Every day I'm more and more convinced the importance of restoring vitamin D deficiency and what threatens its lack, in addition to such consequences as hair loss, constant fatigue and fragility of bones!

The more I study the information, the more I am convinced that take prophylactic doses not efficient. Recommendations 600 units per day for an adult DO NOT restore the deficit, other numbers are needed.

Vitamin D deficiency

More and more endocrinologists are talking about a large-scale vitamin D deficiency all over the planet, and in our country too!

across Russia, vitamin level on the border of 10-20 ng / ml, the situation is even more terrible for older people in all countries, including Korea and America, where there is no problem with the sun! According to research, vitamin D deficiency in people aged 50 and older e is especially strong:

Reference values

• The lower limit of the norm of vitamin D is above 30 ng / ml
• Maintain optimal level in the range of 40 - 70 ng / ml
• The toxic effect of vitamin D is manifested at a level of more than 100 ng / ml

To find the optimal dosage, you need to donate blood at 25 (OH) D3 and calculate your personal dosage of vitamin D, depending on your weight, this is the most ideal and accurate option. How to do this, I write in detail in and give the tools.

Vitamin D analysis

Where can I take a vitamin D test? It is impossible to take it for free in the city polyclinic, it was excluded from the list of tests even on the testimony of a doctor. You can donate blood for vitamin D levels in a paid laboratory, it is best to choose an analysis by spectrometry, as it is optimally reliable.

Vitamin D dosages

Now about how to choose the dosage of vitamin D.

I give a table for selecting the dosage of vitamin D, but please note right away that these are average dosages intended for an adult over 18 years old, they are not suitable for children, for people who are very thin or vice versa, with increased weight. And all the tables that you find on the Internet will be copied from this original one - they give average and overestimated dosages of vitamin D.

These are average doses. which are guaranteed to raise vitamin D levels in 90% of people. You can calculate a more accurate dosage from your weight using ready-made tools from mine.

Vitamin D dosages:

How to use the table:

1. Doing a vitamin D test
2. We look at the recommended dosage of vitamin D according to the table
3. We give a re-analysis in 3-6 months

Example: If the initial level of vitamin D is 20 ng / ml, then we take 2000 units daily. to ensure that it rises to a blood level of 30 ng/ml.

Now about that if you are unable to get tested for vitamin D. In this case, take 1000 units. a day for several months and find an opportunity to check it in the future.

Vitamin D preparations

I chose the Carlson Labs version of Vitamin D, Super Daily D3 in liquid form (see first photo). In 1 drop 1000 units. vitamin D, drops are absolutely tasteless and odorless, do not contain ballast substances. One such bottle will last for a whole year!

There is a great option for kids. Carlson Labs, Baby's Super Daily D3, in 1 drop 400 units. Children after 1 year can take 2 drops per day.

I also trust the Solgar brand, Vitamin D3, in 1 capsule, the dosage is 1000 units. vitamin D3.

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Vitamin D is usually prescribed by doctors to children to prevent rickets. But this substance has a number of pharmacological properties that are useful for the body of adults and adolescents. For example, D 3 (cholecalciferol) normalizes phosphorus-calcium metabolism, activates metabolism, improves skin and hair condition. It is especially needed by people living in middle latitudes and receiving insufficient sunlight for its synthesis. But few people know how to properly take vitamin D for adults.

general information

Vitamin D is a fat-soluble compound that is of plant (ergocalciferol or D 2) and animal (cholecalciferol, colecalciferol or D 3) origin. The substance goes through a long path of metabolism in the body: vitamin precursors are synthesized in the skin or ingested with food, then converted in the liver and kidneys into the active formula of calcitriol. To maintain these reactions, it is necessary to eat a balanced diet, often stay in the sun, etc.

According to American studies, vitamin D deficiency is observed in 25-50% of adults and 57% of patients over 60 years of age.

The digestibility of dietary supplements (BAA) of vitamin D depends on the form of the composition - oil or water solution. Adults are better off choosing the second option, the absorption of which occurs without stress on the digestive enzyme systems. The aqueous form of the vitamin contains small micelles - particles in which the central "fat filling" with cholecalciferol is surrounded by a water-soluble shell. Doctors do not advise taking vitamin D oily liquid in old age: it is absorbed and broken down worse.

Watch the video of the endocrinologist-nutritionist about D 3:

Beneficial features

The main function of the active substance is the regulation of mineral metabolism, increasing the level of calcium and phosphorus in the body. Vitamin produces a number of other pharmacological effects, which leads to its widespread use in medicine.

