Ergocalciferol

Registered South African indications:

• Rickets
• Osteomalacia
• Hypoparathyroidism

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypercalcaemia
• Hypercalciuria
• Renal calculi
• Hypervitaminosis D

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Infants
• Sarcoidosis
• Obesity
• Cardiovascular disease
• Hyperphosphatemia
• Hypoparathyroidism
• Vitamin-D-resistant rickets
• Coadministration with digitalis glycosides
• Coadministration with verapamil

Forms avail. in SA and covered in this monograph: sol, tab

Nutritional rickets

• Oral (sol): 0.025-0.1mg/1000-4000 IU, dly

Metabolic rickets
Osteomalacia

• Oral (sol): 0.25-1.25mg/10 000-50 000 IU, dly
• Oral (tab): 50 000 IU, dly

Hypoparathyroidism

• Oral (sol, tab): 1.25-5mg/50 000-200 000 IU, dly

Paed. forms avail. in SA and covered in this monograph: sol

Rickets -prophylaxis

Premature babies

• Oral (sol): 800 IU, dly (EML, 2013)

Exclusively breast-fed, not adequate volumes of milk formula

• Oral (sol): 400 IU, dly (EML, 2013)

Rickets -treatment

• Oral (sol): 5000 IU, dly; Treatment duration: 3 months (EML, 2013)

Pregnancy

• Caution
• There are no adequate data on the use of ergocalciferol in pregnant women. Ergocalciferol should not be used in pregnancy unless the potential benefit outweighs the potential hazards to the foetus
• Animal studies have shown foetal abnormalities associated with hypervitaminosis D. Calcifediol and calcitriol are teratogenic in animals when given in doses several times the human dose. The offspring of a woman administered 17-144 times the recommended dose of calcitriol during pregnancy manifested mild hypercalcaemia in the first 2 days of life, which returned to normal at day 3

Breastfeeding

• Caution
• Ergocalciferol is excreted in breast milk in limited amounts. In a mother given large doses of ergocalciferol, 25-hydroxycholecalciferol appeared in the milk and caused hypercalcaemia in the child. Monitoring of the infants' serum calcium is required in such cases. Ergocalciferol should not be administered to breastfeeding mothers

Renal Impairment

• Mild to moderate (eGFR ≥30 mL/min/1.73 m²): No dose adjustment recommended
• Severe (eGFR ≤29 mL/min/1.73 m²): Caution; no dose adjustment recommended
• Monitor renal function

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Genitourinary Disorders

• Hypercalciuria
• Renal impairment

Endocrine and Metabolic Disorders

• Hypercalcaemia

Others

• Ectopic calcification

• CYP3A4 inducers
• Cholestyramine
• Orlistat
• Cytotoxic agents
• Aluminium hydroxide
• Digitalis glycosides
• Verapamil
• Thiazide diuretics
• Sodium sulphate
• Magnesium sulphate
• Vitamin D analogues or metabolites

• Serum calcium
• Serum phosphorus
• X-rays

Activated ergocalciferol increases serum calcium and phosphate concentrations primarily by increasing intestinal absorption of calcium and phosphate through binding to a specific receptor in the mucosal cytoplasm of the intestine. Activated ergocalciferol stimulate resorption of bone and is required for normal mineralization of bone.

Solution (per ml) 0.125mg (5000iu)

• Calciferol oily solution (Pharmacare) 

Tablet 50 000iu

• A-Lennon Calciferol (Pharmacare)