Efficacy and safety of short-term high-dose vitamin D

January 01, 0001

Efficacy and safety of short-term high-dose vitamin D

The aim of this study by researchers from Melbourne, Australia was to compare the efficacy and safety of a 10-day, high-dose v a 3- month, continuous low-dose oral cholecalciferol course in a vitamin D deficient population. Fifty-nine vitamin D deficient inpatients (serum 25(OH)D = 50 nmol/L) were enrolled in a prospective, randomised, open- label trial. Participants were randomly assigned to a high-dose regimen of cholecalciferol 50 000 IU daily for 10 days or a 3-month, continuous low- dose cholecalciferol regimen of 3000 IU daily for 30 days, followed by 1000 IU daily for 60 days. Both groups received calcium citrate 500 mg daily. Twenty-six patients completed the study within 3 ± 1 months.

The mean increases in serum 25(OH)D were similar in both the high- and low-dose groups (to 55 v 51 nmol/L, respectively). There was no significant difference in the proportion of subjects who attained serum 25(OH)D concentrations greater than 50 nmol/L between the high- and low- dose groups. Hypercalciuria (urine calcium greater than 7.5 mmol/day) occurred in three patients (two low-dose, one high-dose), while renal impairment worsened in one patient. No patient developed hypercalcaemia (corrected calcium greater than 2.6 mmol/L), vitamin D toxicity (25(OH)D greater than 200 nmol/L) or nephrolithiasis during the study.

The researchers concluded: "Both the 10-day, high-dose and the 3-month, low-dose cholecalciferol regimens effectively increased serum 25(OH)D to within the normal range. The high-dose regimen may be an effective and cheap alternative for patients with vitamin D deficiency."

The authors say this may be a more effective and cheap alternative, but also more convenient. Ongoing dosing will have to be worked out.

For the full abstract, click here.

MJA 192 (12): 686-689, 21 June 2010
© The Medical Journal of Australia 2010
Efficacy and safety of oral continuous low-dose versus short- term high-dose vitamin D: a prospective randomised trial conducted in a clinical setting. Kathryn L Hackman, Claudia Gagnon, Roisin K Briscoe, Simon Lam, Mahesan Anpalahan and Peter R Ebeling. Correspondence to Peter Ebeling: [email protected]

Category: T. Endocrine/Metabolic/Nutritional. Keywords: efficacy, safety, oral, continuous, low dose, high dose, vitamin D, prospective randomised trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 2 July 2010

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