For the musculoskeletal system

Vitamin D increases the absorption of calcium by the body and promotes its deposition in bone tissue. Thanks to this, the bones become strong, and the risk of developing osteoporosis is reduced. Scientists from the University of Birmingham have shown that increased amounts of vitamin D should be taken in inflammatory processes in the joints. This substance helps to cope with rheumatoid arthritis, reduces pain, increases mobility.

For skin, nails and hair

The normal level and control of vitamin D in the body slows down the aging of the skin, makes it smooth and hydrated, improves tone and elasticity. The substance is also useful for hair: D 3 activates “sleeping” hair follicles and increases the density of the hair, and also prevents female pattern baldness (on the forehead and in the parietal zone). Cholecalciferol also strengthens nails, accelerates their growth.

For the thyroid gland

Therapeutic doses of vitamin D prevent the development of autoimmune diseases, which include Hashimoto's thyroiditis. Clinical studies have confirmed that in patients with hypothyroidism against the background of an autoimmune process, the content of active metabolites of calciferol in the blood decreases sharply. Vitamin D 3 enhances the effect of calcitonin, a thyroid hormone that increases the supply of calcium to the bones.

For the treatment of psoriasis

The vitamin binds to specific receptors in the epidermis and slows down the formation of psoriatic cells. As a result, the size and number of plaques on the skin decrease, and the intensity of peeling decreases. Calcitriol also enhances the activity of cathelicidin, an anti-inflammatory and wound healing agent.

For colds

Research published in the British Medical Journal confirms that vitamin D is involved in a normal immune response. This compound protects the body from respiratory viral infections, including the flu. It activates T-lymphocytes, which quickly destroy pathogenic microbes that have entered the body. Preventive doses of vitamin D in the autumn-winter season can reduce the frequency of colds by 25-30%.

During the menopause

In 1/3 of women with the onset of menopause, active leaching of calcium from bone tissue begins, which is caused by hormonal changes. Osteomalacia and osteoporosis are observed, the frequency of pathological fractures increases even with small mechanical influences. Taking vitamin D helps to regulate changes, increases the supply of calcium to the bones, and prevents the development of beriberi, which is often the cause of a hip fracture in women.

For weight loss

The compound is involved in metabolic reactions: it increases the sensitivity of tissues to insulin, regulates the level of lipids and carbohydrates in the blood. Therefore, its deficiency increases the risk of visceral obesity, a dangerous condition that provokes the development of cardiovascular and endocrine diseases. If you are overweight, you need to take high doses of vitamin D per day.

Daily rate

Table 1 - Vitamin D requirement for different patient groups

To convert the concentration of vitamin D from IU to mcg, it must be taken into account that 1 microgram corresponds to 40 international units.

UNIT CONVERTER: VITAMIN D

Cholecalciferol (D3)/ergocalciferol (D2)

Substance form

IU mg mcg g

Decimals in the result

Convert

IU conversion ⇄ g/mg/mcg (developed by pharmacists and doctors based on reliable data)

To accurately determine the level of vitamin in the body, a venous blood test is performed. The study shows the amount of active metabolite 25-(OH)-D (25-hydroxycalciferol). The concentration of a substance is measured in ng / ml.

Clarification of the results according to the opinions of US endocrinologists:

• less than 20 ng / ml - a serious deficiency;
• 21-29 ng / ml - lack of vitamin;
• 30-100 ng / ml is the norm.

Who needs to take

Indications for the appointment of vitamin D:

• osteoporosis and osteomalacia;
• pathology of the osteoarticular system - arthritis, osteochondrosis, osteoarthritis;
• long-term non-healing fractures;
• caries and destruction of tooth enamel;
• decreased thyroid function or body defenses;
• autoimmune diseases.

Women

Vitamin D preparation in low daily doses is indicated to improve the appearance of the skin, stimulate hair and nail growth. Regular intake of dietary supplements helps to prolong youth and preserve female beauty. The body of women especially needs supplements in the menopause, when there is a sharp decrease in the strength of bone tissue.

men

Vitamin supplements are recommended for athletes and bodybuilders. Cholecalciferol increases the endurance of the male body, increases the effectiveness of training. It also stimulates the recruitment of muscle mass and increases the production of testosterone.

To old people

People of retirement age should use supplements to prevent vitamin D deficiency, since aging skin cannot synthesize it enough. This substance is also used to reduce the risk of fractures, increase bone strength in osteoporosis.

Contraindications

List of contraindications for the use of oral vitamin D supplements 3:

• allergy to the components of the drug;
• hypervitaminosis D;
• increased calcium in the blood;
• severe gastrointestinal diseases with malabsorption syndrome;
• vascular calcification;
• kidney failure;
• phenylketonuria.

For women during pregnancy and lactation, supplements are prescribed only after consulting a gynecologist.

