Vitamin D2

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

ergocalciferol (vitamin D2) 1,250 mcg (50,000 unit) capsule

Vitamin D (ergocalciferol-D2, cholecalciferol-D3, alfacalcidol) is a fat-soluble vitamin that helps your body absorb calcium and phosphorus. Having the right amount of vitamin D, calcium, and phosphorus is important for building and keeping strong bones. Vitamin D is used to treat and prevent bone disorders (such as rickets, osteomalacia). Vitamin D is made by the body when skin is exposed to sunlight. Sunscreen, protective clothing, limited exposure to sunlight, dark skin, and age may prevent getting enough vitamin D from the sun. Vitamin D with calcium is used to treat or prevent bone loss (osteoporosis). Vitamin D is also used with other medications to treat low levels of calcium or phosphate caused by certain disorders (such as hypoparathyroidism, pseudohypoparathyroidism, familial hypophosphatemia). It may be used in kidney disease to keep calcium levels normal and allow normal bone growth. Vitamin D drops (or other supplements) are given to breast-fed infants because breast milk usually has low levels of vitamin D.

Take vitamin D by mouth as directed. Vitamin D is best absorbed when taken after a meal but may be taken with or without food. Alfacalcidol is usually taken with food. Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist. If your doctor has prescribed this medication, take as directed by your doctor. Your dosage is based on your medical condition, amount of sun exposure, diet, age, and response to treatment. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you are taking the chewable tablet or wafers, chew the medication thoroughly before swallowing. Do not swallow whole wafers. If you are taking the rapidly-dissolving tablets, dry your hands before handling the medication. Place each dose on the tongue, allow it to dissolve completely, and then swallow it with saliva or water. You do not need to take this medication with water. Certain medications (bile acid sequestrants such as cholestyramine/colestipol, mineral oil, orlistat) can decrease the absorption of vitamin D. Take your doses of these medications as far as possible from your doses of vitamin D (at least 2 hours apart, longer if possible). It may be easiest to take vitamin D at bedtime if you are also taking these other medications. Ask your doctor or pharmacist how long you should wait between doses and for help finding a dosing schedule that will work with all your medications. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day if you are taking it once a day. If you are taking this medication only once a week, remember to take it on the same day each week. It may help to mark your calendar with a reminder. If your doctor has recommended that you follow a special diet (such as a diet high in calcium), it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor. If you think you may have a serious medical problem, get medical help right away.

• nausea/vomiting
• constipation
• loss of appetite
• increased thirst
• increased urination
• mental/mood changes
• unusual tiredness

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking vitamin D, tell your doctor or pharmacist if you are allergic to it; or to other vitamin D products (such as calcitriol); or if you have any other allergies. This product may contain inactive ingredients (such as peanut/soy), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• high calcium/vitamin D levels (hypercalcemia/hypervitaminosis D)
• difficulty absorbing nutrition from food (malabsorption syndrome)
• kidney disease
• liver disease

Liquid products, chewable tablets, or dissolving tablets may contain sugar and/or aspartame. Liquid products may also contain alcohol. Caution is advised if you have diabetes, liver disease, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, doses of vitamin D greater than the recommended dietary allowance should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include:

• burosumab
• phosphate binders

Check the labels on all your prescription and nonprescription/herbal products (such as antacids, laxatives, vitamins) because they may contain calcium, magnesium, phosphate, or vitamin D. Ask your pharmacist about using those products safely.

Vitamin D is very similar to calcitriol. Do not use medications containing calcitriol while using vitamin D.

This medication may interfere with certain laboratory tests (including cholesterol tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: seizures, confusion, irregular heartbeat.

Lab and/or medical tests (such as calcium/magnesium/phosphorus levels) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Foods rich in vitamin D include: fortified dairy products, eggs, sardines, cod liver oil, chicken livers, and fatty fish.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store vitamin D products (except alfacalcidol) at room temperature away from light and moisture. Do not store in the bathroom. Store alfacalcidol drops in the refrigerator between 36-46 degrees F (2-8 degrees C). Do not freeze. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised December 2022.

Copyright(c) 2023 First Databank, Inc.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.

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Vitamin D2

Medically reviewed by Drugs.com on Mar 11, 2021. Written by Cerner Multum.

What is ergocalciferol?

Ergocalciferol is vitamin D2. Vitamin D helps your body absorb calcium.

Ergocalciferol is used to treat hypoparathyroidism (decreased functioning of the parathyroid glands).

Ergocalciferol is also used to treat rickets (softening of the bones caused by vitamin D deficiency) or low levels of phosphate in the blood (hypophosphatemia).

