ergocalciferol: clinical use

Prescribing considerations

• Confirm an indication related to vitamin D malabsorption from gastrointestinal, hepatic or biliary disease.
• Review concurrent vitamin D, calcium, phosphate and magnesium exposure to reduce duplication and toxicity risk.
• Ensure adequate dietary calcium and hydration where clinically appropriate.
• Use particular caution in infants, vitamin D-resistant rickets, renal calculi, heart disease or arteriosclerosis.
• The product is not recommended for hypoparathyroidism.

Contraindications and cautions

• Hypersensitivity to ergocalciferol or ethyl oleate
• Hypercalcaemia
• Vitamin D toxicity or hypervitaminosis D
• Decreased renal function
• Metastatic calcification

Monitoring

• Serum and urinary calcium
• Serum phosphate
• Renal function, including urea nitrogen and creatinine
• Clinical features of hypercalcaemia or ectopic calcification
• Blood glucose where clinically relevant; discontinue the selected product if hyperglycaemia develops

Clinical pharmacology

Ergocalciferol is converted in the liver and subsequently metabolised in the kidneys. Its metabolites regulate calcium homeostasis by increasing intestinal calcium and phosphate absorption and influencing renal and skeletal mineral handling. It is stored in tissues including liver and fat and eliminated mainly through bile, with enterohepatic recycling.

Formulation and product differences

• The selected product is an intramuscular solution administered by a healthcare professional.
• Its only listed excipient is ethyl oleate.
• It is supplied in glass ampoules, must be protected from light and should not be administered using a plastic syringe.
• Oral products have different licensing, excipients and suitability; check product-specific information rather than assuming interchangeability.

Injection

Route: Parenteral

Strengths: 300000 units