Dosage forms

The main forms of release of drugs for adults:

1. Capsules. The oil solution of the vitamin is enclosed in a gelatinous or vegetable shell. Doctors do not recommend this form of release for older people. The gelatin capsule shell is poorly soluble in the intestine.
2. Liquid. An aqueous or oily solution is available in bottles. The dosage of vitamin D can be adjusted independently, but many adults do not like the taste of the drug.
3. Chewable tablets. This form of vitamin D 3 is well absorbed. But the composition of the tablets may contain flavors or flavorings.
4. Spray. The aerosol formulation for sublingual administration is well absorbed. Sprays have a pleasant berry or citrus taste. The disadvantage is the high price and a small range of such dietary supplements.

There are injectable oil solutions that are administered intramuscularly. Transfer to parenteral use of drugs is indicated for acute beriberi, a serious condition of the patient.

List of drugs

Pharmaceutical companies produce supplements in different dosages: from 400 to 5000 IU. There are medicines with a dose of 10,000 IU (0.25 mg) of vitamin D that can be taken for beriberi or severe osteoporosis. Most dietary supplements are made on the basis of animal raw materials (lanolin, etc.), but there are special preparations for vegetarians - they contain D 3 synthesized from lichen.

TOP 6 Vitamin Mono Supplements:

Drugs can be found in regular pharmacies or in online beauty and health stores. But due to the high trade margins of intermediaries, the cost of dietary supplements is often overestimated by 1.5-2 times. Therefore, it is better to buy vitamin D on the US iHerb website.

Instructions for use

Nutrient is usually prescribed for preventive purposes in the autumn-winter period; in the summer it is not necessary to drink it. Doctors recommend taking vitamin D in low dosages: 1000-2000 IU. Chewable tablets should be chewed thoroughly and not swallowed immediately. Liquid forms should be dosed in drops and drunk with water. For better absorption, drugs are consumed in the first half of the day immediately after or during meals. It is better to divide a large daily dose into 2 doses - in the morning and in the evening.

Calculation of norms for various diseases:

• elderly people with severe osteoporosis can take vitamin D 3 all year round, even in summer, at a dosage of 800-1000 IU;
• for psoriasis and other dermatological problems, it is recommended to drink 2000-5000 IU per day;
• with inflammation of the joints, you need to take 2000 IU per day for 3 months;
• for people with obesity, doctors usually prescribe high single doses (about 5000 IU) for 1-2 months;
• to strengthen the immune system, vitamin D should be taken during the seasonal increase in the incidence and not more than 2000 IU.

Attention! Preparations should not be used simultaneously with vitamin complexes that contain D 3.

Adverse reactions

Additives sometimes provoke dyspeptic disorders: nausea, loss of appetite, heaviness in the abdomen, flatulence. Headaches and drowsiness may also appear. An allergic reaction to the drug is manifested by itching, red blisters on the skin, diarrhea. All side effects mainly occur when using high doses or with prolonged use of the drug.

Possibility of overdose

Vitamin is a fat-soluble compound, so its excess can accumulate in the body and cause unpleasant symptoms. Overdose symptoms occur if an adult takes more than 10,000 IU of vitamin D per day.

Initial symptoms of excess:

• thirst, dry mouth;
• headache;
• fatigue, decreased work capacity;
• nausea and vomiting;
• constipation.

With long-term use of vitamin supplements in high doses, the risk of systemic toxicity increases, which is manifested by difficulty in breathing, interruptions in the work of the heart, swelling of the face, etc. An overdose can also disrupt the functioning of the kidneys and provoke vascular calcification.

Attention! If these symptoms appear, you should stop taking supplements and consult a doctor as soon as possible and undergo detoxification, as well as symptomatic therapy.

Vitamins of group D are formed as a result of exposure to ultraviolet radiation in the tissues of plants and animals. Their activity is expressed in international units (IU). One IU contains 0.000025 mg or 0.025 mcg of a chemically pure vitamin.The amount of vitamin is also measured in IU. B 1 (IU) \u003d 0.025 mcg, 40 (IU) \u003d 1 mcg of cholecalciferol.

Substances of group D

• D2-ergocalciferol, isolated from yeast, provitamin is ergosterol;
• , from animal tissues, provitamin-7 degodrocholesterol;
• D4 (22, 23)-dihydro-ergocalciferol;
• D5(24)-ethylcholecalciferol from wheat oils;
• D6 (22) -dihydroethylcalciferol.

Today, vitamin D is called (D2, D3) - these are fat-soluble crystals that are odorless and colorless (dissolve in organic compounds, fats and do not dissolve in water), and also do not collapse under the influence of high temperature.