Ergocalciferol may also be used for purposes not listed in this medication guide.

Warnings

You should not take ergocalciferol if you have had an allergic reaction to vitamin D, or if you have high levels of calcium or vitamin D in your body, or any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

Use only the recommended dose of ergocalciferol. An overdose could cause serious or life-threatening side effects.

Before taking this medicine

You should not take ergocalciferol if you have had an allergic reaction to vitamin D, or if you have:

• high levels of vitamin D in your body (hypervitaminosis D);
• high levels of calcium in your blood (hypercalcemia); or
• any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

Tell your doctor if you have ever had:

• heart disease;
• kidney disease; or
• an electrolyte imbalance.

Certain forms of ergocalciferol may contain ingredients you should know about, such as peanut or soybean oil, sugar, aspartame (phenylalanine), or certain food dyes. Ask a doctor before using ergocalciferol if you have allergies, diabetes, or phenylketonuria (PKU).

Too much vitamin D could harm an unborn baby, and your dose needs may be different during pregnancy. Tell your doctor if you are pregnant or if you become pregnant while taking ergocalciferol.

Ergocalciferol can pass into breast milk and may cause side effects in the nursing baby. Tell your doctor if you are breast-feeding.

Do not give ergocalciferol to a child without medical advice. Your child’s dose will depend on age, weight, diet, and other factors.

How should I take ergocalciferol?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use only the recommended dose of ergocalciferol.

It may be best to take ergocalciferol after a meal, but you may take Vitamin D2 with or without food.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You will need frequent medical tests.

Your doctor may begin to reduce your ergocalciferol dose as your condition improves. Carefully follow all instructions about adjusting your dose. In some cases, there may be a very small difference in amount between safe and dangerous doses of this medicine.

Your doctor will determine how long to treat you with this medicine.

Ergocalciferol may be only part of a complete program of treatment that also includes dietary changes and taking calcium and vitamin supplements. Follow your doctor’s instructions very closely.

Learn about the foods you should eat to make sure you get enough calcium and vitamin D in your diet. Your ergocalciferol dose may need to be adjusted as you make changes to your diet.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of vitamin D can cause serious or life-threatening side effects.

Overdose symptoms may include nausea, loss of appetite, thirst, urinating more or less than usual, body aches, stiffness, confusion, or irregular heartbeats.

What should I avoid while taking ergocalciferol?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking ergocalciferol.

Ergocalciferol side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop taking Vitamin D2 and call your doctor at once if you have:

• chest pain, feeling short of breath;
• growth problems (in a child taking ergocalciferol); or
• early signs of vitamin D overdose–weakness, metallic taste in your mouth, weight loss, muscle or bone pain, constipation, nausea, and vomiting.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ergocalciferol?

Certain medications can make it harder for your body to absorb vitamin D. If you take other medications, take them at least 2 hours before or 2 hours after you take ergocalciferol.

Tell your doctor about all your other medicines, especially:

• a diuretic or “water pill”; or
• mineral oil (sometimes taken as a laxative).

This list is not complete. Other drugs may affect ergocalciferol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Popular FAQ

Generally, it takes a few weeks of taking daily vitamin D supplements for vitamin D levels in the body to rise. Each 1,000 IU of vitamin D3 daily is expected to raise blood levels of 25(OD)D by 10 ng/ml after a few weeks. But it may take months to resolve symptoms of severe vitamin D deficiency such as rickets in children. It depends on how low your vitamin D levels were in the first place and some individual factors. Obesity, polluted environments, and malabsorption syndromes (such as Crohn’s disease) are just some factors that can increase the time it takes for vitamin D levels to work. Continue reading

You can raise your vitamin D levels quickly in three main ways, but it can take up to a week for increased vitamin D intake or exposure to be reflected in a vitamin D blood test: increasing your intake of foods that are naturally rich in vitamin D or fortified with vitamin D, taking a vitamin D supplement, or getting outside and exposing your skin to sunlight (although experts do not recommend this without sun protection). Continue reading

Experts cannot say if oral vitamin D helps improve psoriasis symptoms, because overall, trial results have been mixed. While some open-label studies show a moderate to marked improvement (with some reports of remission), most double-blinded RCTs have shown only slight or no improvement. Supplementation could be considered on a case-by-case basis. Continue reading

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More about Vitamin D2 (ergocalciferol)

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What Are the Effects of Taking 50,000 IU of Vitamin D Weekly?

