Defrol Capsule

Introduction

Cholecalciferol, also known as Vitamin D3, is a member of the vitamin D family of compounds. It is an essential nutrient involved in regulating calcium and phosphorus in the body. Cholecalciferol is the main form of vitamin D used in over-the-counter dietary supplements and food fortification.

Uses

Cholecalciferol is used to supplement vitamin D, particularly for those who are deficient due to an inadequate diet or lack of exposure to sunlight. It can be used to prevent and treat a number of conditions associated with vitamin D deficiency, such as rickets, osteoporosis, and certain cancers. In addition, it can be used to treat certain metabolic disorders, hypertension, and muscle weakness.

Brand Name	Defrol
Type	Capsule
Weight	40000 IU
Generic	Cholecalciferol [Vitamin D3]
Manufacturer	ACME Laboratories Ltd.
Available in	English বাংলা

Mechanism of Action

Cholecalciferol is converted to its active form, calcitriol, in the body. Calcitriol binds to vitamin D receptors, which are found in most cells and tissues throughout the body. This, in turn, activates various genes involved in the regulation of calcium and phosphorus in the body. Ultimately, this helps ensure that the body can absorb and utilize these minerals.

How Long Does It Take To Work?

Cholecalciferol begins to work within days, but it can take weeks or months for the full effects to be seen. This depends on the severity of the deficiency and the person's individual response to the supplement.

Absorption

Cholecalciferol is primarily absorbed in the small intestine via a combination of diffusion and active transport. It can also be absorbed through the skin via sunlight.

Route of Elimination

Cholecalciferol is eliminated from the body primarily through the feces.

Dosage

For capsule: Adults:

Treatment of Vitamin D3 deficiency: 40000 IU once weekly for 7 weeks. Doses for maintenance therapy is 1400-2000 IU/day. To confirm the target level of 25 hydroxyvitamin D, measurement of it should be determined 3-4 months after initiating the maintenance therapy.
Prevention of Vitamin D3 deficiency: 20000 IU every 4 weeks. Higher doses may be required in certain situations.
Addition to specific therapy for osteoporosis: 20000 IU once a month.

For capsule: Children (12-18 years):

Treatment of Vitamin D3 deficiency: 20000 IU once every 2 weeks for 6 weeks.
Prevention of Vitamin D3 deficiency: 20000 IU every 6 weeks.

For film-coated tablet: 1000 IU (1-2 tablets) daily, or as directed by physician. Take the medicine with food or within 1 hour after a meal.

For oroflash or chewable tablets: 1000 IU to 2000 IU daily, or as directed by physician. Take the medicine with food or within 1 hour after a meal. Place the tablet in mouth swallow after chewing.

For Syrup:
For patients with risk of Cholecalciferol deficiency:

0-1 yr: 400 IU/ day (2 ml)
>1 Yr: 600 lU/ day (3 ml)

For Cholecalciferol deficient patients:

0-1 yr: 2000 IU/ day (+50000 IU/week ) for 6 weeks
1 -18 yrs: 2000 IU/ day for 6 weeks.

Injection: Prevention:

Infants receiving Vitamin D enriched milk: ½ ampoule (0.5 ml) i.e. 1,00000 I.U. every 6 months.
Nursed infants or infants not receiving Vitamin D enriched milk or young children up to 5 years of age: 1 ampoule (1 ml) i.e. 2,00000 I.U. every 6 months.
Adolescents: 1 ampoule (1 ml) i.e. 2,00000 I.U. every 6 months during winter.
Pregnancy: ½ ampoule (0.5 ml) i.e. 1,00000 I.U. from the 6th or 7th month of pregnancy.
Elderly: ½ ampoule (0.5 ml) i.e. 1,00000 I.U. every 3 months. Digestive disorders, concomitant treatment with antiepileptics & other particular condition not described above; ½ ampoule (0.5 ml) i.e. 1,00000 I.U. or 1 ampoule (1 ml) i.e. 2,00000 I.U. every 3 or 6 months.

Injection: Vitamin D deficiency:

1 ampoule (1 ml) i.e. 2,00000 I.U. which can be repeated 1 to 6 months later. Or, as directed by the registered physician.

The recommended dietary allowance of vitamin D is 600-1000 IU/day for adults. However, some individuals may require higher doses.

Administration

Cholecalciferol is available in oral and injectable forms. It is typically taken once daily or as directed by a physician.

Side Effects

Cholecalciferol is generally well tolerated, but it can cause headaches, stomach upset, dizziness and more rarely, rash. Excessive doses of cholecalciferol can lead to hypercalcemia, kidney damage and other adverse effects.

Toxicity

Cholecalciferol can be toxic in high doses. The maximum tolerable daily dose of cholecalciferol for adults is 10,000 IU, although some individuals may be able to tolerate higher doses.

Precautions

Cholecalciferol should be used with caution in individuals with kidney disease, as it can further impair kidney function. Additionally, individuals who take cholesterol or calcium-lowering medications should not take cholecalciferol without medical advice.

Interactions

Cholecalciferol can interact with various medications, such as corticosteroids, anticonvulsants, and antiretrovirals. It can also inhibit the absorption of other medications, such as certain antibiotics.

Disease Interaction

Cholecalciferol can interact with certain diseases, such as hyperparathyroidism, sarcoidosis, and primary hyperthyroidism, resulting in hypercalcemia. It should be used with caution in individuals with these conditions.

Drug Interaction

Cholecalciferol can interact with certain drugs, such as thiazide diuretics, calcium channel blockers, and certain anticonvulsants. It can increase the risk of hypercalcemia in individuals taking these medications.

Food Interactions

Cholecalciferol can interact with calcium and vitamin A. It should be taken at least two hours apart from calcium and vitamin A containing foods.

Pregnancy Use

Cholecalciferol is generally considered safe for use during pregnancy. However, it should be used at the lowest possible dose and only under the supervision of a healthcare provider.

Lactation Use

Cholecalciferol is considered safe for use during breastfeeding. However, it should be used at the lowest possible dose and only under the supervision of a healthcare provider.

Acute Overdose

Acute overdose of cholecalciferol can result in hypercalcemia, which can be serious and require medical attention. Symptoms of hypercalcemia include nausea, vomiting, abdominal and muscle pain, confusion, weakness, and dehydration.

Contraindication

Cholecalciferol is contraindicated in individuals with a history of kidney stones, hypercalcemia, hyperparathyroidism, and certain metabolic disorders.

Use Direction

The recommended dose of cholecalciferol is 600-1000 IU/day. Higher doses may be required in some individuals. Cholecalciferol should be taken as a single daily dose or as directed by a healthcare provider. It should be taken with food for optimal absorption.