There are contraindications. Before starting use, consult your doctor.

Commercial names abroad (abroad) - Arachitol, Actifral D3, Adrigyl, Calcirol, Deetipat, Dekristol, Detrixin, Devaron, Devitre, D-Tracetten, Iper D3, Laevovit D3, Neo Dohyfral, Ospur D3, Ostoforte, Vigantol, Vigorsan, Zymad.

All preparations of vitamins and minerals.

You can ask a question or leave a review about the medicine (please, do not forget to indicate the name of the drug in the text of the message).

Preparations containing Colecalciferol (ATC code A11CC05):

Aquadetrim (vitamin D3) - instructions for use

Clinical and pharmacological group

A drug that regulates the metabolism of calcium and phosphorus.

Pharmacological action

A drug that regulates the metabolism of calcium and phosphorus. Vitamin D3 is an active antirachitic factor. Most important function Vitamin D is responsible for regulating calcium and phosphate metabolism, which promotes skeletal mineralization and growth.

Vitamin D3 is the natural form of vitamin D, which is formed in humans in the skin under the influence of sun rays. Compared to vitamin D2, it is characterized by 25% higher activity.

Colecalciferol plays a significant role in the absorption of calcium and phosphates in the intestine, in the transport of mineral salts and in the process of bone calcification, and also regulates the excretion of calcium and phosphates by the kidneys.

The presence of calcium ions in the blood in physiological concentrations ensures the maintenance of muscle tone of skeletal muscles, myocardial function, promotes nervous stimulation, and regulates the process of blood coagulation.

Vitamin D is necessary for the normal functioning of the parathyroid glands and is also involved in the functioning of the immune system, influencing the production of lymphokines.

Lack of vitamin D in food, impaired absorption, calcium deficiency, as well as insufficient exposure to the sun during the period of rapid growth of a child leads to rickets, in adults - to osteomalacia, pregnant women may experience symptoms of tetany, disruption of the calcification processes of the bones of newborns.

An increased need for vitamin D occurs in women during menopause, as they often develop osteoporosis due to hormonal imbalances.

Pharmacokinetics

Suction

An aqueous solution of colecalciferol is absorbed better than an oil solution (this is important when used in premature infants, since in this category of patients there is insufficient production and flow of bile into the intestines, which impairs the absorption of vitamins in the form of oil solutions).

After oral administration, colecalciferol is absorbed from the small intestine.

Distribution and metabolism

Metabolized in the liver and kidneys.

Penetrates through the placental barrier. Stands out with breast milk. Colecalciferol accumulates in the body.

Removal

T1/2 is several days. Excreted by the kidneys in small quantities, most of it is excreted in bile.

Pharmacokinetics in special clinical situations

In case of renal failure, an increase in T1/2 is possible.

Indications for use of the drug AQUADETRIM®

Prevention and treatment:

• vitamin D deficiency;
• rickets and rickets-like diseases;
• hypocalcemic tetany;
• osteomalacia;
• metabolic osteopathies (hypoparathyroidism and pseudohypoparathyroidism).

Treatment of osteoporosis, incl. postmenopausal (as part of complex therapy).

Dosage regimen

The dose is set individually, taking into account the amount of vitamin D that the patient receives as part of the diet and in the form of medications.

The drug is taken in 1 spoon of liquid (1 drop contains 500 IU of colecalciferol).

For the purpose of prevention in full-term newborns from 4 weeks of life to 2-3 years, with proper care and sufficient stay on fresh air, the drug is prescribed in a dose of 500-1000 IU (1-2 drops) per day.

Premature babies from 4 weeks of age, twins and children living in unfavorable conditions, prescribe 1000-1500 IU (2-3 drops) per day.

In the summer, the dose can be reduced to 500 IU (1 drop) per day.

Pregnant women are prescribed 500 IU (1 drop) per day throughout pregnancy, or 1000 IU per day, starting from the 28th week of pregnancy.

In the postmenopausal period, 500-1000 IU (1-2 drops) per day are prescribed.

For the treatment of rickets, the drug is prescribed daily at a dose of 2000-5000 IU (4-10 drops) per day for 4-6 weeks, depending on the severity of rickets (I, II or III) and the course of the disease. In this case, the patient’s clinical condition and biochemical parameters (calcium, phosphorus levels, alkaline phosphatase activity in the blood and urine) should be monitored. The initial dose is 2000 IU per day for 3-5 days, then, if well tolerated, the dose is increased to an individual therapeutic dose (usually up to 3000 IU per day). A dose of 5000 IU per day is prescribed only for pronounced bone changes. If necessary, after a 1 week break, the course of treatment can be repeated.

