(02-06-11) Cholecalciferol loading dose guideline for vitamin D-deficient adults

CLINICAL STUDY

Lenneke van Groningen1, Susanne Opdenoordt1, Adriaan van Sorge2, Darryl Telting3, Astrid Giesen2
and Hans de Boer1
1Department of Internal Medicine, Ziekenhuis Rijnstate, 2Department of Clinical Pharmacology and 3Department of Clinical Chemistry, Rijnstate Hospital
Arnhem, Wagnerlaan 55, 6800 TA Arnhem, The Netherlands
(Correspondence should be addressed to H de Boer; Email: [email protected])
Abstract
Introduction: Severe vitamin D deficiency is very common. Evidence-based guidelines for rapid
correction with high-dose oral cholecalciferol are not yet available.
Objective: To develop a practical cholecalciferol loading dose regimen.
Materials and methods: A total of 208 vitamin D-deficient subjects (serum 25-hydroxyvitamin D3
(25-OHD3) level !50 nmol/l), aged 18?88 years, were treated with solubilized cholecalciferol,
50 000 IU/ml. They received either 25 000 IU every fortnight for 8 weeks (total dose 100 000 IU),
25 000 IU every week for 6 weeks (total dose 150 000 IU), or 25 000 IU every week for 8 weeks (total
dose 200 000 IU). Blood samples were collected at baseline and 10 days after the final dose of
cholecalciferol.
Results: Most patients were severely vitamin D deficient: 76% had a serum 25-OHD3 level!30 nmol/l
at baseline. Cholecalciferol in a cumulative dose of 100 000, 150 000, and 200 000 IU increased
mean serum 25-OHD3 level by 29 nmol/l (95% confidence interval (CI): 23?35 nmol/l), 43 nmol/l
(95% CI: 36?50 nmol/l), and 69 nmol/l (95% CI: 64?75 nmol/l) respectively. The change in 25-OHD3
(D25-OHD3) was related to the dose per kilogram body weight (R2Z0.38, P!0.0001), and is
described by the equation: D25-OHD3Z0.025!(dose per kg body weight).
Conclusion: The cholecalciferol loading dose required to reach the serum 25-OHD3 target level of
75 nmol/l can be calculated as follows: dose (IU)Z40!(75Kserum 25-OHD3)!body weight.

Source: European Journal of Endocrinology 162 805?811

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.