Vitamin D is especially needed for newborns in the winter. In summer, its deficiency is completely compensated by ultraviolet radiation.

food sources

Vitamin D in food is an important part of the human diet. The list of such products includes:

• oatmeal,
• potato,
• parsley,
• alfalfa grass,
• nettle,
• dandelion green,
• yolks and horsetail,
• seafood (, mackerel, mackerel, herring, tuna),
• fish (most in cod and halibut)
• fermented milk products (cheese, cottage cheese, creamy and vegetable). Vitamin D is low in milk, and it contains phosphorus, which negatively affects its absorption.

The amount of vitamin D in food:

• Herring - 294-1676 mg / 100 g;
• Canned salmon - 200-800 mg / 100g;
• Sour cream - 50 mg / 100 g;
• Yolks - 45-390 mg / 100 g;
• Medium fat milk - 45-390 mg / g;
• Creamy - 10-150 mg / g;
• Mackerel - 304-405 mg / g;
• Chicken - 55 mg / g;
• Pork liver-44 mg/g;
• Beef liver - 45 mg / g.
  

Preparations containing vitamin D and indications for their use

The largest amount of vitamin D is contained in calcitriol and alfacalcidol tablets, their dosage must strictly correspond to the norm. Basically, preparations of ergocalciferol (D2), cholecalciferol (D3) are used. Dihydrotachisterol preparations do not have fundamental advantages in their action. Calcitriol, alfacalcidol - they need to be taken with impaired functions of phosphorus metabolism.

Vigantol is a source of natural raw materials of vitamin D3 in drops, without artificial additives, dyes and preservatives. The drug is prescribed to premature babies, newborns and infants as a prevention and treatment of rickets. Vigantol contributes to the normal formation of the structure of the teeth and the musculoskeletal system.

Alpha-DZ-TEVA is a drug whose active ingredient is alfacalcidol, a source of vitamin D. It is used in the treatment of the main types and forms of osteoporosis, kidney failure, rickets and hypoparathyroidism.

Ergocalciferol - D2 is intended for preventive and therapeutic use, has a lot of dosage forms:

• oil solution in capsules of 500 or 1000 IU;
• dragee 500 IU;
• Alcohol solution 0.5% (one drop contains about 4000 IU).

There are combination preparations containing cholecalciferol and vitamin D:

Calcium Sediko, Calcium D3, Vitrum Calcium + DZ. The intake of calcium and vitamin D in the body is especially effective in the treatment of diseases requiring the use of vitamin D.

Side effects

Side effects are almost the same for all groups of vitamins, these include: loss of appetite and headache, constipation and polyuria, allergies and high blood pressure, arrhythmia and myalgia, impaired renal function, arthralgia and exacerbation of pulmonary tuberculosis.

Dose and daily requirement

Appropriate schemes and doses of vitamins should be prescribed by a doctor, taking into account the components of phosphorus and calcium in the blood plasma. For the treatment of rickets, children are prescribed up to 3000 IU per day.

An overdose of vitamin D negatively affects the body, with its accumulation of excess, it begins not to help, but to harm health. The dangerous threshold is: in infants 20,000 IU, in older children 50,000 IU. Adults are the most resistant to overdose.

Daily requirement of vitamin D:

• Neonates: 400 IU (10 mcg);
• Adolescents: 400 IU (12.5 mcg);
• Women during pregnancy and lactation: 400 - 500 IU, (10 - 12.5 mcg);
• Adults 100 IU, (2.5 mcg).
  

Hypovitaminosis D - signs and causes

Hypovitaminosis D has a different origin, more often it is acquired, and less often inherited. Acquired hypovitaminosis D is caused by the intake of vitamin with food in insufficient quantities. Hereditary hypovitaminosis D is caused by defects in the genes involved in vitamin metabolism.

In the hereditary form of hypovitaminosis D, hypophosphatemic vitamin D (resistant rickets) is often found. In another inherited form of hypovitaminosis D, taking large doses of the vitamin leads to recovery.

The main cause of hypovitaminosis D is the excessive administration of the drug into the body. With moderate hypovitaminosis, a pronounced violation of the functions of organs occurs.

Signs of hypovitaminosis D in children are manifested by rickets, and in adults by low plasma phosphorus and low or normal calcium levels, hyperphosphaturia and hypocalciuria, aminoaciduria.

Vitamin D in premature and newborn babies is absent or contained in small doses. Breast milk contains only 4% of the daily dose required by an infant.

Several causes of hypovitaminosis have been noted:

• deficiency of solar radiation;
• impaired absorption of the element into the body with steatorrhea and jaundice;
• renal and hepatic metabolic disorders;
• the use of large doses of glucocorticoids and the use of vaseline oil.
  

