Colecalciferol 1000–2000 units/day

Source: UK SPC (eMC) for Colecalciferol 1 000 IU Capsules, §4.2 (https://www.medicines.org.uk/emc/product/7247/smpc). One capsule contains 1 000 IU colecalciferol (vitamin D3); the dose above is the 1 000-2 000 IU/day regimen this page is named for. OTHER ADULT REGIMENS IN §4.2: treatment of vitamin D deficiency — 1-4 capsules (1 000-4 000 IU) daily for 10 weeks depending on the severity of the disease and the patient's response, followed by maintenance therapy of 1-2 capsules (1 000-2 000 IU) daily; follow-up serum 25(OH)D should be measured approximately three to four months after starting maintenance therapy to confirm the target level has been achieved. As an adjunct to specific therapy for osteoporosis — 1 capsule (1 000 IU) daily. HIGHER DOSES MAY BE REQUIRED, with monitoring of serum 25(OH)D, in populations at high risk of deficiency, which the SPC lists as: institutionalised or hospitalised individuals; dark skinned individuals; individuals with limited effective sun exposure due to protective clothing or consistent sunscreen use; patients being evaluated for osteoporosis; obese individuals; use of certain concomitant medicines (e.g. anticonvulsants, glucocorticoids, anti-retrovirals); those recently treated for vitamin D deficiency and requiring maintenance therapy; PATIENTS WITH LIVER OR RENAL DISEASE; and patients with malabsorption including inflammatory bowel disease and coeliac disease. The SPC does not give numeric higher doses for these groups. RENAL CAUTION (critical for this page): §4.3 lists SEVERE RENAL IMPAIRMENT as a contraindication, and §4.4 states that in patients with severe renal insufficiency vitamin D in the form of colecalciferol is not metabolised normally and OTHER FORMS OF VITAMIN D SHOULD BE USED; in renal impairment generally, use with caution and monitor the effect on calcium and phosphate levels, taking the risk of soft tissue calcification into account. Should not be taken by patients with a tendency to form calcium-containing renal calculi. Medical supervision is required whilst on treatment to prevent hypercalcaemia; allowance must be made for other vitamin D supplements, vitamin D containing medicines or other sources, and the need for additional calcium supplementation considered for individual patients (calcium supplements to be given under close medical supervision). Caution in patients receiving treatment for cardiovascular disease (cardiac glycosides including digitalis) and in sarcoidosis (risk of increased metabolism of vitamin D to its active form — monitor serum and urine calcium). PAEDIATRIC/ADOLESCENT (no per-kg dose is stated, so paedDose is null): over 12 years, for treatment of vitamin D deficiency or insufficiency, 1 capsule (1 000 IU) daily depending on the severity of the disease and the patient's response, to be given only under medical supervision. NOT RECOMMENDED for infants and children under 12 years. Verify any paediatric use against a children's formulary. METHOD: taken orally; the capsule should be swallowed whole with water, preferably with the main meal of the day. NOTE ON SOURCES: this SPC is for a 1 000 IU capsule product — other colecalciferol products have different strengths and their own posology. §4.5 (interactions) was captured only as an appendix to the §4.4 text in this bundle and was truncated at the fetch limit; §4.5 must be checked in full on the SPC.