Drugs List

Therapeutic Indications

Uses

Treatment of calcium and vitamin D deficiency

Contraindications

Hypervitaminosis D
Galactosaemia
Hereditary fructose intolerance
Hypoparathyroidism
Metastatic calcification
Nephrolithiasis
Prolonged immobilisation with hypercalciuria and/or hypercalcaemia
Severe hypercalcaemia
Severe hypercalciuria
Severe renal impairment
Skeletal metastasis

Precautions and Warnings

Children under 6 years
Diarrhoea
Elderly
Predisposition to nephrolithiasis
Breastfeeding
Dehydration
Electrolyte imbalance
Glucose-galactose malabsorption syndrome
History of nephrolithiasis
Lactose intolerance
Malabsorption associated with chronic gastrointestinal disorders
Mild renal impairment
Pregnancy
Sarcoidosis

Allow for calcium and vitamin D intake from other sources
Contains lactose
Preparation contains sucrose
Breastfeeding: Hypercalcaemia of infant possible if mother taking vitamin D
Check serum calcium level if nausea and vomiting occur
Monitor renal function on long term therapy
Monitor serum and urinary calcium in patients with sarcoidosis
Monitor serum calcium levels in patients with renal impairment
Monitor serum calcium levels on prolonged use
Reduce dose/temporarily withdraw treatment if hypercalcaemia occurs
Discontinue or reduce dose if renal impairment worsens

Pregnancy and Lactation

Pregnancy

Use calcium with ergocalciferol with caution during pregnancy.

The manufacturer recommends that the use of calcium and ergocalciferol during pregnancy should only be under the direction of a physician and should only be used during the second and third trimester of pregnancy.

Lactation

Use calcium with ergocalciferol with caution during breastfeeding.

Vitamin D and its metabolites pass in to breast milk. This should be taken into consideration when giving additional vitamin D to a child.

Breast milk from women taking pharmacological doses of vitamin D may cause hypercalcaemia if given to an infant. Serum calcium concentrations should be monitored in the breastfeeding neonate.

Low dose vitamin D (up to 10micrograms/400IU per day) can be taken by breastfeeding women. It helps ensure that the mother's requirements for vitamin D are met but also builds up adequate foetal stores for early infancy (Specialist Pharmacy Service).

Side Effects

Constipation
Decreased appetite
Drowsiness
Dry mouth
Headache
Hypercalcaemia
Hypercalciuria
Tiredness
Weakness

Presentation

Oral formulations of calcium with ergocalciferol.

Drugs List

Therapeutic Indications

Uses

Treatment of calcium and vitamin D deficiency

Dosage

Adults

Children

Contraindications

Hypervitaminosis D
Galactosaemia
Hereditary fructose intolerance
Hypoparathyroidism
Metastatic calcification
Nephrolithiasis
Prolonged immobilisation with hypercalciuria and/or hypercalcaemia
Severe hypercalcaemia
Severe hypercalciuria
Severe renal impairment
Skeletal metastasis

Precautions and Warnings

Children under 6 years
Diarrhoea
Elderly
Predisposition to nephrolithiasis
Breastfeeding
Dehydration
Electrolyte imbalance
Glucose-galactose malabsorption syndrome
History of nephrolithiasis
Lactose intolerance
Malabsorption associated with chronic gastrointestinal disorders
Mild renal impairment
Pregnancy
Sarcoidosis

Allow for calcium and vitamin D intake from other sources
Contains lactose
Preparation contains sucrose
Breastfeeding: Hypercalcaemia of infant possible if mother taking vitamin D
Check serum calcium level if nausea and vomiting occur
Monitor renal function on long term therapy
Monitor serum and urinary calcium in patients with sarcoidosis
Monitor serum calcium levels in patients with renal impairment
Monitor serum calcium levels on prolonged use
Reduce dose/temporarily withdraw treatment if hypercalcaemia occurs
Discontinue or reduce dose if renal impairment worsens

Pregnancy and Lactation

Pregnancy

Use calcium with ergocalciferol with caution during pregnancy.

The manufacturer recommends that the use of calcium and ergocalciferol during pregnancy should only be under the direction of a physician and should only be used during the second and third trimester of pregnancy.

Lactation

Use calcium with ergocalciferol with caution during breastfeeding.

Vitamin D and its metabolites pass in to breast milk. This should be taken into consideration when giving additional vitamin D to a child.

Breast milk from women taking pharmacological doses of vitamin D may cause hypercalcaemia if given to an infant. Serum calcium concentrations should be monitored in the breastfeeding neonate.

Low dose vitamin D (up to 10micrograms/400IU per day) can be taken by breastfeeding women. It helps ensure that the mother's requirements for vitamin D are met but also builds up adequate foetal stores for early infancy (Specialist Pharmacy Service).

Side Effects

Constipation
Decreased appetite
Drowsiness
Dry mouth
Headache
Hypercalcaemia
Hypercalciuria
Tiredness
Weakness

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: July 2019

Reference Sources

Summary of Product Characteristics: Calcium and Ergocalciferol tablets. Crescent Pharma Limited. September 2016.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 5 July 2019

Specialist Pharmacy Service (SPS)
Available at: https://www.sps.nhs.uk/
Safety in Lactation: Vitamins. Last revised: 19 April 2016
Last accessed: 5 July 2019