5,000 IU10, 000 IU50, 000 IU

A fatsoluble vitamin, vitamin D comes mostly in two forms: cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2). Compared to ergocalciferol, cholecalciferol has ten times greater potency. Additionally, it stimulates a faster manufacture of serum calcidiol sustained longer at higher concentrations. Milk and cereal among other foods have vitamin D enrichment. Additional food sources include fish liver oils, fatty fish, and eggs from hens that have been dosed with vitamin D.

The skin produces cholecalciferol following exposure to sunlight. In those who are in good health, 7dehydrocholesterol present in the skin changes into cholecalciferol. Ingesting 200 IU of cholecalciferol is same as exposing around 20% of body surface area briefly to sunlight. Cutaneous production is therefore quite effective. Many people lack the capacity to adequately store cholecalciferol, though. Hence, supplementing cholecalciferol is imperative.

The metabolic or clinical reactions once activated within the body are not influenced by the structural distinctions between the two forms of vitamin D. Human studies have been inconsistent even if animal studies have shown a disparity in toxicity between vitamin D2 and vitamin D3. Needed for normal bone development and mineralization, vitamin D is responsible for correct calcium and phosphate balance. Measuring 25hydroxyvitamin D [25(OH)D] serum levels—representing all sources of vitamin D (including sunlight, nutritional or supplements)—helps one to establish patient specific dosing. Though cholecalciferol is indicated for usage in several medical conditions, it is mostly used today for vitamin D supplementation and the prevention and treatment of vitamin D deficit and rickets.

Note: Nutraceuticals are promoted under the 1994 Dietary Supplement and Health Education Act (DSHEA) in the United States. Because of this, nutraceuticals are not governed under the same rules as medicines; there are not necessarily scientific evidence supporting claimed benefit(s) available for them. Consumers should also understand that nutraceuticals are not subject to strict quality control standards and that significant variance can exist in both their potency and their purity.

Ch olecalciferol is comparable to ergocalciferol clinically; hence, when starting cholecalciferol treatment, clinicians should also consider contraindications and safety measures for ergocalciferol.

Hypercalcemia, hypervitaminosis D, and vitamin D sensitivity or hypersensitivity to any of the excipients in the formulation render cholecalciferol unacceptable. One underlying cause of idiopathic hypercalcemia babies whose vitamin D consumption has to be limited is hypersensitivity to vitamin D.

Patients with renal illness, particularly renal failure, could be at higher risk for vitamin Dinduced hypercalcemia even with normal doses. To guarantee appropriate supplementation and, in pediatric patients, correct growth, close clinical monitoring is necessary. Use of a vitamin D analog seems indicated in accordance with the National Kidney Foundation for patients with stage 3 or more severe kidney disease.

Patients with fat malabsorption brought on by cystic fibrosis, Crohn’s disease, some kinds of liver illness, gallbladder disease, or biliary tract disease may need Higher vitamin D doses made necessary by reduced gut absorption. Some patients on concurrent medications (e.g., some anticonvulsants) might need higher doses as well. In such circumstances, one might favor the prescription of active vitamin D analogs.

With the regular daily dose of Vitamin D within the advised dietary daily intakes for a pregnant woman, no adverse effects have been noted. Studies on animal reproduction have found fetal abnormalities in several species linked to hypervitaminosis D; hence, utilization of vitamin D in excess of the recommended Unless in the opinion of the doctor the possible benefits outweigh the risks involved, dietary allowance during a normal pregnancy should be avoided. With a Tolerable Upper Intake Limit of 4000 International Units/day, the vitamin D RDI during pregnancy is 600 International Units per day.

The 25hydroxyvitamin D metabolite of vitamin D (cholecalciferol) is delivered into human breast milk at levels matching those of the maternal serum concentration. Normal breast milk Without maternal supplementation, concentrations of vitamin D in exclusively breastfed babies who do not have other vitamin D supplements are inadequate to avoid vitamin D deficiency. Prolonged, exclusive breastfeeding of babies without advised supplementation is a major cause of rickets in newborns, mostly in dark-skinned babies nursing moms who are not vitamin D replete.

Generally, the use of extra vitamin D following advised dietary intakes is not linked with significant negative effects. Though overdose of vitamin D might have negative effects, such symptoms connected to hypervitaminosis D (and resulting hypercalcemia) are almost never noted. An excess of vitamin D results in unusually high levels of calcium in the blood and is virtually always brought on by vitamin D analogs (e.g., calcitriol, rather than vitamin D present in dietary supplements (e.g., cholecalciferol, ergocalciferol), doxercalciferol, paricalcitol). However, patients consuming greater doses of vitamin D supplements should note any of the following possible symptoms of high vitamin D/calcium levels: nausea/vomiting, constipation, loss headache, unusual weariness or tiredness, mental/mood alterations or irritability, increased urinary frequency, polydipsia (increased thirst), of appetite. A medical examination might be needed for these symptoms. Anorexia, weight loss, polyuria, and arrhythmmias can all be seen. Furthermore, prolonged hypervitaminosis D might cause hypercalciuria brought on by bone resorption leading to hypercalcemia. Hypercalcemia is minor in early phases of vitamin D poisoning, and renal function stays normal. Continued bone resorption and elevated calcium levels result in parathyroid production suppression as vitamin D toxicity progresses. Calcification of the blood vessels and other tissues Prolonged vitamin D toxicity has been linked with it. Data do not support a link between kidney stones and vitamin D poisoning. Death caused by Failure of the heart and renal systems probably causes D intoxication. Long-term doses of vitamin D of 10,000–40,000 International Units per day and long-term serum 25(OH)D levels of 500–600 nmol/L (200–400 ng/mL) are related with vitamin D toxicity. Because of vitamin D’s lengthy halflife, signs of Toxicity could be prolonged.

