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Prescription ergocalciferol dosing for vitamin D repletion: a retrospective evaluation.
Pharmacotherapy 2012; 32(2):135-41P

Abstract

STUDY OBJECTIVES

To determine the efficacy and safety of vitamin D repletion with prescription ergocalciferol and to determine patient-specific factors that may influence the amount of ergocalciferol needed to attain vitamin D sufficiency.

DESIGN

Retrospective medical record review.

SETTING

University-affiliated outpatient health system.

PATIENTS

A total of 1446 patients aged 18-89 years who had a prescription for ergocalciferol 50,000 IU between January 1, 2007, and December 31, 2008, were identified; of these patients, 582 patients had a vitamin D concentration measured 120 days before their first prescription (baseline) and had another concentration measured 60-180 days after this prescription (follow-up) and were deemed "first-time users" of ergocalciferol.

MEASUREMENTS AND MAIN RESULTS

Vitamin D sufficiency was defined as a 25-hydroxyvitamin D (vitamin D) concentration of 30 ng/ml or higher. Twenty-nine different ergocalciferol prescribing regimens were identified in the 1446 patients. For the 582 first-time users of ergocalciferol, vitamin D concentrations increased from a mean ± SE of 17.7 ± 0.32 ng/ml at baseline to 32.9 ± 0.73 ng/ml at first follow-up concentration, with a mean ± SE prescribed ergocalciferol dose of 63,876 ± 1973 IU given over an average of 17 weeks. Overall, 326 (56%) of the 582 first-time users attained sufficiency with their prescribed regimen. With use of a logistic regression model to control for variables that could influence a patient's response to vitamin D, patients prescribed 50,000-100,000 IU/week were significantly more likely to attain vitamin D sufficiency compared with those prescribed less than 50,000 IU/week (OR 2.61, 95% CI 1.37-4.99). Body mass index of 30 kg/m(2) or higher decreased the odds of attaining vitamin D sufficiency, whereas use of a loading dose did not increase the odds of attaining sufficiency.

CONCLUSION

Many different ergocalciferol regimens were used to replace vitamin D, and overall attainment of vitamin D sufficiency appeared to be moderate. Based on our findings, an ergocalciferol regimen of 50,000-100,000 IU/week with no loading dose could be considered as a starting point for vitamin D repletion.

Authors+Show Affiliations

Department of Clinical Pharmacy, Universityof Colorado Skaggs School of Pharmacy and PharmaceuticalSciences, Aurora, Colorado 80045, USA. joseph.vandegriend@ucdenver.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22392422

Citation

Vande Griend, Joseph P., et al. "Prescription Ergocalciferol Dosing for Vitamin D Repletion: a Retrospective Evaluation." Pharmacotherapy, vol. 32, no. 2, 2012, pp. 135-41.
Vande Griend JP, McQueen RB, Linnebur SA, et al. Prescription ergocalciferol dosing for vitamin D repletion: a retrospective evaluation. Pharmacotherapy. 2012;32(2):135-41.
Vande Griend, J. P., McQueen, R. B., Linnebur, S. A., & Vondracek, S. F. (2012). Prescription ergocalciferol dosing for vitamin D repletion: a retrospective evaluation. Pharmacotherapy, 32(2), pp. 135-41. doi:10.1002/PHAR.1052.
Vande Griend JP, et al. Prescription Ergocalciferol Dosing for Vitamin D Repletion: a Retrospective Evaluation. Pharmacotherapy. 2012;32(2):135-41. PubMed PMID: 22392422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prescription ergocalciferol dosing for vitamin D repletion: a retrospective evaluation. AU - Vande Griend,Joseph P, AU - McQueen,Robert B, AU - Linnebur,Sunny A, AU - Vondracek,Sheryl F, PY - 2012/3/7/entrez PY - 2012/3/7/pubmed PY - 2012/10/23/medline SP - 135 EP - 41 JF - Pharmacotherapy JO - Pharmacotherapy VL - 32 IS - 2 N2 - STUDY OBJECTIVES: To determine the efficacy and safety of vitamin D repletion with prescription ergocalciferol and to determine patient-specific factors that may influence the amount of ergocalciferol needed to attain vitamin D sufficiency. DESIGN: Retrospective medical record review. SETTING: University-affiliated outpatient health system. PATIENTS: A total of 1446 patients aged 18-89 years who had a prescription for ergocalciferol 50,000 IU between January 1, 2007, and December 31, 2008, were identified; of these patients, 582 patients had a vitamin D concentration measured 120 days before their first prescription (baseline) and had another concentration measured 60-180 days after this prescription (follow-up) and were deemed "first-time users" of ergocalciferol. MEASUREMENTS AND MAIN RESULTS: Vitamin D sufficiency was defined as a 25-hydroxyvitamin D (vitamin D) concentration of 30 ng/ml or higher. Twenty-nine different ergocalciferol prescribing regimens were identified in the 1446 patients. For the 582 first-time users of ergocalciferol, vitamin D concentrations increased from a mean ± SE of 17.7 ± 0.32 ng/ml at baseline to 32.9 ± 0.73 ng/ml at first follow-up concentration, with a mean ± SE prescribed ergocalciferol dose of 63,876 ± 1973 IU given over an average of 17 weeks. Overall, 326 (56%) of the 582 first-time users attained sufficiency with their prescribed regimen. With use of a logistic regression model to control for variables that could influence a patient's response to vitamin D, patients prescribed 50,000-100,000 IU/week were significantly more likely to attain vitamin D sufficiency compared with those prescribed less than 50,000 IU/week (OR 2.61, 95% CI 1.37-4.99). Body mass index of 30 kg/m(2) or higher decreased the odds of attaining vitamin D sufficiency, whereas use of a loading dose did not increase the odds of attaining sufficiency. CONCLUSION: Many different ergocalciferol regimens were used to replace vitamin D, and overall attainment of vitamin D sufficiency appeared to be moderate. Based on our findings, an ergocalciferol regimen of 50,000-100,000 IU/week with no loading dose could be considered as a starting point for vitamin D repletion. SN - 1875-9114 UR - https://www.unboundmedicine.com/medline/citation/22392422/Prescription_ergocalciferol_dosing_for_vitamin_D_repletion:_a_retrospective_evaluation_ L2 - https://doi.org/10.1002/PHAR.1052 DB - PRIME DP - Unbound Medicine ER -