Treatment should be continued until a clear therapeutic effect is obtained, followed by a transition to a prophylactic dose of 500-1500 IU per day.

When treating rickets-like diseases, 20,000 - 30,000 IU (40-60 drops) per day are prescribed, depending on age, body weight and severity of the disease, under the control of biochemical blood parameters and urine analysis. The course of treatment is 4-6 weeks.

When treating postmenopausal osteoporosis (as part of complex therapy), 500-1000 IU (1-2 drops) per day is prescribed.

Side effect

Symptoms of hypervitaminosis D: loss of appetite, nausea, vomiting; headaches, muscle and joint pain; constipation; dry mouth; polyuria; weakness; mental disorders, incl. depression; weight loss; sleep disturbance; increase in temperature; protein, leukocytes, hyaline casts appear in the urine; increased calcium levels in the blood and its excretion in the urine; calcification of the kidneys, blood vessels, and lungs is possible. If signs of hypervitaminosis D appear, it is necessary to discontinue the drug, limit the intake of calcium, and prescribe vitamins A, C and B.

Other: hypersensitivity reactions are possible.

Contraindications to the use of the drug AQUADETRIM®

• hypervitaminosis D;
• hypercalcemia;
• hypercalciuria;
• urolithiasis (formation of calcium oxalate stones in the kidneys);
• sarcoidosis;
• acute and chronic kidney diseases;
• renal failure;
• active form of pulmonary tuberculosis;
• children up to 4 weeks of age;
• hypersensitivity to vitamin D3 and other components of the drug (especially benzyl alcohol).

The drug should be used with caution in patients in a state of immobilization; when taking thiazides, cardiac glycosides; during pregnancy and lactation (breastfeeding); at infants with a predisposition to early overgrowth of fontanelles (when the small size of the anterior crown is established from birth).

Use of the drug AQUADETRIM® during pregnancy and breastfeeding

During pregnancy, Aquadetrim® should not be used in high doses due to the possibility of teratogenic effects in case of overdose.

Aquadetrim® should be prescribed with caution during lactation, because When using the drug in high doses, a nursing mother may develop overdose symptoms in the child.

During pregnancy and breastfeeding, the dose of vitamin D3 should not exceed 600 IU per day.

Use for liver dysfunction

Colecalciferol is metabolized in the liver and kidneys.

Use for renal impairment

If renal function is impaired, T1/2 may increase. Contraindicated in acute and chronic kidney diseases; with renal failure.

Use in children

Contraindicated for children under 4 weeks of age.

Special instructions

When prescribing the drug, it is necessary to take into account all possible sources of vitamin D.

Use of the drug in medicinal purposes in children it is necessary to carry out under close medical supervision and adjust the dosage regimen during periodic examinations, especially in the first months of life.

Long-term use of Aquadetrim in high doses or use of the drug in loading doses can lead to chronic hypervitaminosis D3.

Aquadetrim® and calcium in high doses should not be used simultaneously.

Control of laboratory parameters

When using the drug for medicinal purposes, it is necessary to monitor the level of calcium in the blood and urine.

Overdose

Symptoms: loss of appetite, nausea, vomiting, constipation, anxiety, thirst, polyuria, diarrhea, intestinal colic. Frequent symptoms are headache, muscle and joint pain, depression, mental disorders, ataxia, stupor, and progressive weight loss. Renal dysfunction develops with albuminuria, erythrocyturia and polyuria, increased potassium loss, hyposthenuria, nocturia and increased blood pressure.

In severe cases, clouding of the cornea is possible, less often - swelling of the optic nerve papilla, inflammation of the iris, up to the development of cataracts. Possible formation of kidney stones, calcification of soft tissues, incl. blood vessels, heart, lungs, skin.

Cholestatic jaundice rarely develops.

Treatment: drug withdrawal. Make an appointment large quantity liquids. If necessary, hospitalization may be required.

Drug interactions

With simultaneous use of Aquadetrim with antiepileptic drugs, rifampicin, cholestyramine, the absorption of colecalciferol is reduced.

