Nurses Compass
Drug Guide
Ergocalciferol
Classification
Therapeutic: Vitamin supplement, Nutritional supplement
Pharmacological: Vitamin D analog
FDA Approved Indications
- Vitamin D deficiency
- Prevent and treat rickets and osteomalacia
Mechanism of Action
Ergocalciferol is converted in the liver to calcidiol, which is further converted in the kidneys to calcitriol, the active form of vitamin D. It promotes calcium absorption in the gastrointestinal tract and maintains serum calcium and phosphate levels, supporting normal bone mineralization.
Dosage and Administration
Adult: Typically, 50,000 IU once weekly for deficiency; dose varies based on deficiency severity and patient response.
Pediatric: Dose varies based on age and severity of deficiency. Consult specific pediatric dosing guidelines.
Geriatric: Adjust dose based on renal function and serum calcium levels.
Renal Impairment: Monitor calcium and vitamin D levels; dose adjustments may be necessary.
Hepatic Impairment: No specific adjustment required, but monitor vitamin D levels.
Pharmacokinetics
Absorption: Absorbed from the gastrointestinal tract.
Distribution: Bind to vitamin D binding protein in plasma.
Metabolism: Largely metabolized in the liver to calcidiol.
Excretion: Excreted mainly via the bile and feces.
Half Life: Approximately 15 days for calcidiol.
Contraindications
- Hypercalcemia
- Vitamin D toxicity
Precautions
- Use with caution in patients with hyperparathyroidism, renal disease, or granulomatous diseases like sarcoidosis. Regular monitoring of serum calcium, phosphate, and vitamin D levels is recommended.
Adverse Reactions - Common
- Hypercalcemia (Less common but significant)
- Nausea, vomiting (Common)
- Loss of appetite (Common)
Adverse Reactions - Serious
- Nephrolithiasis (kidney stones) (Rare)
- Hypercalciuria (Rare)
Drug-Drug Interactions
- Thiazide diuretics (increase risk of hypercalcemia)
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor serum calcium, phosphate, and vitamin D levels. Assess for signs of vitamin D toxicity.
Diagnoses:
- Risk for hypercalcemia
- Imbalanced nutrition: less than body requirements
Implementation: Administer as prescribed, usually with food to enhance absorption. Educate patient on signs of toxicity.
Evaluation: Regularly evaluate serum calcium and vitamin D levels to ensure adequacy and prevent toxicity.
Patient/Family Teaching
- Take medication with food to improve absorption.
- Report symptoms of hypercalcemia: weakness, confusion, nausea, vomiting.
- Avoid excessive intake of dietary calcium or vitamin D supplements unless directed by healthcare provider.
Special Considerations
Black Box Warnings: N/A
Genetic Factors: Genetic factors affecting vitamin D metabolism may influence individual response.
Lab Test Interference: None known.
Overdose Management
Signs/Symptoms: Hypercalcemia symptoms: nausea, vomiting, weakness, confusion, kidney stones.
Treatment: Discontinue vitamin D, administer corticosteroids if needed, ensure adequate hydration, and monitor calcium levels.
Storage and Handling
Storage: Store at room temperature away from light and moisture.
Stability: Stable when stored properly.