Vitamin DCholecalciferol/Ergocalciferol

About Vitamin D

Vitamin D helps the body absorb calcium and keep bones mineralized; too little causes rickets in children and soft, weak bones in adults. A deficiency is found with a blood test, and MedlinePlus describes treatment as vitamin D supplements, with the prescriber deciding how much, how often and for how long.

The label for the 50,000-unit capsule lists three uses: hypoparathyroidism, rickets that does not respond to usual vitamin D, and familial hypophosphatemia. Clinicians also prescribe it outside the label to correct a deficiency, for example as one capsule a week for a set number of weeks followed by a lower maintenance dose. Over-the-counter D3 is a supplement, and the FDA does not approve supplements before they are sold. Both forms raise blood vitamin D levels; most evidence reviewed by the NIH finds that D3 raises them further and keeps them up longer.

Too much vitamin D raises blood calcium, causing loss of appetite, nausea, weakness, constipation, thirst and frequent urination, and can damage the kidneys; the label notes the effects can last two months or more after stopping. It is not used with high blood calcium or vitamin D toxicity, and the label asks prescribers to count vitamin D from all sources and to check blood calcium. Some capsules contain the dye tartrazine.

Taking Vitamin D

How to take it

On the schedule the prescriber sets, which may be daily or weekly depending on the reason. Swallow the capsule whole; do not chew or crush it. It works only if you also get enough calcium from food, and the prescriber may give diet advice.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and continue as usual. Do not take a double dose.

Storage

At room temperature in a closed container, away from light, heat and moisture, and out of reach of children.

Interactions to know about

Mineral oil reduces its absorption, and the weight-loss drug orlistat can lower vitamin D levels. In people with hypoparathyroidism, thiazide water pills taken with it can push calcium too high. Tell the prescriber about other vitamin D or calcium products, including multivitamins, and about kidney or liver disease.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Vitamin D differs from pharmacy to pharmacy

Ergocalciferol capsules cost pharmacies very little each, so a cash quote is mostly the dispensing fee and depends on how the pharmacy prices cheap generics: a flat-price list, a per-capsule price or a minimum charge. A short course of weekly capsules carries the same fee as a large fill.

Over-the-counter D3 is a shelf product with no dispensing fee; as a supplement, it is not FDA-approved.

Ways to pay less for Vitamin D without insurance

• Ask whether ergocalciferol is on the pharmacy’s flat-price generic list.
• If the prescriber has set a fixed course, ask for the whole course to be dispensed in one fill, so you pay one fee.
• Ask the prescriber whether an over-the-counter product would suit you instead, and at what strength.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Vitamin D

1. 1.Is this vitamin D2 or D3, and how often do I take it?
2. 2.How long should I take this strength, and when will my level be rechecked?
3. 3.Should I keep taking my multivitamin or calcium alongside it?
4. 4.Do any of my medicines, such as a water pill, interact with it?
5. 5.Does this capsule contain tartrazine?

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