With simultaneous use of Aquadetrim and thiazide diuretics, the risk of developing hypercalcemia increases.

The simultaneous use of Aquadetrim with cardiac glycosides may enhance their toxic effect (increases the risk of developing cardiac arrhythmias).

Conditions for dispensing from pharmacies

The drug is approved for use as an over-the-counter product.

Storage conditions and periods

The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life - 3 years.

Cholecalciferol or vitamin D is involved in many processes in the body. IN lately The fact that it affects tissue repair after exercise is actively discussed, and can be considered the only steroid-like substance that can be recommended to everyone, young and old. Vitamin D preparations have been in use for several decades. They are used not only for children with growth delays, but also for adults. A deficiency of this substance in the diet of a modern city dweller is quite common. Previously, the main source of the drug was the well-known fish oil; today there are more affordable and easy-to-use forms. From a biochemical point of view, this is not just one vitamin, but a whole group. They are formed in the human body under the influence of ultraviolet radiation. And the lack of insolation in the cold season, together with the “office-home” lifestyle in the warm season, provoke problems with a deficiency of this substance.

Dosage form

Vitamin D3 most often comes in capsule form along with calcium for better absorption. There are other forms of dietary supplements with this vitamin, from gel capsules with the same fish oil to chewable strips.

Pharmacological action

Normally, it should be formed in the body under the influence of sunlight. Affects many biochemical processes in the human body:

• regulates mineral metabolism. Promotes bone growth and the formation of normal dentin tissue in children. In older people, it helps to prevent osteoporosis and “fix” a certain amount of calcium in bone tissue. Overall, it is the most important vitamin for the formation of a healthy skeleton. In children, its use serves as a prevention of rickets. Interacts with calcium and promotes its absorption;
• affects overall metabolism. Promotes the absorption of minerals from the proximal intestine - calcium, magnesium. Sometimes they write that vitamins D2 and D3 speed up metabolism and promote weight loss; there are even entire studies on this topic. The result is that a deficiency of this substance can indeed cause a slowdown in metabolism and weight gain, but its adequate consumption simply promotes a healthy metabolic rate, but does not “accelerate” anything and does not serve as a “fat burner”;
• acts simultaneously as a vitamin and a hormone, the latter “type of activity” of the substance is manifested in its ability to increase the absorption of calcium, which was indicated above. It is not the vitamin itself that works as a hormone, but its metabolite formed in the human body, while the “hormonal” function of vitamin D also includes activation of the synthesis of certain types of proteins;
• reduces the body's susceptibility to cancer and cardiac diseases. Regions in which nutrition contributes to a deficiency of this vitamin have long been considered “risky” for these types of diseases. May also influence the incidence of diabetes, arthritis and autoimmune diseases. According to some data, adequate food intake with vitamins of this group helps prevent autoimmune lesions;
• Adequate levels of vitamin D are necessary for the normal functioning of the human thyroid gland. It is believed that its deficiency may contribute to the development of hypothyroidism along with iodine deficiency. It is this fact that gives many scientists reason to believe that consuming vitamin D important factor obesity prevention;
• the substance also affects the complex of human immune reactions. His good level serves as an indicator of the normal functioning of the immune system, the introduction of additional supplements to the diet is considered necessary for everyone who faces seasonal fluctuations in immunity;
• in sports practice it is used in a complex that supports physical activity and muscle tone;
• there is evidence that vitamin D also affects the absorption of magnesium, which allows it to be considered a substance that improves performance nervous system in humans, vitamin D preparations are also used in the treatment of multiple sclerosis;
• serves for the prevention of cancer.

Indications

The indication for use is vitamin D hypovitaminosis. It is usually diagnosed by taking a blood test. But it can also manifest itself with a number of general symptoms:

• in children, the most severe symptom of vitamin D deficiency is manifestations of rickets;
• in some cases, softening of the bones occurs - osteomalaria;
• burning sensation in the mouth and throat, especially not associated with inflammatory processes. Sometimes constantly inflamed gums are also included among the manifestations;
• insomnia and sleep disturbances, such as waking up unusually early and not getting enough sleep during the day;
• deterioration of vision, including color vision;
• fluctuations in appetite. In the Russian medical tradition, loss of appetite and weight loss are distinguished. In America, there are studies that link vitamin D deficiency with abnormally increased appetite and cravings for certain unhealthy foods. There are also works in which the authors insist that vitamin D deficiency may be one of the causes of depression on a weight loss diet, low athletic performance, as well as various systemic disorders that do not allow weight loss.

