Increased risk of hypercalcemia if given with thiazide diuretics, Ca or phosphate

Antiepileptics eg carbamazepine, phenobarbitone, phenytoin, and primidone may increase
vitamin D requirements

Rifampicin and INH  may reduce efficacy of vitamin D .

Corticosteroids may counteract the effect of vitamin D
Digoxin or any cardiac glycoside

Reduced absorption  when taken withn cholestyramine , colestipol, mineral oil, oristat,
ketoconazole

Hip fracture
Osteoporosis
Rickets & osteomalacia
Post-menopausal osteoporosis

Nutrutional deficiency

Deficiency due to malabsorption states of liver

Hypocalcemia due to hypoparathyroidism

Irritability, headache, pruritus, nausea, vomiting, anorexia, metallic taste, dry mouth, constipation,
 weight loss,and conjuntivitis

Generally well tolerated.

Excessive intake of vitamin D leads to the development of hyperphostaemia or
hypercalcaemia. Associated effects of hypercalcemia include hypercalciuria, etopic
calcification, and renal and CV damage

Hypercalcemia,
Hypersenstivity to cholecalciterol or any component of formulation
Malabasorption syndrome
Evidence of vitamin D toxicity

Special precautions-

Excessive intake may lead to development of hyperphosphatemia or hypercalcemia,
infants, renal impairment, or calculi, heart diseases

Monitor plasma phosphate and Ca level.

Recommended blood test to monitor blood levels of 2 (OH ) D two months after treatment and
adjust dose of vitamin D as needed. 

Plasma phosphate concentrations should be controlled during treatment

Caution to be excercised if there is concurrent use of calcium/other vitamin D containing
preparationsor thiazide diuretics and also in patients with renal impairment/heart disease

Pregnancy and lactation - use as directed by the physician

Indication-
Hip fracture
Osteoporosis
Rickets & osteomalacia
Post-menopausal osteoporosis

Nutrional deficiency-
Hypocalcemia due to hypoparathyroidism

Deficiency due to malabsorption due to malabsorption or liver diseases

Dosage-
Osteoporosis -  5000 - 50000iu daily or single large of 100,000 - 500,000 iu
IM inj

Nutrional deficiency-
adult- 10mcg 400 units daily. may also be given IM inj

Hypocalcemia due to hypoparathyroidism
Adult- up to 5mg  - 200000 units daily. May also be via IM inj

Deficiency due to malabsorption due to malabsorption or liver diseases
Adult- up to 1mg - 40000 units daily . May be given by IM inj

Pharmacology

Chloecalciterol  Vitamin D3 which is essential for maintenance of calcium homestatis and normal bone formation.

First it gets converted to 25- dihydroxyvitamin D3 in the liver and further converted into 1, 25 dihydroxyvitamin D3 calciferol in the kidney .

Pharmacokinetics

Cholecalciferol is rapidly absorbed from intesteine.

Peak serum conc were reached within 3 to 6 hrs following an oral admin single dose of cholecalciferol

Take with or without food

Pregnancy-

It should be used when benefit outweigh the risk because controlled studies in humans or animals are not available.