Taking a high dose of vitamin D makes older people more likely to fall, says a study published today by the American Medical Association. As I wrote here three months ago, taking vitamin D can do amazing things for people who need it, while it's a growing problem for those who overuse it. This latest study was conducted in Switzerland, among men and women mostly in their 70s who had fallen in the past. It compared the effects of a monthly dose of 24,000 IU of vitamin D (equivalent to 800 IU per day) to two higher doses of vitamin D: 60,000 IU or 24,000 IU with 300 micrograms of calcifediol -- a super-potent form of vitamin D. Although the higher-doses raised vitamin D levels more than the lower dose, they were each associated with an increased risk of falls over the course of a year (about 66 percent fell) compared with the lower dose (47.9 percent fell). Seniors who were not deficient in vitamin D (that is, their blood levels were already at or above 20 ng/mL) but were still given 60,000 IU of vitamin D per month experienced the most falls.
MNT is the registered trade mark of MediLexicon International Limited.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. Prior Authorization Drugs thatThis restriction requires that specific clinical criteria be met prior to the approval of the Quantity Limits Drugs that have quantity limits associated with each prescription. restriction typically limits the quantity of the drug that will Step Therapy Drugs that have step therapy associated with each prescription. typically requires that certain criteria be met prior to approval for the prescription. Other Restrictions Drugs that