Calcifediol monohydrate

How it works

It is the 25-hydroxylated form of vitamin D, the immediate precursor that is converted in the kidney to active 1,25-dihydroxyvitamin D, thereby raising vitamin D status and supporting calcium and phosphate homeostasis.

Prescribing in practice

• Excessive or unmonitored use can cause hypercalcaemia and hypercalciuria, so avoid concurrent high-dose vitamin D or calcium supplements unless specifically indicated and review calcium status.
• It is taken orally, and being more polar than colecalciferol it has a faster onset and does not require hepatic 25-hydroxylation.
• Use with particular caution in patients with renal impairment, sarcoidosis or other granulomatous disease and in those predisposed to hypercalcaemia or renal stones.

Monitoring

Monitor serum calcium (and where appropriate phosphate and renal function), especially when initiating or adjusting therapy or in patients at risk of hypercalcaemia.

Counselling the patient

• Take as prescribed and do not add extra vitamin D or calcium products without advice.
• Report symptoms of high calcium such as nausea, thirst, increased urination, constipation or confusion.

Evidence & guidelines

Calcifediol is an established treatment for vitamin D deficiency supported by pharmacological and clinical data on raising vitamin D status.