Hypervitaminosis D

Hypervitaminosis d in children occurs as a result of the use of the drug in large quantities. Early signs of hypervitaminosis D in children, as in adults: loss of appetite, diarrhea, nausea, headache, vomiting, cessation of growth in children, dry mouth, thirst, metal taste, general weakness.

Late signs are cloudy urine, bone pain, pruritus, increased blood pressure, eye photosensitivity, arrhythmia, drowsiness, and weight loss.

Side effects occur as a result of an overdose, due to taking it in large doses of 1 million IU or more, the simultaneous use of vitamins with fortified food containing a large amount of them causes increased sensitivity to the drug.

Symptoms of chronic intoxication occur when taken in doses: in children 2-4 thousand IU per day, in adults 20-60 thousand IU. Side effects: calcification of the lungs, kidneys, soft tissues, blood vessels, kidney failure can be fatal.

Prevention and treatment with vitamin D should be carried out under the supervision of a specialist, while taking into account many factors. If the child's diet contains foods rich in vitamin D and he spends a lot of time under the sun, then taking the vitamin is not only unnecessary, but also contraindicated. You should also use vitamin D following the instructions for use.

Registration number:

Tradename: VITAMIN DZ BON

INN: Colecalciferol

Dosage form: solution for intramuscular injection and oral administration.

Compound for 1 ampoule (1 ml)
Active substance:
Colecalciferol (vitamin DZ) 5.0 mg (200,000 IU)
Excipients:
Medium chain triglycerides q.s. up to 1 ml

Description
Transparent liquid with a yellowish tint, odorless.

Pharmacotherapeutic group
Calcium-phosphorus metabolism regulator.

ATX code: [A11CC05]

Pharmacological properties
Vitamin D3, regulator of calcium and phosphorus metabolism. Enhances calcium absorption in the intestine and phosphorus reabsorption in the renal tubules. It contributes to the formation of the bone skeleton and teeth in children, the preservation of the structure of bones. Necessary for the normal functioning of the parathyroid glands. Participates in the synthesis of lymphokines and ATP.

Pharmacokinetics
It is absorbed in the distal small intestine with the participation of bile acids, in the blood it binds to alpha2-globulins and partially to albumins, is transferred to the liver, (first hydroxylation) is transformed into 25-hydroxycholecalciferol (calcidiol). This is the main circulating form, which is converted in the kidneys (second hydroxylation) into the corresponding active forms. The most important of these is 1,25-dihydroxycholecalciferol (calcitriol).
The main places of deposition are adipose tissue and muscles.
Vitamin D is excreted primarily in the faeces. A small amount is excreted in the urine.

Indications for use
Prevention and treatment of rickets, spasmophilia, osteomalacia of various origins, metabolic osteopathies (hypoparathyroidism, pseudohypoparathyroidism), hypocalcemic tetany.

Contraindications
Hypersensitivity to vitamin D3, hypercalcemia, hyperkalydiuria, sarcoidosis, calcium nephrourolithiasis, thyrotoxicosis (probability of hypersensitivity), renal osteodystrophy with hyperphosphatemia, hypervitaminosis D.

Carefully:
Atherosclerosis, heart failure, renal failure, pulmonary tuberculosis (active form), hyperphosphatemia, phosphate nephrourolithiasis, organic heart disease, acute and chronic diseases of the liver and kidneys, diseases of the gastrointestinal tract (including peptic ulcer of the stomach and duodenum), period pregnancy and lactation, hypothyroidism.

Use during pregnancy and lactation
Hypercalcemia during pregnancy can cause defects in the physical and mental development of the fetus.
Since vitamin D3 and its metabolites pass into breast milk, during pregnancy, the daily dose of D3 should not exceed 600 IU.

Dosage and administration
The drug is used both intramuscularly and orally.
Infants receiving milk with vitamin D: 1/2 ampoule (i.e. 100,000 IU) every 6 months
Infants who are breastfed or not receiving vitamin D milk, children aged 5 years and older: 1 ampoule (i.e. 200,000 IU) every 6 months
Teens: 1 ampoule (i.e. 200,000 IU) every 6 months during winter
Pregnant: 1/2 ampoule (i.e. 100,000 IU) from 6 to 7 months of pregnancy, the same dose may be repeated in case of lack of sun, or the last trimester of pregnancy falls in the winter.
Elderly people: 1/2 ampoule (i.e. 100,000 IU) every 3 months
Adults or children with malnutrition:
Adults or children on concomitant antiepileptic therapy: 1/2 to 1 ampoule (i.e. 100,000 IU to 200,000 IU) every 3 months
For vitamin D3 deficiency: 1 ampoule (i.e. 200,000 IU), a single repeated application is recommended over the next 1-6 months.
To accurately set the required volume of the drug, use a glass syringe

Side effect
Hyperphosphatemia, hypercalcemia, hypercalciuria, anorexia, polyuria, constipation, headache, myalgia, arthralgia, increased arterial pressure, arrhythmias, renal failure, allergic reactions.