FDA categorizes ergocalciferol (Vitamin D2) as C, hence dietary supplements of cholecalciferol should be treated similarly regarding pregnancy. No negative effects have been observed from the usual daily intake of Vitamin D inside the suggested dietary daily intakes for a pregnant woman. Studies on animal reproduction have revealed anomalies in several species related to hypervitaminosis D; hence, use of vitamin D above the suggested Unless, in the judgment of the doctor, possible benefits outweigh the hazards involved, nutritional allowance during typical pregnancy should be avoided. With a Tolerable Upper Intake Limit of 4,000 International Units daily, the RDI of vitamin D during pregnancy is 600 International Units per day.

At concentrations near to those found in maternal serum, the 25hydroxyvitamin D metabolite of vitamin D (cholecalciferol) is distributed into human breast milk. Normal breast milk In babies only breastfed without any other vitamin D supplementation, concentrations (without maternal supplementation) are insufficient to stop vitamin D deficit. In darkskinned babies breastfed by mothers not vitamin D replete, extended, exclusive breastfeeding without suggested supplements is a major source of rickets in infants. Usually seen as safe is the use of vitamin D within the suggested daily nutritional intake for lactating women. Although nursing mothers who receive high-dose vitamin D supplementation have been found to raise the amount of vitamin D in breast milk and to somewhat increase 25(OH)D. Levels in infants: Although the results have not been confirmed, supplementation to newborns is still advised. Typically, the infant’s serum calcium levels should be observed while a nursing mother is given large doses of vitamin D since hypercalcemia has high dose maternal usage has been linked with it.

Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond-use date. Do not flush unused medications or pour down a sink or drain.

1. Nasim B, Al Sughaiver HMZ, Abdul Rahman SM, Inamdar RFB, Chakaki R, Abuhatab S. Efficacy of Vitamin D3 versus Vitamin D2 in Deficient and Insufficient Patients: An Open-Label, Randomized Controlled Trial. Ibnosina Journal of Medicine & Biomedical Sciences. 2019; 11(2): 57-61.
2. Institute of Medicine (IOM), Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press, 2011.
3. Drisdol (ergocalciferol) package insert. New York, NY: Sanofi-Synthelabo, Inc.; 2009 Nov.
4. Kidney Disease Improving Global Outcomes. KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD_MBD). 2009. http://www.kdigo.org/pdf/KDIGO%20CKD-MBD%20GL%20KI%20Suppl%20113.pdf.– LinkOpens in New Tab
5. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes – Panel on Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine (IOM). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. The National Academy of Sciences Press, Washington DC; 1997
6. Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Prevention of rickets and Vitamin D deficiency in Infants, Children, and Adolescents. Pediatrics 2008;112:1142-1152.
7. Rocaltrol® (calcitriol) package insert. Nutley, NJ: Roche Laboratories, Inc.; 2004 Jul.[/fn][fn]Hectorol® (doxercalciferol) package insert. Middleton, WI: Bone Care International, Inc.; 2005 Jun.
8. Hectorol® (doxercalciferol) package insert. Middleton, WI: Bone Care International, Inc.; 2005 Jun.
9. Chan JC, Jacob M, Brown S, et al. Aluminum metabolism in rats: effects of vitamin D, dihydrotachysterol, 1,25-dihydroxyvitamin D and phosphate binders. Nephron1988;48:61—4.
10. McNamara JO. Drugs effective in the therapy of the epilepsies. Gilman AG, Hardman JG, Limbird LE, (eds.) In: Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 10th ed., New York, McGraw-Hill Companies. 2001:530—2.
11. Marcus R. Agents affecting calcification and bone turnover: Calcium phosphate, parathyroid hormone, vitamin D, calcitonin, and other compounds. Gilman AG, Hardman JG, Limbird LE, (eds.) In: Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 10th ed., New York, McGraw-Hill Companies. 2001:1715—43.
12. Lanoxin® (digoxin) package insert. Research Triangle Park, NC: Glaxo Smith Kline; 2001 Aug.
13. Amin S, LaValley MP, Simms RW, et al. The role of vitamin D in corticosteroid-induced osteoporosis: an analytical approach. Arthritis Rheum 1999;42:1740—51.
14. Reid IR. Preventing glucocorticoid-induced osteoporosis. N Engl J Med 1997;337:420—1.
15. Questran® and Questran® Light (cholestyramine) package insert. Spring Valley, NY: Par Pharmaceutical Inc; 2002 July.
16. Xenical® (orlistat) package insert. Nutley, NJ: Roche Laboratories Inc.; 2005 Jan.
17. Hypponen E, Fararouei M, Sovio U, et al. High-dose vitamin D supplements are not associated with linear growth in a large Finnish cohort. J Nutr 2011;141:843-848.