Medicine Information

d-high

Name: d-high
Brand: d-high
Rating: 4.5 (117 reviews)

Capsule40000 IUVitamins and MineralsATC: A11CC05

Generic Name

Cholecalciferol (Vitamin D3)

Manufacturer

Example Pharma Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
d high 40000 iu capsule	৳ 35.00	৳ 140.00

Description

Overview of the medicine

A vitamin D3 supplement used to treat and prevent vitamin D deficiency, osteomalacia, and rickets. It helps the body absorb calcium and phosphate, crucial for bone health.

Uses & Indications

Vitamin D deficiency

Osteomalacia

Rickets

Support in osteoporosis treatment

Hypoparathyroidism

Dosage

Adults

For severe deficiency, 40000 IU once weekly for 6-8 weeks, then maintenance dose as per doctor's advice. Should not exceed 4000 IU daily for long term without supervision.

Elderly

Same as adult dosage, but caution with renal function and concomitant medications. Close monitoring is advised.

Renal_impairment

Use with caution; monitoring of calcium, phosphate, and parathyroid hormone levels is crucial. May require activated vitamin D forms (e.g., calcitriol) instead of cholecalciferol.

How to Take

Oral. Can be taken with food, preferably the largest meal of the day, for better absorption.

Mechanism of Action

Cholecalciferol is converted in the liver and kidney to its active form, calcitriol, which regulates calcium and phosphate metabolism, bone mineralization, and neuromuscular function.

Pharmacokinetics

Onset

Several days to weeks for significant effects on calcium levels.

Excretion

Primarily excreted in the bile and feces; small amounts in urine.

Half life

Approximately 15-20 days (for cholecalciferol), but active metabolites have longer half-lives.

Absorption

Well absorbed from the gastrointestinal tract, especially with fatty meals.

Metabolism

Converted in the liver to 25-hydroxyvitamin D (calcifediol) and then in the kidneys to 1,25-dihydroxyvitamin D (calcitriol), the active form.

Side Effects

Contraindications

Hypercalcemia (high blood calcium levels)
Hypervitaminosis D (excessive vitamin D levels)
Nephrolithiasis (kidney stones, especially if calcium-related)
Severe renal impairment without monitoring
Hypersensitivity to cholecalciferol or any excipients

Drug Interactions

Corticosteroids

May reduce the effects of vitamin D by antagonizing its actions and decreasing calcium absorption.

Thiazide diuretics

May increase the risk of hypercalcemia by decreasing urinary calcium excretion.

Cardiac glycosides (e.g., digoxin)

Hypercalcemia induced by vitamin D can potentiate the effects of cardiac glycosides, increasing the risk of arrhythmias.

Anticonvulsants (e.g., phenytoin, barbiturates)

May increase vitamin D metabolism in the liver, potentially reducing its effectiveness and requiring higher doses.

Cholestyramine, Colestipol, Orlistat (fat absorption inhibitors)

May reduce the absorption of fat-soluble vitamins like vitamin D, requiring dose adjustment or separate timing.

Storage

Store below 30°C in a dry place, away from direct sunlight, heat, and moisture. Keep out of reach of children. Do not freeze.

Overdose

Symptoms include hypercalcemia (nausea, vomiting, loss of appetite, weakness, polyuria, polydipsia, confusion, kidney stones, cardiac arrhythmias). Treatment involves discontinuing vitamin D, a low calcium diet, hydration, and possibly corticosteroids or bisphosphonates. Seek immediate medical attention.

Pregnancy & Lactation

Generally considered safe at recommended doses for treating deficiency. High doses (above 4000 IU daily) should be avoided unless medically necessary due to potential fetal harm (hypercalcemia in the mother can affect the fetus). Consult your doctor.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 capsules/box30 capsules/bottle

Shelf Life

Typically 2-3 years from manufacturing date, check expiry date on packaging.

Availability

Pharmacies, Hospitals

Approval Status

Approved by regulatory authorities worldwide

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials and epidemiological studies support the efficacy and safety of cholecalciferol in treating vitamin D deficiency and related bone disorders, as well as its role in overall health. Ongoing research explores its broader health benefits.

Lab Monitoring

Serum 25-hydroxyvitamin D levels (to assess vitamin D status)
Serum calcium levels (to monitor for hypercalcemia)
Serum phosphate levels
Renal function tests (creatinine, BUN)
Parathyroid hormone (PTH) levels (if indicated)

Doctor Notes

Prior to initiation of high-dose cholecalciferol, assess baseline serum 25(OH)D, calcium, and phosphate levels, and renal function.
Educate patients thoroughly on the importance of adhering to prescribed dosage and the potential risks of overdose/hypercalcemia.
Advise patients to report any unusual symptoms promptly.
Consider co-administration with calcium supplements if dietary intake is insufficient.
Re-evaluate vitamin D status and calcium levels periodically during and after treatment.

Patient Guidelines

Take exactly as prescribed by your doctor, usually with your largest meal to enhance absorption.
Do not exceed the recommended dose without consulting your doctor.
Report any symptoms of hypercalcemia (e.g., persistent nausea, vomiting, frequent urination, unusual thirst, muscle weakness) to your doctor immediately.
Ensure adequate dietary calcium intake unless advised otherwise by your doctor.
Regular follow-up appointments and blood tests are important during high-dose therapy.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it's almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.

Driving Precautions

Generally, cholecalciferol does not affect the ability to drive or operate machinery. However, if you experience side effects like dizziness or confusion (rare, usually due to hypercalcemia), avoid these activities.

Lifestyle Advice

Regular, moderate sun exposure (with appropriate skin protection) can help the body produce its own vitamin D.
Maintain a balanced diet rich in calcium and vitamin D, including fortified foods.
Engage in regular weight-bearing exercise to support bone health.
Avoid smoking and excessive alcohol consumption, which can negatively impact bone density.