any other component of this medicine.
• If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
• For the following conditions: High calcium levels, high vitamin D levels, kidney stones, or low phosphate levels.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems.You need to make sure that this drug is safe for your medical condition and in combination with other drugs you are already taking. Do not start or stop taking any medication or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

All forms of issue:

• Tell all healthcare providers that you are taking this drug.These are doctors, nurses, pharmacists and dentists.
• If you are allergic to tartrazine, consult your doctor. Some products contain tartrazine.
• This drug may interfere with other drugs taken by mouth. If you are taking other drugs, you may need to take them at a different time from the time you take this drug. Consult your doctor.
• Follow your doctor’s recommended diet.
• Tell your doctor if you are pregnant or planning to become pregnant. The benefits and risks of taking this drug during pregnancy will need to be discussed.
• Tell your doctor if you are breastfeeding. It is necessary to consult if the drug poses any risk to the child.

Chewable Tablet:

• If you have PKU, please consult your doctor. Some foods contain phenylalanine.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects. Call your doctor or get medical help right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

• Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• Severe constipation.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

• Nausea or vomiting.
• Constipation.

This list of potential side effects is not exhaustive.If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner.Read all the information provided to you. Follow all instructions strictly.

All forms of issue:

• Take this drug with food.

Chewable Tablet:

• Chew thoroughly before swallowing. Some brands can be swallowed whole or after being dissolved in the mouth. If you have questions, ask your pharmacist.

Powder:

• Mix with food or liquid before use.

Liquid:

• Doses of the liquid preparation should be measured with caution. Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for a dosing product for this drug.

What should I do if a dose of a drug is missed?

• Take the missed dose as soon as you can.
• If it’s time to take your next dose, do not take the missed dose and then return to your normal drug schedule.
• Do not take 2 doses at the same time or an additional dose.

How do I store and / or discard this drug?

• Store at room temperature.
• Store in a dry place. Do not store in the bathroom.
• Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs.Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information on medicinal products

• If your health does not improve or even worsens, see your doctor.
• You should not give your medicine to anyone and take other people’s medicines.
• Some medicines may have other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• Some medicines may have other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by the consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient.This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional.Please consult your doctor for complete information on the possible risks and benefits of taking this drug.

Copyright

© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

KOLEDAN instructions for use, price in pharmacies in Ukraine, analogues, composition, indications | COLEDAN oral drops, solution of the company “World Medicine”

pharmacodynamics . Vitamin D ₃ is an active antirachitic factor.The most important function of vitamin D is to regulate calcium and phosphate metabolism, which contributes to proper mineralization and skeletal growth.

Vitamin D ₃ is a natural form of vitamin D that is produced in humans by exposure to sunlight. Compared with vitamin D ₂ is characterized by 25% higher activity.

It is necessary for the functioning of the parathyroid glands, intestines, kidneys and skeletal system. Colecalciferol plays an essential role in the absorption of calcium and phosphates from the intestine, in the transport of mineral salts and in the process of bone calcification, and regulates the excretion of calcium and phosphates by the kidneys.The presence of calcium ions in the blood at physiological concentrations ensures the maintenance of skeletal muscle tone, myocardial function, promotes the conduction of nervous excitement, and regulates the blood coagulation process. Vitamin D is also involved in the functioning of the immune system by influencing the production of lymphokines.

Lack of vitamin D ₃ in food, weakening its absorption, calcium deficiency, as well as insufficient exposure to the sun during the period of rapid growth of the child lead to rickets, and in adults – to osteomalacia, in pregnant women – to the appearance of symptoms of tetany and lack of tooth enamel in newborns.

Women in the period of menopause who often suffer from osteoporosis, due to hormonal disorders, need to increase the dose of vitamin D ₃ .

Pharmacokinetics

Suction . Aqueous solution of vitamin D ₃ is better absorbed than oil. Premature babies have insufficient formation and flow of bile into the intestines, which disrupts the absorption of vitamins in the form of oil solutions.

After oral administration, colecalciferol is absorbed in the small intestine.

Distribution . Penetrates through the placental barrier and into breast milk.

Metabolism . It is metabolized in the liver and kidneys, turning into an active metabolite – calcitriol, which combines with a carrier protein and is transported to target organs (intestines, bones, kidneys). The half-life in the blood is several days and may increase in the case of kidney disease.

Derivation of . It is excreted in urine and feces.