Overdose
Symptoms of vitamin D hypervitaminosis:
Early (due to hypercalcemia) - constipation or diarrhea, dryness of the oral mucosa, headache, pollakiuria, nocturia, polyuria, anorexia, metallic taste in the mouth, nausea, vomiting, unusual fatigue, general weakness, hypercalcemia, hypercalciuria.
Late: bone pain, turbidity of urine (the appearance of hyaline casts in the urine, proteinuria, leukocyturia), increased blood pressure, pruritus, photosensitivity of the eyes, conjunctival hyperemia, arrhythmia, drowsiness, myalgia, nausea, vomiting, pancreatitis, gastralgia, weight loss, rarely - psychosis (changes in the psyche and mood).
Symptoms of chronic vitamin D deficiency. When taken for several weeks or months for adults at doses of 20-60 thousand IU / day, children - 2-4 thousand IU / day): calcification of soft tissues, kidneys, lungs, blood vessels , arterial hypertension, renal and chronic heart failure (these effects most often occur when added to hypercalcemia, hyperphosphatemia), growth retardation in children (long-term use at a dose of 1.8 IU / day).
Treatment: withdrawal of the drug, a diet low in calcium, consumption of large amounts of fluid, the appointment of glucocorticosteroids, a-tocopherol, ascorbic acid, retinol, thiamine, in severe cases - intravenous administration of large amounts of 0.9% sodium chloride solution, furosemide, electrolytes, performing hemodialysis.
There is no specific antidote.
To exclude an overdose, in some cases it is recommended to determine the concentration of calcium in the blood (see "Special Instructions").

Interaction with other drugs
The risk of hypercalcemia is increased by thiazide diuretics. The effect is reduced by phenytoin (an increase in the rate of biotransformation); cholestyramine, glucocorticosteroids, calcitonin, etidronic and pamidronic acid derivatives, plicamycin, gallium nitrate, vitamin A reduces toxicity. Barbiturates increase the rate of biotransformation. Increases the toxicity of cardiac glycosides. Long-term therapy against the background of the simultaneous use of antacids containing aluminum and magnesium increases their concentration in the blood and the risk of intoxication (especially in the presence of chronic renal failure).
Kolestiramin, colestipol and mineral oils reduce the absorption of fat-soluble vitamins in the gastrointestinal tract and require an increase in their dosage. Increases the absorption of phosphorus-containing drugs and the risk of hyperphosphatemia.
With simultaneous use with sodium fluoride, the interval between doses should be at least 2 hours, with oral forms of tetracyclines - at least 3 hours.
Simultaneous use with other analogues of vitamin D3 increases the risk of developing hypervitaminosis.

special instructions
When using doses above 1000 IU / day, as well as when taking the drug continuously for several months, it is recommended to periodically determine the concentration of calcium and phosphorus in the blood serum to exclude chronic hypervitaminosis D3 and hyperphosphatemia.
In order to prevent the development of hyperphosphatemia in patients with renal bone disease, the drug can be administered together with phosphate binders.

Release form
1 ampoule 1 ml in a plastic case is placed in a cardboard box along with instructions for use.

Best before date
4 years
Do not use after the expiry date stated on the packaging.

Storage conditions
At a temperature not exceeding 25 ° C in a place protected from light, out of the reach of children.

Terms of dispensing from pharmacies
On prescription

Manufacturer:
For Laboratories BOUCARD-RECORDAT 68, rue Marjolin
92300 Levallois-Perret, France,
produced by OPT PHARMA-LIVRON, 1 rue Côte de Sinar, B.P. 1, 26250 Livron-sur-Drome, France

Representation in Russia: 123610, Moscow, Krasnopresnenskaya emb. 12, office 742

Instructions for medical use of the drug Akvadetrim vitamin D3

Tradename

Aquadetrim vitamin D3

International non-proprietary name

Colecalciferol

Dosage form

Drops for oral administration 15,000 IU/ml

Compound

1 ml solution (30 drops) contains

active substance - cholecalciferol 15,000 IU,

excipients: macrogol glyceryl ricinoleate, sucrose (250 mg), sodium hydrogen phosphate dodecahydrate, citric acid monohydrate, anise flavor, benzyl alcohol (15 mg), purified water.

Description

Colorless, transparent or slightly opalescent liquid with an aniseed odour.

Pharmacotherapeutic group

Vitamins. Vitamin D and its derivatives.

