vitamin D (Rx, OTC)

Brand and Other Names:Drisdol, Calciferol, more...cholecalciferol, 1,25-Dihydroxycholecalciferol, ergocalciferol
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

1 mcg = 40 international units (IU)

oral solution

  • 8000IU/mL (200mcg/mL)

capsule

  • 50,000IU (1.25mg)

tablet

  • 400IU (10mcg)
  • 2000IU (50mcg)

Nutritional Supplementation

Recommended daily allowance (RDA)

19-70 years: 600 IU (15 mcg)/day

Pregnant or lactating women: 600 IU (15 mcg)/day

Osteoporosis

Prophylaxis and treatment

>50 years: 800-1000 IU (20-25 mcg) PO once daily with calcium supplements

Hypoparathyroidism

50,000-200,000 IU (0.625-5 mg) PO once daily with calcium supplements

Vitamin D-Resistant Rickets

12,000-500,000 IU (0.3-12.5 mg) PO once daily

Familial Hypophosphatemia

10,000-60,000 IU (0.25-1.5 mg) PO once daily with phosphate supplements

Dosage Forms & Strengths

1 mcg = 40 IU

oral solution

  • 8000IU/mL (200mcg/mL)

capsule

  • 50,000IU (1.25mg)

tablet

  • 400IU (10mcg)
  • 2000IU (50mcg)

Nutritional Supplementation

RDA

0-12 months: 400 IU (10 mcg) PO once daily

1-18 years: 600 IU (15 mcg) PO once daily

Vitamin D-Resistant Rickets

12,000-500,000 IU (0.3-12.5 mg) PO once daily

Familial Hypophosphatemia

40,000-80,000 IU (1-2 mg) PO once daily with phosphate supplements; may be reduced after stage of growth is complete

Nutritional Supplementation

RDA

<70 years: 600 IU (15 mcg) PO once daily

>70 years: 800 IU (20 mcg) PO once daily

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Interactions

Interaction Checker

and vitamin D

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              Serious - Use Alternative (2)

              • pexidartinib

                vitamin D and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • pretomanid

                vitamin D, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              Monitor Closely (25)

              • aluminum hydroxide

                vitamin D increases levels of aluminum hydroxide by Other (see comment). Use Caution/Monitor. Comment: Avoid coadministration. Chronic use of aluminum-containing antacids in conjunction with vitamin D can lead to aluminum retention and possible toxicity.

              • calcium acetate

                vitamin D, calcium acetate. Other (see comment). Use Caution/Monitor. Comment: The concurrent use of vitamin D with calcium salts is generally beneficial; in some patients this combination may result in hypercalcemia.

              • calcium carbonate

                vitamin D, calcium carbonate. Other (see comment). Use Caution/Monitor. Comment: The concurrent use of vitamin D with calcium salts is generally beneficial; in some patients this combination may result in hypercalcemia.

              • calcium chloride

                vitamin D, calcium chloride. Other (see comment). Use Caution/Monitor. Comment: The concurrent use of vitamin D with calcium salts is generally beneficial; in some patients this combination may result in hypercalcemia.

              • calcium citrate

                vitamin D, calcium citrate. Other (see comment). Use Caution/Monitor. Comment: The concurrent use of vitamin D with calcium salts is generally beneficial; in some patients this combination may result in hypercalcemia.

              • calcium gluconate

                vitamin D, calcium gluconate. Other (see comment). Use Caution/Monitor. Comment: The concurrent use of vitamin D with calcium salts is generally beneficial; in some patients this combination may result in hypercalcemia.

              • chlorothiazide

                chlorothiazide increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.

              • chlorthalidone

                chlorthalidone increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.

              • cholestyramine

                cholestyramine will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. Bile acid sequestrants may decrease the absorption of fat-soluble vitamins. Administer vitamin supplementation at least 4 hours prior to cholestyramine.

              • colesevelam

                colesevelam will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. Bile acid sequestrants may decrease the absorption of fat-soluble vitamins. Administer vitamin supplementation at least 4 hours prior to colesevelam.

