Vitamin D

NHSL Medicines Guidance
NHS Lanarkshire

General Notes

The NHSL Vitamin D: Prevention & Treatment of Deficiency in Adults Clinical Guideline gives advice on how to treat adults who are at risk of or who are known to have deficient /insufficient levels of vitamin D. This guidance is written for primary and secondary care prescribers. It refers to adults only.

Further information on prescribing in osteoporosis. See Chapter 6. Endocrine System: Drugs Affecting Bone Metabolism.

Vitamin D With Calcium

Preferred list (P)

THEICAL-D3® chewable tablets

  • One chewable tablet daily.

    • 1000 mg of calcium and 880 units of vitamin D3 per tablet

Total list (T)

ACCRETE D3® tablets

  • One tablet twice a day.

    • 600 mg of calcium and 400 units of vitamin D3 per tablet

ADCAL-D3® caplets or chewable tablets

  • Caplets = Two caplets twice a day

    • 300 mg of calcium and 200 units of vitamin D3 per caplet

  • Chewable tablets = One chewable tablet twice a day.

    • 600 mg of calcium and 400 units of vitamin D3 per tablet

Vitamin D: Loading Dose Regime for the TREATMENT of Adult Deficiency

Preferred list (P)

PLENACHOL® capsules 

  • 40,000 units (1mg) colecalciferol per capsule.
  • 1 capsule per week for 7 weeks.

INVITA D3®  oral solution

  • 1ml single-dose plastic snap and squeeze ampoule.
  • 50,000 units (1.25mg colecalciferol) per ampoule.
  • 1 single-dose ampoule per week for 6-8 weeks.
  • The manufacturer advises the contents of the ampoule can be:
    • emptied directly into the mouth and swallowed
    • emptied onto a spoon and taken orally
    • mixed with a small amount of cold or lukewarm food immediately before administration.

Prescribing Notes:

  • In pregnancy and lactation, the high strength formulations are not recommended and a low strength formulation should be used. Dose requirements may vary depending on the severity of disease, up to 2000 units per day.

Vitamin D: Maintenance Therapy

Preferred list (P)

COLECALCIFEROL

  • 800 units (20 micrograms) or 1000 units (25 micrograms)

Vitamin D: Patients With Severe Renal Impairment

Preferred list (P)

ALFACALCIDOL (1a–hydroxycholecalciferol)

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.