Vitamin D ₃ participates in the regulation of phosphorus and calcium metabolism in the body 6 hours after taking the drug.

After taking vitamin D ₃ after 48 hours there is a significant increase in the level of cholecalciferol in the blood plasma.

• prevention of rickets, including in premature newborns;
• prevention of vitamin D deficiency ₃ in patients with malabsorption and high-risk patients without malabsorption;
• maintenance treatment for osteoporosis;
• treatment of rickets and osteomalacia.
• treatment of hypoparathyroidism.

the drug is intended for oral administration. 1 drop contains 500 IU of vitamin D ₃ . To accurately measure the dose, hold the bottle at a 45 ° angle while dispensing. For adults and older children, take the drug in a spoonful of liquid. For infants, drops are given in a spoonful of water, milk or porridge. Add the drug to food immediately before eating it.

Adults

Prevention of rickets .The recommended dose of the drug is 1 drop (about 500 IU of vitamin D ₃ ) per day.

Prevention of vitamin D deficiency ₃ in patients with malabsorption and high-risk groups without malabsorption . The recommended dose of the drug is 1 drop (about 500 IU of vitamin D ₃ ) per day.

Maintenance treatment for osteoporosis . The recommended dose of the drug is 2 drops (about 1000 IU of vitamin D ₃ ) per day.

Treatment of rickets and osteomalacia . The recommended dose of the drug is 2-10 drops per day (1000-5000 IU of vitamin D ₃ per day). The duration of treatment is within 1 year.

Treatment of hypoparathyroidism . The recommended dose of the drug depends on the level of calcium in the blood plasma and is 20–40 drops (about 10,000–20,000 IU of vitamin D ₃ ) per day. If you need to take higher doses of cholecalciferol, you should use the drugs in a higher dosage.

Children . The drug is used in children from the 2nd week of life.

The total recommended dose for the prevention of rickets in premature infants is 2 drops (about 1000 IU of vitamin D ₃ ) per day.

The total recommended dose for the treatment of vitamin D deficiency ₃ in children , including newborns, is 2-10 drops (about 1000-5000 IU vitamin D ₃ ) per day.

The duration of treatment depends on the course and severity of the disease and is determined by the doctor individually.Treatment of rickets and osteomalacia caused by vitamin D deficiency ₃ lasts for 1 year.

hypersensitivity to the active substance or other components of the drug; hypercalcemia and / or hypercalciuria; hypervitaminosis D; sarcoidosis; renal failure; nephrolithiasis; tuberculosis; pseudohypoparathyroidism (the need for vitamin D may be lower than during the period of normal vitamin sensitivity). Rare hereditary fructose intolerance, glucose-galactose malabsorption, sucrose-isomaltase deficiency.

Adverse reactions, as a rule, do not develop when taken in the recommended doses. In the case of individual hypersensitivity to the drug, which is rarely observed, or as a result of the use of too high doses for a long period, hypervitaminosis D may appear.

From the side of metabolism and nutrition: hypercholesterolemia, weight loss, polydipsia.

From the side of the psyche: depression, decreased libido, mental disorders.

From the nervous system: headache, drowsiness.

From the side of the organ of vision: conjunctivitis, photosensitization.

From the side of the cardiovascular system: arrhythmia, hypertension.

From the digestive tract: loss of appetite, nausea, vomiting, constipation, dry mouth, flatulence, abdominal pain, diarrhea, dyspepsia, pancreatitis.

From the liver and biliary tract: increase in the activity of aminotransferases.

From the immune system, skin and subcutaneous tissue: hypersensitivity reactions, including urticaria, rash, itching and anaphylactoid reactions (due to the content of benzyl alcohol in the preparation).

Musculoskeletal and connective tissue disorders: myalgia, arthralgia, muscle weakness.

From the kidneys and urinary tract: increased levels of calcium in the blood and / or urine, urolithiasis and tissue calcification, uremia, polyuria.

General disorders: increased sweating.

There have also been reports of rhinorrhea and hyperthermia.

Individual satisfaction of the need for vitamin D should take into account all possible sources of this vitamin.

The determination of the child’s daily requirement for vitamin D and the method of its use should be established individually and verified during periodic studies, especially in the first months of life.

Combination therapy with vitamin D or calcium should be carried out only under medical supervision and with monitoring of calcium levels in blood plasma and urine. It is not recommended to use colecalciferol simultaneously with high doses of calcium. Too high doses of the drug, used for a long time, or loading doses can cause chronic hypervitaminosis D ₃ .