In modern practice of obstetrics and gynecology, both pregnancy itself and the process of planning it are considered indications for the use of a substance.

Additional administration of vitamin D preparations is advisable for a number of diseases:

• rickets, osteoporosis, osteomalaria, delayed formation of osteocallus;
• chronic enteritis;
• kidney diseases that interfere with vitamin synthesis in the body;
• tuberculosis.

Sometimes vitamin D deficiency is associated with the use of estrogen-containing contraceptives.

In almost all cases, calcium and vitamin D supplements will be prescribed for the period of recovery from injuries, healing of fractures and cracked bones.

Contraindications

Vitamin D is fat-soluble and is contraindicated in case of organic heart disease, active form of pulmonary tuberculosis, as well as severe damage to the kidneys, liver and intestines.

Overdose

Symptoms of overdose can be quite severe; the vitamin belongs to the class of fat-soluble and accumulates in the human body.

Symptoms of overdose are general; the fact itself is determined through laboratory analysis. Usually a person experiences symptoms from the intestines - constipation, nausea, vomiting, and sometimes diarrhea. Muscle weakness often occurs, as well as sudden, unexplained acute pain in the joints and muscles. Fever, cardiac arrhythmia, and slow pulse may be present.

Treatment usually consists of stopping vitamin D medications and a set of supportive procedures.

Application and dosage

Dosages vary from country to country. The average norm for an adult is 300-500 IU per day. Dosages for the treatment of rickets and its prevention are selected individually.

Special instructions

It is effective only in fat-soluble form.

Interaction

Interacts with many medicines. It is excreted from the body when taking mineral laxatives; the absorption of the vitamin is disrupted if cholesterol-lowering agents are used. Can be completely eliminated without absorption various drugs orlistat. High doses of vitamin D may interfere with iron absorption.

Especially for – fitness trainer Elena Selivanova

Every day I become more and more convinced how important it is to restore vitamin D deficiency and what are the consequences of its deficiency, in addition to such consequences as hair loss, constant fatigue and brittle bones!

The more I study the information, the more convinced I am that take prophylactic dosages not effective. Recommendations 600 Units per day for an adult does NOT restore the deficit, other numbers are needed.

Vitamin D deficiency

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

In Russia, vitamin level is on the border of 10-20 ng/ml, the situation is even more dire among 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 years and older e especially strong:

Reference values

• The lower limit of normal for vitamin D is above 30 ng/ml
• Maintain the level optimally in the range of 40 - 70 ng/ml
• The toxic effect of vitamin D occurs at levels greater than 100 ng/ml

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

Vitamin D test

Where can I get tested for vitamin D? It cannot be taken for free at the city clinic; it was excluded from the list of tests even according to the doctor’s testimony. You can donate blood to check your vitamin D level in a paid laboratory; it is best to choose an analysis using the spectrometry method, 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 keep in mind that these are average dosages intended for an adult over 18 years of age, they are not suitable for children, for people who are very thin or, conversely, overweight. 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 dosages which are guaranteed to raise vitamin D levels in 90% of people. You can calculate a more accurate dosage based on your weight using ready-made tools from my.

Vitamin D dosages:

How to use the table:

1. We do a vitamin D test
2. We look at the recommended dosage of vitamin D in the table
3. We will re-test in 3-6 months

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

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

Vitamin D preparations

I chose the Carlson Labs vitamin D option, Super Daily D3 in liquid form (see first photo). 1 drop contains 1000 units. Vitamin D drops are absolutely tasteless and aromaless, do not contain ballast substances. One bottle like this will last you a whole year!

There is a cool option for kids Carlson Labs, Baby's Super Daily D3, 1 drop contains 400 units. Children over 1 year of age can take 2 drops per day.

I also trust the Solgar brand, Vitamin D3, 1 capsule contains a dosage of 1000 units. vitamin D3.

How can I say THANK YOU for useful posts?

Use the code IFO971 in each order, you can enter it manually during checkout. This is how you support my blog and useful reviews! 5% discount for everyone to order, and for beginners 10%!