              • colestipol

                colestipol will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. Bile acid sequestrants may decrease the absorption of fat-soluble vitamins. Administer vitamin supplementation at least 4 hours prior to colestipol.

              • digoxin

                vitamin D increases toxicity of digoxin by Other (see comment). Use Caution/Monitor. Comment: Vitamin D may cause hypercalcemia which may affect the actions of digoxin and/or lead to cardiac arrhythmias.

              • fosphenytoin

                fosphenytoin decreases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Vitamin D supplementation or dosage adjustments may be required in patients who are receiving chronic treatment with anticonvulsants.

              • hydrochlorothiazide

                hydrochlorothiazide increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.

              • indapamide

                indapamide increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.

              • magnesium citrate

                vitamin D increases levels of magnesium citrate by Other (see comment). Use Caution/Monitor. Comment: Vitamin D can increase serum magnesium concentrations, particularly in the presence of renal impairment. The combined use of vitamin D and magnesium-containing products should be avoided, if possible, in patients with chronic renal failure.

              • magnesium hydroxide

                vitamin D increases levels of magnesium hydroxide by Other (see comment). Use Caution/Monitor. Comment: Vitamin D can increase serum magnesium concentrations, particularly in the presence of renal impairment. The combined use of vitamin D and magnesium-containing products should be avoided, if possible, in patients with chronic renal failure.

              • methyclothiazide

                methyclothiazide increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.

              • metolazone

                metolazone increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.

              • mineral oil

                mineral oil will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. Avoid concomitant use of mineral oil and vitamin D supplements to avoid risk of decreased absorption of vitamin D. Applies to only oral administration of these agents.

              • orlistat

                orlistat will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. When combination must be used, may consider administering vitamin D at least 2 hours before or after administration of orlistat.

              • phenobarbital

                phenobarbital decreases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Vitamin D supplementation or dosage adjustments may be required in patients who are receiving chronic treatment with anticonvulsants.

              • phenytoin

                phenytoin decreases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Vitamin D supplementation or dosage adjustments may be required in patients who are receiving chronic treatment with anticonvulsants.

              • primidone

                primidone decreases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Vitamin D supplementation or dosage adjustments may be required in patients who are receiving chronic treatment with anticonvulsants.

              • sucralfate

                vitamin D increases levels of sucralfate by Other (see comment). Use Caution/Monitor. Comment: Avoid coadministration. Vitamin D analogs may increase the absorption of aluminum from sucralfate. .

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Arrhythmias

                Confusion

                Constipation

                Dry mouth

                Headache

                Hypercalcemia

                Lethargy

                Metallic taste

                Muscle or bone pain

                Nausea

                Sluggishness

                Vomiting

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                Warnings

                Contraindications

                Hypercalcemia

                Hypervitaminosis D

                Ergocalciferol (oral): Gastrointestinal (GI), liver, or biliary disease associated with malabsorption of vitamin D analogues

                Documented hypersensitivity with drugs that could have allergenic crossreactivity with ergocalceferol

                Cautions

                Ergocalciferol: Use with caution in renal impairment (strong caution), heart disease, kidney stones, arteriosclerosis

                Obtain serum calcium twice weekly during titration

                Discontinue if patient becomes hypercalcemic

                Presence of tartrazine in some products may cause allergic reactions

                Vitamin D toxicity may last ≥2 months after therapy is discontinued

                Restrict intake in infants with idiopathic hypercalcemia

                Concurrent use of cardiac glycosides

                Adequate clinical response to vitamin D therapy is dependent on adequate dietary calcium

                Maintain normal serum phosphorous concentrations in patients treated for hyperphosphatemia to prevent metastatic calcification

                When treating hypoparathyroidism, concomitant treatment with intravenous calcium, parathyroid hormone, and/or dihydrotachysterol may also be required

                Adults with a body mass index (BMI) greater than 30 kg/m² are at high risk for vitamin D deficiency due to storage of vitamin D in adipose tissue; doses higher than recommended daily allowance may be required, but must be carefully monitored to avoid toxicity

                Metabolism of vitamin D may be altered in patients with chronic kidney disease

                In renal impairment, supplementation with ergocalciferol may be necessary; monitor closely