During the use of the drug, it is recommended to control the level of calcium, phosphates and glucose in the blood plasma and urine, and in the case of long-term treatment – to control the level of creatinine in the blood plasma.

The drug should be used with caution in immobilized patients, persons with impaired renal function, cardiovascular diseases and patients taking simultaneously thiazides and cardiac glycosides.

The drug should be used with caution in infants born with a small anterior crown.

Use during pregnancy or lactation . During pregnancy, the drug should not be used in high doses due to the possibility of a teratogenic effect in case of an overdose.

Vitamin D passes into breast milk, therefore, during breastfeeding, the drug should be used only as directed by a doctor.

Children. The drug is used in children from the 2nd week of life.

The ability to influence the reaction rate when driving vehicles or other mechanisms . There are no messages for today. However, when driving vehicles or other mechanisms, it is recommended to be especially careful, given the possibility of adverse reactions from the nervous system.

with the simultaneous use of colecalciferol with other drugs, the following interactions are possible:

• with aluminum and magnesium-containing antacids – increased toxic effects of aluminum on bones and the risk of developing hypermagnesemia in patients with renal failure;
• with products containing high doses of calcium or phosphorus – increased risk of hyperphosphatemia;
• with ketoconazole – decrease in biosynthesis and catabolism of the metabolite 1,25 (OH) ₂ -colecalciferol;
• with metabolites and analogues of vitamin D – increased risk of toxic effects, the simultaneous use of these agents is possible only as an exception and only under the control of the level of calcium in the blood plasma;
• with antiepileptic drugs (phenytoin, phenobarbital), means for reducing body weight (orlistat) and lowering cholesterol levels, rifampicin , – reducing the absorption of colecalciferol;
• with cardiac glycosides – an increase in the severity of the toxic effect of the latter (the risk of developing cardiac arrhythmias increases), the simultaneous use of these funds should be carried out with caution;
• with thiazides – increased risk of hypercalcemia, the simultaneous use of these agents should be carried out with caution.

Possible antagonism between cholecalciferol and agents that are prescribed for hypercalcemia, such as calcitonin, etidronate, pamidronate.

symptoms . In case of an overdose of colecalciferol, hypercalcemia develops (occurs after the application of 50,000-100,000 IU of vitamin D ₃ ), hypercalciuria, renal calcifications and bone damage, as well as changes in the cardiovascular system.

Overdose is accompanied by the following effects: muscle weakness, loss of appetite, nausea, vomiting, constipation, polydipsia, polyuria, drowsiness, photosensitivity, pancreatitis, rhinorrhea, hyperthermia, decreased libido, conjunctivitis, cardiac cholesterolemia, increased activity, transaminase urea.Muscle and joint pain, headache, and weight loss are common symptoms. Dysfunction of the kidneys develops with albuminuria, erythrocyturia and polyuria, increased loss of potassium, hypostenuria, nocturia and an increase in blood pressure of an average degree. In severe cases, corneal opacity is possible, less often – edema of the papilla of the optic nerve, inflammation of the iris up to the development of cataracts.

Kidney calculi, calcification of soft tissues such as blood vessels, heart, lungs and skin can form.Cholestatic jaundice rarely develops.

Treatment . In case of overdose, the drug should be discontinued. Depending on the degree of hypercalcemia, a diet with a low calcium content or without calcium, drinking a lot of fluids, forced diuresis induced by the administration of furosemide, as well as taking corticosteroids and calcitonin are recommended.

In the case of normal functioning of the kidneys, the calcium level significantly decreases with the introduction of an infusion solution of sodium chloride (3-6 liters for 24 hours) with the addition of furosemide, in some cases, 15 mg / kg body weight / hour of sodium edetate should also be used, constantly monitoring the level of calcium and ECG.In oligoanuria, on the contrary, hemodialysis is necessary. There is no specific antidote.

at a temperature not exceeding 25 ° C in its original packaging. After opening the bottle, the drug can be used within 6 months.

Date added: 01.04.2021

value, consumption rates, consequences of vitamin D deficiency

History

In the 15th century, an epidemic of rickets began in England in large cities (children with a twisted spine, arms and legs).This was due to the lack of sunlight due to the close development of high buildings, smoke in the air.