Forty-two percent of the American population doesn’t get enough vitamin D, reports the director of wellness at Mercy Medical Center, Stephanie Wheeler. This nutrient, crucial for bone health, immune function and controlling inflammation in the body, is found in foods and also synthesized by the body from exposure to sunlight. If you’re deficient, taking a ​vitamin D supplement​ can help.

Fifty-thousand IU per week is well above official recommendations proposed to avoid health risks. However, it’s often prescribed in this dosage to correct vitamin D deficiencies. But should you take this amount if you don’t have a deficiency? Recent research shows that it might not be harmful and could actually be helpful for the general population.

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Tip

A weekly dosage of 50,000 IU of vitamin D is almost double the tolerable upper intake level. It may or may not pose health risks.

Tolerable Upper Intake Level

The tolerable upper intake level, or UL, is the ​maximum amount of a nutrient that is safe​ for the general population to get each day on a regular basis. Above this amount, the health risks increase; the greater the excess intake, the greater the health risks, according to the National Institutes of Health (NIH).

The National Academy of Medicine (NAM) has set the UL for vitamin D at 4,000 IU, or 100 mcg, per day for all adults. Taking 50,000 IU of vitamin D each week, divided among seven days, would give you 7,143 IU each day, which is nearly double the UL.

How Much You Need

The NAM developed the recommended daily allowance, or RDA, based on the needs of the general population. This is the amount it has determined will prevent deficiencies and the negative health effects caused by getting too little vitamin D in 97.5 percent of people.

The RDA for vitamin D for men and women, ages 19 to 70, is 600 IU daily. If you take 7,143 IU each day, that’s nearly 12 times or 1,200 percent of the RDA.

Conflicting Vitamin D Recommendations

Not everyone agrees with the National Academy’s proposed RDA and UL. Some reputable sources believe that people need well more than the RDA, and in fact more than the UL. For example, the Vitamin D Council, a California-based nonprofit, recommends adults take 5,000 IU daily or 8.3 times the RDA. People with overweight and obesity may require as much as up to 8,000 IU per day, or more than ​13 times the RDA​.

According to the Endocrine Society, the current official guidelines are based specifically on bone health but do not take into account vitamin D levels needed to prevent other conditions that may result from vitamin D deficiency. Specifically, NAM set the benchmark for deficiency at a blood level of 20 ng/ml of 25-hydroxyvitamin D, the main circulating form of vitamin D in the body. However, the Endocrine Society classifies blood levels below 29 ng/ml as insufficient and recommends a better target is 30 ng/ml or higher.

Director of the General Clinical Research Unit and Bone Health Care Clinic at Boston University Medical Center, Michael F. Holick, M.D., Ph.D., told Endocrine News, a publication of the Endocrine Society, that he believes blood levels between 40 and 60 ng/ml are an even better goal and that blood levels up to 100 ng/ml are perfectly safe.

Scientific Support: Increased Vitamin D

Research shows proponents of increased vitamin D intakes may be onto something. A 2017 study in Dermato-Endocrinology evaluated the effects of daily intakes up to 15,000 IU and blood levels up to 120 ng/ml on calcium regulation, kidney, liver and immune function. Using data collected from 3,882 participants between 2013 and 2015, the researchers found that even at blood levels of 120 ng/ml there was ​no negative effect​ on calcium regulation and no incidence of toxicity.

In a 2016 study in the North American Journal of Medical Sciences, participants took 50,000 to 100,000 IU of vitamin D per week without a significant change in blood calcium levels. Serum vitamin D levels also rarely exceeded 100 ng/ml, and there were no signs of toxicity.

A Simple Miscalculation?

According to a statistical analysis published in Nutrients in 2014, the NAM actually miscalculated its estimation of the RDA for vitamin D. In reviewing the 10 studies used by the NAM to determine the RDA, the researchers discovered that although the NAM calculated that 600 IU is the amount needed to reach serum 25-hydroxyvitamin D (25(OH)D) levels of 20 ng/ml, those calculations were ​critically underestimated​.

In fact, the studies showed that 8,895 IU might be required to meet the target blood level of 20 ng/ml. The authors conclude that the NAM’s miscalculation poses serious risks for bone health and disease and injury prevention in the general population.

Vitamin D Side Effects

There are health risks for taking too much vitamin D, but perhaps not at the levels previously suspected. Taking a 50,000 IU ​vitamin D supplement​ weekly is not likely to get you to that level. But it’s a good idea to know what these possible dangers are and at what intake and blood level the mainstream medical community says you are at risk.