                In patients with rickets, the range between therapeutic and toxic doses is narrow in vitamin D–resistant patients; adjust dose based on clinical response to avoid toxicity

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                Pregnancy & Lactation

                Pregnancy category: C (ergocalciferol)

                Lactation: Drug is distributed into breast milk; use with caution

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Stimulates calcium and phosphate absorption from small intestine; stimulates phosphate resorption at renal tubule; stimulates secretion of calcium into blood from bone

                Absorption

                Peak effect: 1 month with daily dosing

                Metabolism

                Metabolized in liver

                Elimination

                Excretion: Urine

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) tablet
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) capsule
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) tablet
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) capsule
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) capsule
                Vitamin D3 oral
                -
                10 mcg (400 unit) capsule
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) capsule
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) chewable tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) chewable tablet
                Vitamin D3 oral
                -
                10 mcg (400 unit) tablet
                Vitamin D3 oral
                -
                10 mcg (400 unit) tablet
                Vitamin D3 oral
                -
                10 mcg (400 unit) tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) capsule
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) capsule
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) capsule
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) tablet
                Vitamin D3 oral
                -
                125 mcg (5,000 unit) tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) tablet
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) chewable tablet
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) capsule
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) tablet
                Vitamin D3 oral
                -
                10 mcg (400 unit) tablet
                Vitamin D3 oral
                -
                25 mcg (1,000 unit) chewable tablet
                Vitamin D3 oral
                -
                50 mcg (2,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                250 mcg (10,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                50 mcg (2,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                1,250 mcg (50,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                1,250 mcg (50,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                50 mcg (2,000 unit) chewable tablet
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) chewable tablet
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                250 mcg (10,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                250 mcg (10,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                1,250 mcg (50,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) tablet
                cholecalciferol (vitamin D3) oral
                -
                10 mcg/mL (400 unit/mL) drops
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                10 mcg/mL (400 unit/mL) drops
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) tablet
                cholecalciferol (vitamin D3) oral
                -
                250 mcg (10,000 unit) tablet
                cholecalciferol (vitamin D3) oral
                -
                50 mcg (2,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                250 mcg (10,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) tablet
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) tablet
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                50 mcg (2,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                10 mcg (400 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                10 mcg/mL (400 unit/mL) drops
                cholecalciferol (vitamin D3) oral
                -
                125 mcg (5,000 unit) capsule
                cholecalciferol (vitamin D3) oral
                -
                50 mcg (2,000 unit) tablet
                cholecalciferol (vitamin D3) oral
                -
                25 mcg (1,000 unit) tablet
                Baby's Super Daily D3 oral
                -
                10 mcg/drop (400 unit/drop) drops
                D-Vi-Sol oral
                -
                10 mcg/mL (400 unit/mL) drops
                D3-2000 oral
                -
                50 mcg (2,000 unit) capsule
                Thera-D 4000 oral
                -
                100 mcg (4,000 unit) tablet
                Thera-D oral
                -
                50 mcg (2,000 unit) tablet
                Dialyvite Vitamin D3 Max oral
                -
                1,250 mcg (50,000 unit) tablet
                Replesta oral
                -
                1,250 mcg (50,000 unit) wafer
                Replesta NX oral
                -
                350 mcg (14,000 unit) wafer
                Decara oral
                -
                1,250 mcg (50,000 unit) capsule
                Decara oral
                -
                1,250 mcg (50,000 unit) capsule
                Decara oral
                -
                1,250 mcg (50,000 unit) capsule
                Decara oral
                -
                625 mcg (25,000 unit) capsule
                Decara oral
                -
                625 mcg (25,000 unit) capsule
                Decara oral
                -
                250 mcg (10,000 unit) capsule

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Select a drug:
                Patient Education
                cholecalciferol (vitamin D3) sublingual

                NO MONOGRAPH AVAILABLE AT THIS TIME

                USES: Consult your pharmacist.

                HOW TO USE: Consult your pharmacist.

                SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Consult your pharmacist.

                DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: No monograph available at this time.

                MISSED DOSE: Consult your pharmacist.

                STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.