In 1928. German scientist Windaus received the Nobel Prize in Chemistry for his study of the properties and structure of vitamin D.

What causes vitamin D deficiency

Vitamin D deficiency in many residents of Russia is due to:

• located in the northern temperate zone (above 42 degrees north latitude)
• limited exposure to the sun (office work, driving)
• Eating meat from animals that have not been exposed to the sun (farms)
• sunscreen use
• Chronic diseases (obesity, intestinal pathology, taking a lot of drugs)

You can determine the level of vitamin D in your body by passing the appropriate test:

25-OH vitamin D (25-hydroxycalciferol) (amount)

For the curious

Vitamin D unites a group of vitamins (D1, D2, D3, D4, D5), of which only two forms (D2 and D3) have important biological significance.

The main biological role of calcitriol (1,25-OH-vitamin D) is to maintain a constant level of calcium in the blood (vitamin D enhances the absorption of calcium in the intestine and, if it is insufficient in the blood, ensures the flow of calcium from bones into the blood ).

Over time, receptors for calcitriol, in addition to the intestines and bones, were found in the kidneys, genitals, pancreas, muscles, cells of the immune and nervous systems.Thus, it became clear that vitamin D performs a large number of different functions in the human body:

• regulates the expression of 3% of the human genome (several thousand genes)
• increases the sensitivity of the insulin receptor (prevention of insulin resistance, obesity, diabetes mellitus)
• strengthens the skeletal system
• reduces the level of parathyroid hormone in the blood
• promotes the synthesis of sex hormones (testosterone, estrogen, progesterone)
• improves reproductive function
• affects innate and acquired immunity
• prevents the development of tumors, depression, Parkinson’s disease

Lack of vitamin D

Lack of vitamin D in the body can lead to development:

• cardiovascular diseases
• Immunodeficiency, allergies, psoriasis, bronchial asthma, rheumatoid arthritis
• periodontal disease
• tumors of the colon, mammary glands, ovaries, prostate
• chronic fatigue, depression, insomnia
• Reduced muscle strength leading to a risk of falls
• decrease in motility and the number of morphologically normal spermatozoa (male factor of infertility)
• risk factor for premature birth, fetopathies (less than 20 ng / ml)

Reaching a Vitamtin D level of 50 ng / ml (125 nmol / L) reduces the risk of developing:

Vitamin D is important during pregnancy.

Its deficiency is associated with the risk of developing gestational diabetes mellitus, premature birth, preeclampsia, and various intrauterine malformations.

No cases of teratogenic (leading to the development of tumors) action of vitamin D have been registered in the world.

Vitamin D norms

Given the different units of measurement, the recommended level is:

60 – 100 ng / ml

150 – 250 nmol / l

To convert from ng / ml to nmol / L you need ng / ml * 2.5 = nmol / L

Example: 30 ng / ml * 2.5 = 75 nmol / L

The Russian Association of Endocrinologists considers the optimal concentration of vitamin D in the blood of an adult is 30-100 ng / ml, is insufficient 20-30 ng / ml, is deficient – less than 20 ng / ml.

According to data presented at the 10th European Congress on Menopause and Andropause (Madrid, 2015), the level of vitamin D in obese patients in Russia:

less than 20 ng / ml – 35%

20-30 ng / ml – 30%

more than 30 ng / ml – 35%

Daily intake of vitamin D as recommended by the American Society of Endocrinologists (2011).

Preventive dose of vitamin D (when you can not detect it in the blood and take it calmly) is 4000 IU per day.

Without medical supervision, it is not recommended to take vitamin D at a dose of 10,000 IU for more than 6 months. (Russian Association of Endocrinologists)

It is almost impossible to overdose on vitamin D. For example, in Holland, an elderly couple (90 and 95 years old) accidentally took a single dose of cholecalciferol 2,000,000 IU each.

Doctors followed them for 2 months and did not reveal any symptoms of overdose or toxicity. The maximum blood concentration of its form of 25-OH-vitamin D on the 8th day was 210 and 170 ng / ml, respectively, which slightly exceeds its target values.

Calculation of the dose of vitamin D3

The daily dose of vitamin D is calculated from the table based on its initial value.

You should also know that:

25 μg (vitamin D) = 1000 IU (vitamin D)

IR – Level Available

For example, to increase the level of vitamin D3 from 15 to 60 ng / ml, it is necessary to take 10,000 IU of vitD daily.