ATC code А11СС 05

Pharmacological properties

Pharmacokinetics

An aqueous solution of vitamin D3 is better absorbed than an oil solution (which is important when used in preterm infants). After oral administration, cholecalciferol absorption occurs in the small intestine by passive diffusion from 50 to 80% of the dose.

Absorption - fast (in the distal small intestine), enters the lymphatic system, enters the liver and into the general circulation. In the blood, it binds to alpha2-globulins and partially to albumins. Accumulates in the liver, bones, skeletal muscles, kidneys, adrenal glands, myocardium, adipose tissue. TCmax (period of maximum concentration) in tissues is 4-5 hours, then the concentration of the drug decreases slightly, remaining at a constant level for a long time. In the form of polar metabolites, it is localized mainly in the membranes of cells and microsomes, mitochondria and nuclei. Penetrates through the placental barrier, excreted in breast milk.

Deposited in the liver.

It is metabolized in the liver and kidneys: in the liver it turns into an inactive metabolite calcifediol (25-dihydrocholecalciferol), in the kidneys it turns from calcifediol into an active metabolite calcitriol (1,25-dihydroxycholecalciferol) and an inactive metabolite 24,25-dihydroxycholecalciferol. It undergoes enterohepatic recirculation.

Vitamin D and its metabolites are excreted in the bile, a small amount - by the kidneys. Cumulates.

Pharmacodynamics

Aquadetrim vitamin D3 is an anti-rachitic drug. The most important function of Aquadetrim vitamin D3 is the regulation of calcium and phosphate metabolism, which promotes mineralization and skeletal growth. Vitamin D3 is the natural form of vitamin D, which is produced in the human skin by exposure to sunlight. It plays a significant role in the absorption of calcium and phosphate from the intestines, in the transport of mineral salts and in the process of bone calcification, and also regulates the reabsorption of calcium and phosphate by the kidneys. Calcium ions are involved in a number of important biochemical processes that determine the maintenance of skeletal muscle tone, in the conduction of nervous excitation, and in the process of blood clotting. Aquadetrim vitamin D3 stimulates the production of lymphokines.

Indications for use of the drug Aquadetrim vitamin D3

Prevention and treatment:

Hypo- and avitaminosis of vitamin D (conditions of increased body demand for vitamin D in nephrogenic osteopathy, malnutrition and unbalanced nutrition, malabsorption syndrome, insufficient insolation, hypocalcemia, hypophosphatemia, renal failure, liver cirrhosis, pregnancy and lactation)

Hypocalcemic tetany

Osteomalacia and bone diseases with metabolic disorders (hypoparathyroidism and pseudohypoparathyroidism)

As part of complex therapy

Osteoporosis in postmenopausal women

Rickets-like diseases

Dosage and administration of Aquadetrim vitamin D3

The drug is taken orally with a small amount of liquid

1 drop contains about 500 IU of vitamin D3.

Prophylactic doses of Aquadetrim vitamin D3:

full-term newborns from 4 weeks of life to 2-3 years of life with proper care and sufficient exposure to fresh air - 500 IU (1 drop) per day;

premature newborns from 4 weeks of age, as well as twins, babies in poor living conditions - 1000 IU (2 drops) per day for one year. In the summer, you can limit the dose to 500 IU (1 drop) per day. The duration of therapy is up to 2-3 years of life;

pregnant women - a daily dose of 500 IU of vitamin D3 for the entire period of pregnancy, or 1000 IU / day from 28 weeks of pregnancy;

women in the postmenopausal period - 500 - 1000 IU (1-2 drops) per day, for 2-3 years, the doctor decides on the need for repeated courses of therapy.

Therapeutic doses of Aquadetrim vitamin D3:

for rickets, start with 2000 IU for 3-5 days, then, if well tolerated, increase the dose to an individual therapeutic dose of 2000-5000 IU (4-10 drops) daily, most often 3000 IU, depending on the severity of rickets (I, II , or III) and the variant of the course, for 4-6 weeks, under careful monitoring of the clinical condition and the study of biochemical parameters (calcium, phosphorus, alkaline phosphatase) of blood and urine. A dose of 5000 IU is prescribed only with pronounced bone changes.

As needed, after one week break, you can repeat the course of treatment. Treatment is carried out until a clear therapeutic effect is obtained, followed by a transition to a prophylactic dose of 500 - 1500 IU / day. The duration of the course of treatment and prevention is determined by the doctor;

with rickets-like diseases 10,000 - 20,000 IU per day (20 - 40 drops), depending on age, weight and severity of the disease, under the control of blood biochemical parameters and urinalysis. The course of treatment is 4-6 weeks. The doctor decides on the need for repeated courses of therapy;

with osteomalacia and postmenopausal osteoporosis as part of complex therapy 500 - 1000 IU (1-2 drops) per day.