Vitamin D Toxicity

Vitamin D is a fat-soluble vitamin, meaning any excess is stored in your fat cells. This differs from water-soluble vitamins, like the B vitamins, which get carried out in urine and need to be replaced each day. Excess fat-soluble vitamin intake can lead to a buildup of the nutrient in your body, which, over time, can be toxic, according to the NIH. Excess ​vitamin D side effects​ include:

• Anorexia
• Weight loss
• Frequent urination
• Heart arrhythmia

More seriously, excess intake can increase blood levels of calcium, which can cause vascular and tissue calcification. This can damage the heart, blood vessels and kidneys.

Long-term intakes of 10,000 to 40,000 IU daily and consistent blood levels of 200 ng/ml or greater are considered to be potentially toxic. According to the NIH, intakes below 10,000 IU daily aren’t likely to cause toxicity symptoms.

Other Potential Negative Effects

But toxicity may not be the only thing to worry about. Even at lower intakes, as low as 30 to 48 ng/ml, the NIH reports potential risks including increased all-cause mortality, greater risk of some cancers, such as of the pancreas, increased risk of cardiovascular events, and a higher incidence of falls and fractures among older adults.

What Should You Do?

These conflicting recommendations and data pose a dilemma for the consumer. A daily intake of 7,000 IU is highly unlikely to cause vitamin D toxicity and very unlikely to cause other problems. However, there’s no way to be sure.

If you think you may be deficient in vitamin D, see your doctor for a ​blood test​. Get her expert advice on the right blood level. If testing shows you are below this level, then follow your doctor’s recommendation for how much vitamin D to take each day.

Food, Sunlight and Supplements

There’s no risk of toxicity from vitamin D in foods or excess exposure to sunlight. It is only caused by taking excessive amounts of ​vitamin D pills​ over a period of time. If you don’t have a deficiency requiring medical treatment, you may be able to hedge your bets by getting more D from natural sources.

Safe Sun Exposure

When you spend time outdoors, ultraviolet B radiation (UVB) penetrates the skin, which converts it to a substance called cutaneous 7-dehydrocholesterol, then to previtamin D3 and finally to vitamin D3. Many factors affect how easily your body creates the vitamin: the season, the time of day, the length of the days where you live, the amount of melanin your skin produces, smog and cloud cover and sunscreen among them. Therefore it’s not a good idea to rely on getting everything you need from sun exposure.

Furthermore, organizations like the Skin Cancer Foundation and the American Academy of Dermatology caution that there is no such thing as safe sun exposure. According to Anne Marie McNeill, MD, PhD, and Erin Wesner, not using sunscreen increases your risk of squamous cell carcinoma, melanoma and premature skin aging.

It doesn’t take a lot of sun exposure for your skin to make vitamin D. About 10 to 15 minutes on the legs, arms, abdomen and back is more than enough. However, McNeill says even that amount of sun exposure can cause dangerous DNA damage, and she recommends protecting your skin with SPF 15 or higher whenever you venture outdoors.

Vitamin D in Your Diet

A better way to get your D is through a healthy diet. According to the NIH, very few foods naturally contain vitamin D; however, there are a few very rich sources, including:

• Swordfish: 566 IU per 3 ounces
• Sockeye salmon: 447 IU per 3 ounces
• Tuna in canned water: 154 IU per 3 ounces
• Beef liver: 42 IU per 3 ounces
• One large whole egg: 41 IU
• Sardines canned in oil: 46 IU in two sardines

Other commercially prepared foods are often fortified with vitamin D. Some examples include:

• Orange juice: 137 IU per cup
• Milk: 115 to 124 IU per cup
• Yogurt: 80 IU per 6 ounces

Regularly including these foods in your diet can often help you get all the vitamin D you need without sun exposure or a supplement.

Vitamin D Deficiency

Not getting adequate vitamin D can also have serious consequences. In its role as a hormone, vitamin D aids the regulation of more than 200 genes in the body. Some of the jobs vitamin D is responsible for include preventing the multiplication of abnormal cells in breast and colon tissue and helping to regulate blood pressure in the kidney and blood sugar in the pancreas.

Additionally, Erin Michos, M.D., M.H.S., reports that there is a strong connection between vitamin D deficiency and an increase in risk of heart attack, congestive heart failure, peripheral arterial disease (PAD), stroke, high blood pressure and diabetes.

High-Risk Populations

For certain people, getting more than the established RDA may be especially important, according to MedlinePlus. These include older adults whose kidneys aren’t as good at converting vitamin D to its active form, people with darker skin colors, people with digestive disorders such as Crohn’s or celiac disease, people with obesity, those with chronic kidney or liver disease and people with lymphomas. These people should be sure to have ​their blood levels tested​ regularly and to adhere to their doctor’s recommendations for diet and supplementation.