Vit D

Therapeutic Class
anti-osteoporotic
Indications

Oral
Nutritional deficiency
Adult: 10 mcg (400 units) daily. May also be given via IM inj. 
Oral
Deficiency due to malabsorption states or liver diseases
Adult: Up to 1 mg (40 000 units) daily. May also be given via IM inj. 
Oral
Hypocalcaemia caused by hypoparathyroidism
Adult: Up to 5 mg (200 000 units) daily. May also be given via IM inj.

Contraindications

Hypercalcaemia. Evidence of vitamin D toxicity.

Warnings / Precautions

Excessive intake may lead to development of hyperphosphataemia or hypercalcaemia. Infants, renal impairment or calculi, heart disease. Monitor plasma phosphate & calcium level. Pregnancy, lactation.

Adverse Reactions

Hyperphosphataemia or hypercalcaemia (in excessive intake). Associated effects of hypercalcaemia include hypercalciuria, ectopic calcification, & renal & CV damage.

Drug Interactions

Increased risk of hypercalcaemia if given with thiazide diuretics, calcium or phosphate. Antiepileptics (e.g. carbamazepine, phenobarbitone, phenytoin & primidone) may increase vitamin D requirements. Rifampicin & isoniazid may reduce efficacy of vitamin D. Corticosteroids may counteract the effect of vitamin D. Digoxin or any cardiac glycoside. Reduced absorption when taken with cholestyramine, colestipol, mineral oil, orlistat. Ketoconazole.

Lab Interactions

Interfere with Zlatkis-Zak reaction causing a falsely increased serum cholesterol determination.

Food Interactions

Olestra (fat substitute).

Mechanism of Actions

Vit D may have anti-osteoporotic, immunomodulatory, anticarcinogenic, antipsoriatic, antioxidant & mood-modulatory activities. Along with parathyroid hormone & calcitonin, regulate serum calcium conc.
Onset: Slow.
Duration: Relatively prolonged duration of action.
Absorption: Well absorbed from the GI tract. Presence of bile is essential for adequate intestinal absorption. Hence absorption may be decreased in patients with decreased fat absorption.
Distribution: Bound to a specific α-globulin. Can be stored in adipose & muscle tissue for long periods of time. Slowly released from storage sites & skin where it is formed in the presence of sunlight or uv light. May distribute into breast milk.
Metabolism: Hydroxylated in the liver by the enzyme vitamin D 25-hydroxylase to form 25-hydroxycholecalciferol (calcifediol). Further hydroxylated in the kidneys by the enzyme vitamin D1-hydroxylase to form the active metabolites 1,25-dihydroxycholecalciferol (calcitriol). Further metabolism also occurs in the kidneys, including the formation of the 1,24,25-trihydroxy derivatives.
Excretion: Mainly in the bile & faeces with only small amounts appearing in urine.

Administration

May be taken with or without food.

Pregnancy Category

A: Drug Pregnancy Category Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters

ATC Classification
A11CC05
Available As
  • Vit D2 0.08 mcg
  • Vit D6 0.20 mg
  • Vit D 0.25 mcg
  • Vit D3 0.25 mcg
  • Vit D3 0.51 mcg
  • Vit D 1.1 mcg
  • Vit D3 10 iu
  • Vit D 10 mcg
  • Vit D3 10 mg
  • Vit D 100 iu
  • Vit D3 100 iu
  • Vit D3 1000 iu
  • Vit D 1000 iu
  • Vit D2 1000 iu
  • Vit D 12.9 iu
  • Vit D3 1200 iu
  • Vit D3 125 iu
  • Vit D3 125 mg
  • Vit D3 1250 iu
  • Vit D 126 iu
  • Vit D3 133 iu
  • Vit D3 135 iu
  • Vit D3 15 iu
  • Vit D3 150 iu
  • Vit D 150 iu
  • Vit D3 160 iu
  • Vit D3 168 iu
  • Vit D3 175 iu
  • Vit D 176 iu
  • Vit D 185 iu
  • Vit D 2.3 mcg
  • Vit D 2.4 mcg
  • Vit D3 2.5 iu
  • Vit D 2.7 mcg
  • Vit D 2.8 mcg
  • Vit D3 200 i.u
  • Vit D 200 iu
  • Vit D3 200 iu
  • Vit D2 200 iu
  • Vit D3 200 mg
  • Vit D3 2000 i.u
  • Vit D3 2000 iu
  • Vit D3 208.3 iu
  • Vit D 2083 iu
  • Vit D 21.8 iu
  • Vit D 220 iu
  • Vit D3 225 iu
  • Vit D3 25 iu
  • Vit D3 25 mg
  • Vit D3 250 iu
  • Vit D 250 iu
  • Vit D2 250 iu
  • Vit D3 250 mg
  • Vit D3 270 iu
  • Vit D 3.9 mcg
  • Vit D3 30 iu
  • Vit D3 30 mg
  • Vit D3 300 iu
  • Vit D 300 iu
  • Vit D2 300 iu
  • Vit D3 300000 iu
  • Vit D 315 iu
  • Vit D3 320 iu
  • Vit D3 3200 iu
  • Vit D 3200 iu
  • Vit D 324 iu
  • Vit D 330 iu
  • Vit D3 333 iu
  • Vit D 3333 iu
  • Vit D 345 iu
  • Vit D3 35 iu
  • Vit D 360 iu
  • Vit D 4 mcg
  • Vit D3 4 mcg
  • Vit D 4.2 mcg
  • Vit D3 4.2 mcg
  • Vit D 4.4 mcg
  • Vit D 4.63 mcg
  • Vit D 40 iu
  • Vit D3 40 mg
  • Vit D 40.5 iu
  • Vit D3 400 iu
  • Vit D2 400 iu
  • Vit D 400 iu
  • Vit D3 400 mg
  • Vit D 42 iu
  • Vit D3 420 iu
  • Vit D 430 iu
  • Vit D 44 iu
  • Vit D3 450 iu
  • Vit D3 5 iu
  • Vit D3 5 mcg
  • Vit D 5 mcg
  • Vit D 5 mg
  • Vit D3 5 mg
  • Vit D 5.3 mcg
  • Vit D 5.6 mcg
  • Vit D3 50 iu
  • Vit D 50 iu
  • Vit D 50 mcg
  • Vit D 50 mg
  • Vit D3 500 iu
  • Vit D 500 iu
  • Vit D3 500 mg
  • Vit D3 5000 iu
  • Vit D 502 iu
  • Vit D 520 iu
  • Vit D 533.3 iu
  • Vit D 54 iu
  • Vit D 550 iu
  • Vit D 6 mcg
  • Vit D3 60,000 iu
  • Vit D3 600 iu
  • Vit D 600 iu
  • Vit D3 6000 iu
  • Vit D3 60000 iu
  • Vit D3 600000 iu
  • Vit D3 62.5 iu
  • Vit D3 630 iu
  • Vit D3 666 iu
  • Vit D 667 iu
  • Vit D 7 mcg
  • Vit D 70 mcg
  • Vit D 700 iu
  • Vit D 72 iu
  • Vit D 8 mcg
  • Vit D3 8 mg
  • Vit D 8.3 mcg
  • Vit D3 800 iu
  • Vit D 800 iu
  • Vit D3 83 mg
  • Vit D 833 iu
  • Vit D 86 iu
  • Vit D 9 mcg
  • Vit D3 900 iu
  • Vit D 94 iu
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