The dosage, as a rule, is prescribed taking into account the amount of vitamin D that comes from other foods.

Side effects of the drug Akvadetrim vitamin D3

In the case of rarely noted individual hypersensitivity to vitamin D3 or as a result of the use of too high doses for a long period, hypervitaminosis D3 may occur:

Psychiatric disorders, including depression

Loss of appetite, nausea, vomiting, dry mouth, constipation

Head, muscle and joint pain

Weight loss

Polyuria

Increased calcium levels in the blood and urine

Kidney stone formation and soft tissue calcification

Contraindications to Aquadetrim vitamin D3

Hypersensitivity to the components of the drug, especially to benzyl alcohol

Hypervitaminosis D

Liver and kidney failure

Elevated levels of calcium and phosphorus in the blood and urine

calcium kidney stones

Sarcoidosis

Neonatal period up to 4 weeks

Drug Interactions

Antiepileptic drugs, rifampicin, cholestyramine, reduce the reabsorption of vitamin D3.

The use simultaneously with thiazide diuretics increases the risk of hypercalcemia.

Simultaneous use with cardiac glycosides may enhance their toxic effect (increased risk of manifestations of cardiac arrhythmias).

The toxic effect is weakened by vitamin A, tocopherol, ascorbic acid, pantothenic acid, thiamine, riboflavin.
Under the influence of barbiturates (including phenobarbital), phenytoin and primidone, the need for colecalciferol can increase significantly (increase the metabolic rate).
Long-term therapy against the background of the simultaneous use of aluminum and magnesium-containing antacids increases their concentration in the blood and the risk of intoxication (especially in the presence of chronic renal failure).
Calcitonin, derivatives of etidronic and pamidronic acids, plicamycin, gallium nitrate and glucocorticosteroids reduce the effect.
Colestyramine, colestipol and mineral oils reduce the absorption of fat-soluble vitamins from the gastrointestinal tract and require an increase in their dosage.
Increases the absorption of phosphorus-containing drugs and the risk of hyperphosphatemia. When used simultaneously with sodium fluoride, the interval between doses should be at least 2 hours; with oral forms of tetracyclines - at least 3 hours.
Simultaneous use with other analogs of vitamin D increases the risk of developing hypervitaminosis.

special instructions

Avoid overdose with Aquadetrim vitamin D3.

Individual provision of a specific need should take into account all possible sources of this vitamin.

Too high doses of vitamin D3, used for a long time or loading doses, can be the cause of chronic hypervitaminosis D3.

Determination of the child's daily requirement for vitamin D and the method of its use should be established by the doctor individually and each time subjected to correction during periodic examinations, especially in the first months of life.

Use with caution in immobilized patients.

Do not use calcium preparations in high doses simultaneously with vitamin D3.

Treatment is carried out under periodic monitoring of the level of calcium and phosphorus in the blood and urine.

Care must be taken when prescribing the drug to elderly people, since in this category of people calcium deposition in the lungs, kidneys and blood vessels increases.

Use with caution in patients with diabetes mellitus.

The period of pregnancy and lactation

During pregnancy, Vitamin D3 should not be used in high doses of 2,000 IU due to the possibility of a teratogenic effect in case of an overdose.

Caution should be given to Vitamin D3 during lactation, as the drug, taken in high doses by the mother, can cause overdose symptoms in the child.

Features of the effect of the drug on the ability to drive

vehicle or potentially dangerous machinery

Does not affect

Overdose of Aquadetrim vitamin D3

Symptoms: anxiety, thirst, loss of appetite, nausea, vomiting, diarrhea, constipation, intestinal colic, polyuria. Common symptoms are headache, muscle and joint pain, mental disorders, including depression, stupor, ataxia, and progressive weight loss. Kidney dysfunction develops with albinuria, erythrocyturia and polyuria, increased loss of potassium, hypostenuria, nocturia and increased blood pressure. In severe cases, clouding of the cornea may occur, less often swelling of the papilla of the optic nerve, inflammation of the iris up to the development of cataracts. Kidney stones may form, and soft tissue calcification occurs, including blood vessels, the heart, lungs, and skin. Rarely develops cholestatic jaundice.

Treatment: withdrawal of the drug, drinking plenty of fluids, symptomatic therapy.

Release form and packaging

10 ml in a dark glass bottle with a polyethylene stopper-dropper and a polyethylene screw cap with a “first opening” guarantee ring together with instructions for medical use in a cardboard box.

Storage conditions

To store in the place protected from light at a temperature from 5 °C to 25 °C. Keep out of the reach of children!

Shelf life

Do not use after the expiration date.

Holiday conditions

Without recipe

Manufacturer

Medana Pharma JSC

98-200 Sieradz, st. V. Loketka 10, Poland