# Vitamin D Deficiency (Nutritional) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: NICE Clinical Knowledge Summaries (CKS) Vitamin D deficiency / Royal Osteoporosis Society (ROS) Vitamin D Guidelines 2020 & Invita D3 50,000 IU Capsules SmPC (https://www.medicines.org.uk/emc/product/10188/smpc) · NICE Guideline PH56: Vitamin D 2014 · One-Alpha (alfacalcidol) 1 microgram soft capsules SmPC sections 4.1-4.4 (eMC product 5516) - Verified date: 2026-08 ## Verified against - DailyMed DRISDOL (ergocalciferol) 50,000 IU capsule label, SetID acb61678-d23d-405d-8c14-1a16cfd3a776 - Vitamin D Deficiency - StatPearls - NCBI Bookshelf (NBK532266) - Vitamin D Deficiency - disease-level clinical article (vitamin-d-deficiency-clinical.txt) ## Treatment metadata - Cholecalciferol — 1.25 mg — oral.solid - Referral & safety-netting (no drug therapy) - Calcidiol — oral.solid ## Complete treatment card ```text VITAMIN D DEFICIENCY (NUTRITIONAL) Sources: NICE Clinical Knowledge Summaries (CKS) Vitamin D deficiency / Royal Osteoporosis Society (ROS) Vitamin D Guidelines 2020 & Invita D3 50,000 IU Capsules SmPC (https://www.medicines.org.uk/emc/product/10188/smpc) · NICE Guideline PH56: Vitamin D 2014 · One-Alpha (alfacalcidol) 1 microgram soft capsules SmPC sections 4.1-4.4 (eMC product 5516) Review status: REVIEWED against DailyMed DRISDOL (ergocalciferol) 50,000 IU capsule label, SetID acb61678-d23d-405d-8c14-1a16cfd3a776, Vitamin D Deficiency - StatPearls - NCBI Bookshelf (NBK532266), Vitamin D Deficiency - disease-level clinical article (vitamin-d-deficiency-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Most people with low vitamin D have no symptoms at all - Bone pain, joint and muscle aches, fatigue, and muscle twitching from secondary hyperparathyroidism [bone pain · fatigue · muscle pain] - In children: irritability, lethargy, developmental delay, and bone changes [developmental delay · irritability · lethargy] TESTS (5) - Total serum 25-hydroxyvitamin D is the test used to check for deficiency in high-risk patients - A level of at least 30 ng/mL is recommended to limit fall and fracture risk in older adults - Levels above 100 ng/mL carry a risk of toxicity from secondary high calcium - A level over 150 ng/mL is considered frankly toxic - PTH and serum calcium are checked once deficiency is confirmed, to screen for secondary hyperparathyroidism IF NOT THIS - what else fits (6) - Celiac disease is one condition to rule out as a cause - Cystic fibrosis is also on the list of possible causes - End-stage liver disease is included among possible causes - Not enough sun exposure is a cause to consider - Insufficient dietary intake is a cause to consider - Antiepileptic drug use is a cause to consider Source StatPearls "Vitamin D Deficiency" - disease-level clinical article Status traced to the source above 1. CHOLECALCIFEROL [1st line] Adult Loading: 50,000 IU (1.25 mg) once weekly for 8 weeks. Maintenance after loading: 1,000-2,000 IU daily. An equivalent loading option is 6,000 IU daily for 8 weeks. Always prescribe in IU - do not write "one tablet", because Egyptian products range from 1,000 IU tablets to 50,000 IU capsules. Peds Children: 2,000 IU daily, or 50,000 IU once weekly for 6 weeks, then 1,000 IU daily as maintenance. Check the product strength before prescribing. Source Regimen per Vitamin D Deficiency - StatPearls - NCBI Bookshelf (NBK532266), stated here in our own words; strength conversion and the toxicity warning from DailyMed DRISDOL (ergocalciferol) 50,000 IU capsule label, SetID acb61678-d23d-405d-8c14-1a16cfd3a776 Why Vitamin D3 replacement that restores vitamin D stores needed for intestinal calcium absorption and bone mineralisation; corrects nutritional vitamin D deficiency and helps prevent the metabolic bone disease that results from chronic deficiency. Caution Take with a fat-containing meal to maximize gastrointestinal absorption. The margin between an effective and a toxic dose is narrow - the US label states: "THE RANGE BETWEEN THERAPEUTIC AND TOXIC DOSES IS NARROW." (DailyMed DRISDOL (ergocalciferol) 50,000 IU capsule label, SetID acb61678-d23d-405d-8c14-1a16cfd3a776) Monitor serum calcium; avoid in hypercalcemia or granulomatous conditions (sarcoidosis). 50,000 IU corresponds to 1.25 mg elemental cholecalciferol. Alfacalcidol belongs to renal osteodystrophy, hypoparathyroidism and the other states where 1-alpha hydroxylation is actually impaired. If that entry is wanted, it is a separate condition, not a line on this one. Egypt DAVALINDI 1000 I.U. 100 TABS. MUP 77.00 EGP (0.77/unit) -> ? strength differs D3 PANAX BUTRITION 5000 I.U. 30 CAPS. PANAX PHARMA 32.00 EGP (1.07/unit) -> ? strength differs D3 5000 I.U. 30 TABS. NAPCO 38.00 EGP (1.27/unit) -> ? strength differs HINDA D3 - 30 TABS. HP PHARMA 92.00 EGP (3.07/unit) -> ? strength differs AVALON VITAMIN D 30 CAPSULES ORGANIX COMPA... 170.00 EGP (5.67/unit) -> ? strength differs DETHREA D 10 ML COPAD > VIGOR... 45.00 EGP [? strength differs] VITAMIN D3 2000 I.U. 120 SOFTGELS (NOW) NOW FOODS > SOFICOPHARM 999.00 EGP -> ? strength differs VITAMIN D3 10.000 I.U. 120 SOFTGELS (NOW) NOW FOODS > SOFICOPHARM 1300.00 EGP -> ? strength differs UR-D 200 I.U./ML ORAL DROPS 25 ML HI-PHARM 21.60 EGP -> ? strength differs, ? different route - not oral solid VIDROP 2800 I.U./ML ORAL DROPS 15 ML MUP 26.00 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Vitamin D Deficiency - disease-level clinical article (vitamin-d-deficiency- clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - The features of vitamin D toxicity and hypercalcemia are confusion, anorexia, vomiting, polyuria, polydipsia, muscle weakness, and nephrocalcinosis. 3. CALCIDIOL [2nd line] Adult 30 to 200 μg daily Peds No paediatric dose is stated in the sources held for this drug. Source Vitamin D Deficiency (Nutritional) - disease-level clinical article (vitamin-d- deficiency-clinical.txt) Why Vitamin D metabolite for patients with severe hepatic dysfunction that does not require 25-hydroxylase activation in the liver. Caution Serum calcium levels should be monitored to prevent hypercalcemia. Egypt no Egyptian brand matched - prescribe by generic name Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)