Treatment with vitamin D3. Vitamin D3: instructions, use, indications, contraindications, action, overdose of vitamin D3. Overdose and side effects Lack of calcium in the body is a common problem that occurs in both adults and children. And even products containing calcium are not always able to save the situation. In order for this element to be absorbed by the body, a special “sun” vitamin – D3 – is needed. But besides the absorption of microelements, this vitamin has many other important functions. The sun is a source of vitamin D3 This vitamin promotes the synthesis of immune cells by the bone marrow. Thanks to this property, the body’s defenses are restored and a person is less susceptible to infections. As mentioned above, D3 maintains calcium levels. This is why not only the bones become strong, but also the nerves. D3 helps nerve fibers regenerate. People who receive the required amount of vitamin are less likely to suffer from multiple sclerosis. For endocrine system The solar element is also useful. It normalizes the production of pancreatic insulin, adjusting the existing glucose level. Cholecalciferol (scientific name for vitamin D3) helps cell growth and renewal. Thus, it inhibits the growth of malignant cells, helping our body. Factors influencing performance strict vegetarian diet; anthracid therapy; kidney or liver diseases; age-related changes; period of pregnancy or lactation. Effects of Vitamin D3 from Different Sources For an adult, the daily dietary intake of cholecalciferol should be at least 10 mcg. Children under 18 years old required rate ranges from 1.5 to 5 µg. Signs of vitamin deficiency Vitamin D3 deficiency can manifest itself in different ways. In older people, signs of vitamin deficiency are often osteoporosis or insomnia. In schoolchildren, low levels of cholecalciferol are accompanied by fatigue, vision problems. In infants, deficiency of this element may cause rickets. Avitaminosis D3 Products with a “solar” element Products with vitamin D3 To prevent cholecalciferol levels from decreasing, you need to constantly diversify your diet with certain foods. A large amount of this element contains: herring; caviar; fish oil; mackerel; fermented milk products; eggs; Also, a small amount of the “sunshine” vitamin is present in beef, pork liver, chanterelle mushrooms and duck. People suffering from such vitamin deficiency need to walk in the sun more often. Preparations containing vitamin D3 In some cases, it is not possible to replenish cholecalciferol reserves naturally. Help to avoid vitamin deficiency special drugs. The most prescribed drug for such vitamin deficiency is Calcium D3 nikomed. One tablet of the product combines a daily dose of calcium and vitamin D3. A less common medicine is Aquadetrim. These drops are prescribed to children for the prevention or treatment of rickets. For adults, the drug is indicated for joint pathologies. One more thing effective remedy– calcium citrate. Also prescribed for calcium deficiency and for the prevention of rickets. Calcium D3 Nycomed Instructions for use of Calcium D3 nycomed One tablet of this drug contains 1250 mg of calcium carbonate, 2 mg of colecalciferol (synthetic vitamin D3). Doctors advise taking the medicine for the prevention and treatment of calcium deficiency, as well as for osteoporosis or its complications. The main contraindication to the use of the drug is severe renal failure. Even a slight overdose of the drug is fraught with: nausea; vomiting; loss of appetite; constipation; increased fatigue; kidney damage; cardiac arrhythmia. Colecalciferol reduces the absorption of tetracyclines from the gastrointestinal tract. The product can be used during pregnancy or breastfeeding. vitamins Aquadetrim A liquid solution of 1 ml of the drug (30 drops) contains 15,000 IU of colecalciferol. Aquadetrim is prescribed to children a month after birth to prevent rickets. In this case, the daily dose of the medicine is 1-2 drops. For premature babies older than 4 weeks, the dose can be increased to 3 drops. Pregnant women in autumn winter period It is recommended to take no more than 1 drop per day. For postmenopausal women, the daily dose of Aquadetrim is 1-2 drops. Adults need to take 2-3 drops daily to prevent osteoporosis. Calcium citrate The fundamental difference between calcium citrate and the above-described products is its natural composition. Other drugs are based on synthetic analogues of cholecalciferol. Colecalciferol is less easily absorbed than natural cholecalciferol. Citrate is prescribed for bone fractures, for the prevention and treatment of rickets, and for age-related softening bone tissue. Calcium Citrate for Bone Growth For an adult, the daily dose of citrate is 600 mg. This