Q. My blood level of vitamin D (16) is very low. A few years ago I was prescribed 50,000 IUs once a week, but I had to quit after just one month. It caused severe acid reflux that took me several months to get under control. I’d feel a lot better if I could get my vitamin D levels up, but how can I manage that with my hypersensitive stomach? Using acid suppressors over a period of time creates a rebound reflux that really makes things worse. I’d appreciate any suggestions you can offer. A. With such a low level of vitamin D in your body, you would probably feel better if you could bring it up. Low vitamin D has been linked to asthma, infections, depression, joint pain, heart disease and high blood pressure, among other problems. You might want to try a lower dose of vitamin D3 to see if you can tolerate it. The earlier medication you took was vitamin D2. Vitamin D3 is available OTC in doses such as 1,000 or 2,000 IU. Now that spring is here, you might also want to get 15 or 20 minutes a day of sun exposure.
We are sending you our Guide to Vitamin D Deficiency for more details on the pros and cons of this essential nutrient. We also describe the appropriate levels of 25-hydroxyvitamin D, the test that showed your body is so low in this vitamin. Although vitamin D is not supposed to cause side effects, you are not the only person to report difficulties, particularly with the high-dose once-a-week regimen. Anyone else who has had a reaction to vitamin D may report it in the comments below.Dosing & UsesDosage Forms & Strengths 1 mcg = 40 international units (IU) Recommended daily allowance (RDA) 19-70 years: 600 IU (15 mcg)/day Pregnant or lactating women: 600 IU (15 mcg)/day >50 years: 800-1000 IU (20-25 mcg) PO once daily with calcium supplements 50,000-200,000 IU (0.625-5 mg) PO once daily with calcium supplements 12,000-500,000 IU (0.3-12.5 mg) PO once daily 10,000-60,000 IU (0.25-1.5 mg) PO once daily with phosphate supplements Dosage Forms & Strengths
1 mcg = 40 IU 0-12 months: 400 IU (10 mcg) PO once daily 1-18 years: 600 IU (15 mcg) PO once daily 40,000-80,000 IU (1-2 mg) PO once daily with phosphate supplements; may be reduced after stage of growth is complete <70 years: 600 IU (15 mcg) PO once daily >70 years: 800 IU (20 mcg) PO once daily InteractionsInteraction CheckerEnter a drug nameNo Results ContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorSeverityName Muscle or bone pain 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 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; 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 Pregnancy category: C (ergocalciferol) Lactation: Drug is distributed into breast milk; Controlled studies in pregnant women show no evidence of fetal risk.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. Stimulates calcium and phosphate absorption from small intestine; stimulates phosphate resorption at renal tubule; stimulates secretion of calcium into blood from bone Peak effect: 1 month with daily dosing FormularyAdding 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.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.pare 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. This drug is available at the lowest co-pay. commonly, these are generic drugs. This drug is available at a middle level co-pay. commonly, these are "preferred" (on formulary) brand drugs. This drug is available at a higher level co-pay. commonly, these are "non-preferred" brand drugs. commonly, these are "non-preferred" brand drugs or specialty NOT COVERED – Drugs that are not covered by the plan.