This guidance is for use in adults only (including elderly and care home residents).
In most patients we can use both calcium and vitamin D. There are multiple preparations available through the formulary (Adcal D3, Calcichew D3, Calfovit sachets, Calceos, etc.). Care is needed in patients with hypercalcaemia, hyperparathyroidism or those who only need vitamin D.
IM injectable forms (ergocalciferol 300,000 IU) are also available and have been used in both primary and secondary care. This should be used in circumstances where oral medication is not possible, under the guidance of metabolic bone specialists.
In cases of hypercalcaemia and hyperparathyroidism with vitamin D deficiency, a low dose of vitamin D (400 IU) with monitoring is used.
Idris Pharmaceuticals Ltd.
Tel. 01932 824100
Dekristol capsules contain arachis (peanut) oil and are contraindicated for patients with nut allergies.
Source: Osteoporosis Group, Nottingham University Hospitals, December 2010
Prevention
The usual dose for prevention of vitamin D deficiency in adults is 800 IU per day. For patients over 65 and long-term care residents, the dose is up to 1,000 IU per day with adequate calcium. Multiple over-the-counter preparations containing between 400 IU and1,000 IU are available. Sunvit D3 (1,000 IU) is a preparation that patients can buy OTC.In most patients we can use both calcium and vitamin D. There are multiple preparations available through the formulary (Adcal D3, Calcichew D3, Calfovit sachets, Calceos, etc.). Care is needed in patients with hypercalcaemia, hyperparathyroidism or those who only need vitamin D.
Deficiency
In case of proven deficiency the best option is to use cholecalciferol (Dekristol) which is available as 20,000 IU capsules. The recommended treatment is 1 to 2 capsules monthly for 6 - 8 months. In cases of severe vitamin D deficiency where loading is required, the recommended treatment is 2 capsules weekly for 8 weeks with monitoring of bone profile (serum calcium and phosphate) at 4 weeks. This is to be followed up by maintenance of 1,000 IU per day.IM injectable forms (ergocalciferol 300,000 IU) are also available and have been used in both primary and secondary care. This should be used in circumstances where oral medication is not possible, under the guidance of metabolic bone specialists.
In cases of hypercalcaemia and hyperparathyroidism with vitamin D deficiency, a low dose of vitamin D (400 IU) with monitoring is used.
Pro D3 capsules
Glasshouse Chemist can supply Pro D3 capsules containing 10,000 IU and 20,000 IU of colecalciferol.
Cholecalciferol capsules 20,000 IU (Dekristol)
The product is licensed elsewhere in Europe and can be obtained through pharmaceutical importers as follows:Idris Pharmaceuticals Ltd.
Tel. 01932 824100
Dekristol capsules contain arachis (peanut) oil and are contraindicated for patients with nut allergies.
Source: Osteoporosis Group, Nottingham University Hospitals, December 2010