volume should be divided into several doses, according to the recommendations of the attending physician. This drug cannot be combined with hormonal contraceptives, glucocorticosteroids, or levothyroxine. Contraindications and harm Like other substances, vitamin D3 has contraindications. You should not take D3 if you have renal osteodystrophy or calcium nephrourolithiasis. You should not use the product when hypersensitivity to the components. People with pathologies of the kidneys, liver, heart, or pulmonary tuberculosis should take D3 with caution. A dosage reduction is necessary for patients suffering from gastric or duodenal ulcers. It is strictly contraindicated for women who are pregnant or breastfeeding to use D3 without a doctor's prescription. Prices and pharmacies You can buy D3-based medications at any pharmacy. The average price for chewable tablets Calcium D3 nycomed (20 pieces) in Russia is 250-300 rubles. Aquadetrim drops will cost the buyer 200-220 rubles. Calcium citrate from the American manufacturer Solgar (60 tablets) costs 750-830 rubles. However, for small towns or villages, these drugs can cost an order of magnitude more. Colecalciferol Vitamin D3:: Dosage form drops for oral administration, capsules, oral solution [oil], tablets Vitamin D3: Pharmacological action A remedy that replenishes vitamin D3 deficiency. Participates in the regulation of calcium-phosphorus metabolism, enhances the absorption of Ca2+ and phosphates in the intestine (by increasing the permeability of cellular and mitochondrial membranes of the intestinal epithelium) and their reabsorption in the renal tubules of the kidneys; promotes bone mineralization, the formation of the bone skeleton and teeth in children, enhances the process of ossification, and is necessary for the normal functioning of the parathyroid glands. Vitamin D3 is formed in the skin under the influence of UV rays from the provitamin 7-dehydrocholesterol. To maintain a normal level of vitamin D in the blood serum, it is enough to irradiate only the skin of the child’s face and hands with sunlight for 2 hours a week, and UV irradiation of the mother (1.5 minimum erythemal doses for the whole body for 90 s) increases the content of vitamin D3 in her milk 10 times. Vitamin D3:: Indications Hypo- and avitaminosis of vitamin D (prevention and treatment), conditions of increased body need for vitamin D: rickets, osteomalacia, osteoporosis, nephrogenic osteopathy, inadequate and unbalanced nutrition (including parenteral, vegetarian diet), malabsorption syndrome, insufficient insolation , hypocalcemia, hypophosphatemia (including familial), alcoholism, liver failure, cirrhosis, obstructive jaundice, gastrointestinal diseases (glutenic enteropathy, persistent diarrhea, tropical sprue, Crohn's disease), rapid weight loss, pregnancy (especially with nicotine and drug addiction , multiple pregnancy), lactation period; breastfed newborns with insufficient insolation; taking barbiturates, cholestyramine, colestipol, mineral oils, anticonvulsants (including phenytoin and primidone). Hypoparathyroidism: postoperative, idiopathic, tetany (postoperative and idiopathic), pseudohypoparathyroidism. Vitamin D3:: Contraindications Hypersensitivity, hypercalcemia, hypervitaminosis D, renal osteodystrophy with hyperphosphatemia. Caution. Atherosclerosis, sarcoidosis or other granulomatosis, CHF, history of nephrourolithiasis, hyperphosphatemia, chronic renal failure, pregnancy, lactation, childhood. Vitamin D3: Side effects Allergic reactions. Hypercalcemia, hypercalciuria; loss of appetite, polyuria, constipation, headache, myalgia, arthralgia, increased blood pressure, arrhythmias, impaired renal function, exacerbation of the tuberculosis process in the lungs. Overdose. Symptoms of vitamin D hypervitaminosis: early (due to hypercalcemia) - constipation or diarrhea, dry oral mucosa, headache, thirst, pollakiuria, nocturia, polyuria, anorexia, metallic taste in the mouth, nausea, vomiting, unusual fatigue, general weakness, hypercalcemia , hypercalciuria; late - bone pain, cloudiness of urine (appearance of hyaline casts in the urine, proteinuria, leukocyturia), increased blood pressure, skin itching, photosensitivity of the eyes, conjunctival hyperemia, arrhythmia, drowsiness, myalgia, nausea, vomiting, pancreatitis, gastralgia, weight loss, rarely - changes in the psyche (up to the development of psychosis) and mood. Symptoms of chronic vitamin D intoxication (when taken for several weeks or months for adults in 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 cardiovascular failure up to death (these effects most often occur when hyperphosphatemia is combined with hypercalcemia), growth impairment in children (long-term use