Ergocalciferol Dosage

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Usual Adult Dose for Hypocalcemia

50,000 to 200,000 units orally or IM once a day.

Usual Adult Dose for Hypoparathyroidism

25,000 to 200,000 units orally or IM once a day. Should be given with calcium supplementation.

Usual Adult Dose for Familial Hypophosphatemia

Oral or IM:
250 to 1500 mcg/day (10,000 to 60,000 international units) with phosphate supplements

Usual Adult Dose for Osteomalacia

2000 to 5000 units orally once a day. In patients with malabsorption of vitamin D, the dose is 10,000 units IM once a day or 10,000 to 300,000 units orally once a day.

Usual Adult Dose for Renal Osteodystrophy

20,000 units orally or IM once a day.

Usual Adult Dose for Vitamin D Deficiency

1000 units orally once a day. In patients with malabsorption of vitamin D, the dose is 10,000 units IM once a day or 10,000 to 100,000 units orally once a day.

Usual Adult Dose for Rickets

Oral or IM
Vitamin D-dependent rickets (in addition to calcium supplementation): 250 mcg to 1.5 mg/day (10,000 to 60,000 international units); doses as high as 12.5 mg/day may be necessary

Nutritional rickets:
Adults with Normal Absorption: 25 to 125 mg/day (1,000 to 5,000 international units) for 6 to 12 weeks

Adults with Malabsorption: 250 to 7500 mcg/day (10,000 to 300,000 international units)

Usual Adult Dose for Vitamin/Mineral Supplementation

400 units orally once a day.

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Oral:
Dietary Supplementation for Prevention of Vitamin D Deficiency:
Dietary Intake Reference (DIR) (1997 National Academy of Science Recommendations): Neonates, and Children: 200 international units/day.
(Note: DIR is under review as of March 2009)

Alternative dosing:
1 Month to 12 years (Wagner, 2008): 10 mcg/day (400 international units/day)

Less than 38 weeks gestational age: 10 to 20 mcg/day (400 to 800 international units), up to 750 mcg/day (30,000 international units)

1 Month to 1 Year Fully or Partially Breastfed: 10 mcg/day (400 international units/day) beginning in the first few days of life. Continue supplementation until infant is weaned to greater than or equal to 1,000 mL/day or 1 qt/day of vitamin D-fortified formula or whole milk (after 12 months of age)

Nonbreast-fed infants, older children ingesting less than 1,000 mL of vitamin D-fortified formula or milk: 10 mcg/day (400 international units/day)

Children with increased risk of vitamin D deficiency (chronic fat malabsorption, maintained on chronic antiseizure medications): Higher doses may be required. Laboratory testing (25(OH)D, PTH, bone mineral status) should be used to evaluate.

Adolescents without adequate intake: 10 mcg/day (400 international units/day)

Usual Pediatric Dose for Hypoparathyroidism

50,000 to 200,000 units orally or IM once a day. Should be given with calcium supplementation.

Usual Pediatric Dose for Osteomalacia

1000 to 5000 units orally once a day. In patients with malabsorption of vitamin D, the dose is 10,000 units IM once a day or 10,000 to 25,000 units orally once a day.

Usual Pediatric Dose for Renal Osteodystrophy

4000 to 40,000 units orally or IM once a day.

Usual Pediatric Dose for Rickets

Oral or IM:
Vitamin D-dependent rickets (in addition to calcium supplementation):

Less than 1 month: 25 mcg/day (1,000 international units) for 2 to 3 months; once radiologic evidence of healing is observed, dose should be decreased to 10 mcg/day (400 international units/day).

1 to 12 months: 25 to 125 mcg/day (1,000 to 5,000 international units) for 2 to 3 months; once radiologic evidence of healing is observed, dose should be decreased to 10 mcg/day (400 international units/day).

Greater than 12 months: 125 to 250 mcg/day (5,000 to 10,000 international units) for 2 to 3 months; once radiologic evidence of healing is observed, dose should be decreased to 10 mcg/day (400 international units/day).

Nutritional rickets:
Children (with normal absorption): 25 to 125 mcg/day (1,000 to 5,000 international units) for 6 to 12 weeks.

Children with malabsorption: 250 to 625 mcg/day (10,000 to 25,000 international units).

Usual Pediatric Dose for Familial Hypophosphatemia

Oral or IM:
Initial: 1000 to 2000 mcg/day (40,000 to 80,000 international units) with phosphate supplements. Daily dosage is increased at 3 to 4 month intervals in 250 to 500 mcg (10,000 to 20,000 international units) increments.

Usual Pediatric Dose for Vitamin D Deficiency

Vitamin D insufficiency or deficiency associated with CKD (stages 2-5, 5D): serum 25 hydroxyvitamin D (25[OH]D) level less than 30 ng/mL:

Serum 25(OH)D level 16 to 30 ng/mL: Children: 2000 international units/day for 3 months or 50,000 international units every month for 3 months.

Serum 25(OH)D level 5 to 15 ng/mL: Children: 4000 international units/day for 12 weeks or 50,000 international units every other week for 12 weeks.

Serum 25(OH)D level less than 5 ng/mL: Children: 8000 international units/day for 4 weeks then 4000 international units/day for 2 months for total therapy of 3 months or 50,000 international units/week for 4 weeks followed by 50,000 international units 2 times/month for a total therapy of 3 months.

Maintenance dose [once repletion accomplished; serum 25(OH)D level greater than 30 ng/mL]: 200 to 1000 international units/day.
Dosage adjustment: Monitor 25(OH)D, corrected total calcium and phosphorus levels 1 month following initiation of therapy, every 3 months during therapy and with any Vitamin D dose change.

Prevention and treatment of vitamin D Deficiency in cystic fibrosis:

Infants less than 1 year: 400 international units/day.

Children greater than 1 year: 400 to 800 international units/day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dialysis

Vitamin D and its metabolites are not dialyzable.

Other Comments

Patients should receive adequate calcium during ergocalciferol therapy. Serum calcium should be monitored 1 to 2 times a week during dosage titration, and approximately once a month after stabilization of dosage. Ergocalciferol should be withheld if hypercalcemia develops.

1 mcg = 40 USP international units

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