Vitamin D deficiency

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Treatment

0-30nmol/L
  • 3200 IU colecalciferol tablets (fultium) daily for 12 weeks
  • Calculate dietary calcium intake 
30-50nmol/L and symptoms or taking drugs known to cause vit D deficiency (see below)
  • 800 IU colecalciferol tablets (fultium) daily for 12 weeks
  • Calculate dietary intake
  • Prescribers may choose to continue prescribing 800IU daily for housebound patients 
>50nmol/L 
  • Sufficient
  • Bareatric patients should be kept at 75-100
  • At risk groups may need OTC supplement 400 - 800IU
    • >65yrs old
    • pigmented skin
    • lack of sun
    • pregnant
    • breastfeeding
  • for at least the two darkest seasons of the year
  • Bareatric patients should be kept at 75-100

Prescribing tips 

  • Fultium D3 is cheaper than generic, (colecalciferol caps 600 and 20 000 are high cost) 
  • Vegan: Vitabiotics OTC / Hux D3
  • Vegetarian & Halal: Pro D3 / Hux D3 / Vitabiotics
  • Children: Fultium drops (6 drop = 400IU) daily for kids / Wellbaby Vit D drops from pharmacy
  • Liquid: Fultium drops – 3 drops = 200IU / Invita D3 soution

 Vitamin D deficiency symptoms

  • Unexplained fatigue
  • Difficulty thinking clearly
  • Bone pain
  • Frequesnt fractures
  • Muscle weakness
  • Soft bones

Drugs which can cause vitamin D deficiency

  • Antiepileptics: Phenytoin, Carbamazepine 
  • Antineoplastic drugs: Cyclophophamide, Taxol, Tamoxifen 
  • Antibiotics: Clotrimazole, Rifampicin 
  • Anti-inflammatory agents: Dexamethasone 
  • Antihypertensives: Nifedipine, Spironolactone 
  • Antiretroviral drugs: Ritononavir, Saquinavir 
  • Endocrine drugs: Cyproterone acetate 
  • Herbal: Kava kava, St. John's wort (Hyperforin)

Rifampicin Phenytoin spironolactone nifedipine Tamoxifen dexamethasone Carbamazepine Fultium D3 Cyclophophamide Taxol Clotrimazole Ritononavir Saquinavir

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