at a dose of 1.8 thousand IU/day). Treatment: drug withdrawal, low Ca2+ diet, consumption large quantities liquids, administration of corticosteroids, alpha-tocopherol, ascorbic acid, retinol, thiamine, in severe cases - intravenous administration of large quantities of 0.9% NaCl solution, furosemide, electrolytes, hemodialysis. Vitamin D3:: Method of application and dosage Orally or intramuscularly, for the prevention of rickets - at a dose of 200 thousand IU (5 mg) once every 6 months (up to 5 years). If the child is rarely exposed to the sun or his skin is hyperemic, the single dose is increased to 400 thousand IU, and is also administered once every six months (up to 5 years). Treatment of rickets, spasmophilia and hypocalcemia - 200 thousand IU once a week for 2 weeks (in combination with Ca2+ drugs). To prevent attacks of tetany - up to 1 million IU/day. For osteomalacia and osteoporosis - 200 thousand IU every 15 days for 3 months. Drops for oral administration (1 drop = 500 IU): for the prevention of rickets in children infancy(full-term), starting from 2 weeks of life - daily, 500 IU/day; in special cases (for example, premature babies) - up to 1000 IU/day for stage I prematurity. and 1000-2000 IU/day) for stage II and III prematurity. (excluding summer months); for the treatment of rickets - 2000-5000 IU / day in 2-3 doses for 1-1.5 months, then switch to maintenance therapy - 500 IU / day) for 2 years and in the winter at the 3rd year of life. A dose of 5000 IU is prescribed only for pronounced bone changes. 3 months after the end of the 1st course, children at risk are given a second course of anti-relapse treatment at 2000-5000 IU/day for 3-4 weeks, with the exception of the summer months. Infants suffering from spasmophilia - 5000 IU 3 times a day. For adults, for the prevention of osteomalacia - 500-1000 IU 3 times a day, for the treatment of osteomalacia - up to 2500 IU 3 times a day. For hypoparathyroidism and pseudohypoparathyroidism - 7500-15000 IU/day). In this case, it is necessary to monitor the concentration of Ca2+ in the blood every 3-6 months and, if necessary, correct the dosage regimen. Vitamin D3:: Special instructions The daily requirement for vitamin D3 for adults is 400 IU (10 mcg). Use under close medical supervision of Ca2+ concentrations in the blood and urine (especially when combined with thiazide diuretics). When used prophylactically, it is necessary to keep in mind the possibility of overdose, especially in children (do not prescribe more than 10-15 mg per year). Long-term use in high doses leads to chronic hypervitaminosis D3. It should be borne in mind that sensitivity to vitamin D varies from patient to patient, and in some patients taking even therapeutic doses can cause symptoms of hypervitaminosis. Newborns' sensitivity to vitamin D varies, and some may be sensitive to even very low doses. Children who receive vitamin D over a long period of time have an increased risk of stunted growth. To prevent hypovitaminosis D, a balanced diet is most preferable. Breastfed newborns, especially those born to mothers with dark skin and/or insufficient sun exposure, have high risk the occurrence of vitamin D deficiency. Experiments on animals have shown that calcitriol in doses 4-15 times higher than recommended doses for humans has a teratogenic effect. Maternal hypercalcemia (associated with prolonged overdose of vitamin D during pregnancy) can cause increased sensitivity to vitamin D in the fetus, suppression of parathyroid function, specific elf-like appearance syndrome, mental retardation, and aortic stenosis. In old age, the need for vitamin D may increase due to a decrease in the absorption of vitamin D, a decrease in the ability of the skin to synthesize provitamin D3, a decrease in sun exposure, and an increase in the incidence of renal failure. Vitamin D3:: Interaction The toxic effect is weakened by vitamin A, tocopherol, ascorbic acid, pantothenic acid, thiamine, riboflavin. With hypervitaminosis D, it is possible to enhance the effect of cardiac glycosides and increase the risk of arrhythmia due to the development of hypercalcemia (adjustment of the dose of cardiac glycoside is advisable). Under the influence of barbiturates (including phenobarbital), phenytoin and primidone, the need for colecalciferol can significantly increase (increase the metabolic rate). Long-term therapy with the simultaneous use of Al3+ and Mg2+-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 corticosteroids reduce the effect. Cholestyramine, 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. 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. Concomitant use with other vitamin D analogues increases the risk of developing hypervitaminosis.