Vigantol

Vigantol is used as a means to regulate the metabolic processes of elements such as phosphorus and calcium.

The result of such regulation is the replenishment of the lack of cholecalciferol inside the body, potentiation of the absorption of Ca inside the gastrointestinal tract, and with this intrarenal phosphate reabsorption. In addition, the medication helps the processes of bone mineralization, which is required for the full functioning of the parathyroid glands. [1]

Indications Vigantol

It is used to treat diseases such as spasmophilia, rickets and osteomalacia.

Release form

The release of the medicinal substance is realized in the form of an oily oral liquid, inside glass dropper bottles with a volume of 10 ml. Inside the pack - 1 such bottle.

Pharmacodynamics

Cholecalciferol is formed inside the epidermis under the influence of UV radiation, after which it is transformed into its bioactive form - the element 1,25-hydroxycholecalciferol. This happens in 2 phases of hydroxylation: the initial one is inside the liver (state 25), and the next one is inside the kidneys (state 1). In combination with calcitonin, as well as parathyroid hormone, the substance 1,25-dihydroxycholecalciferol has a significant effect on the regulation of metabolic processes of phosphate with calcium. The bioactive form of cholecalciferol potentiates calcium absorption inside the intestine, and in addition, stimulates the passage of Ca into the osteoid and its excretion from bone tissues. [2]

In the case of a lack of calciferol , the process of skeletal calcification does not develop, as a result of which rickets appears, or bone decalcification occurs, which becomes the cause of osteomalacia. With a lack of Ca or calciferol, the potentiation of the release of parathyroid hormone occurs (this is a reversible process). Because of this secondary hyperparathyroidism, the metabolic process inside the bone tissue increases, which can cause fractures, increasing the fragility of the bones. [3]

Taking into account the physiological regulation, production and principle of influence, cholecalciferol must be considered a precursor of steroid hormones. In addition to the physiological production inside the epidermis, this component enters the body along with food or medicines. Because the latter option does not slow down the epidermal binding of calciferol, intoxication may occur.

The element ergocalciferol has a plant synthesis pathway. Inside the human body, its activation also occurs through metabolic processes, as in cholecalciferol. The substance shows a similar qualitative and quantitative therapeutic effect.

Pharmacokinetics

Absorption is realized inside the gastrointestinal tract. The active ingredient is synthesized with α2-globulins, as well as with albumin (a small part).

Cumulation of cholecalciferol is realized inside adipose and bone tissues, kidneys with adrenal glands, liver, myocardium and skeletal muscles. The drug reaches tissue parameters Cmax after 4-5 hours, after which they decrease slightly, although they still continue to remain at the required level for a long time.

It has been determined that cholecalciferol can cross the placenta, and at the same time be excreted in the mother's milk.

With intrarenal and intrahepatic biotransformation, metabolic elements that have no activity appear (calcifediol with dihydroxycolecalciferol), as well as calcitriol, which demonstrates therapeutic activity.

Excretion is mainly carried out with bile; a small part of drugs is excreted in the urine.

Dosing and administration

For newborns, Vigantol is prescribed for oral administration - the medicine is mixed inside a spoon with milk or other liquid.

To prevent the appearance of rickets in healthy or premature infants up to 2 months of age, a daily portion of 1 drop of solution is used. It is necessary to apply the medication for 5 days, after which a break is required for 2 days. Children aged 1-2 years should not use drugs in the summer.

For premature infants over 10 days of age, the daily dosage is 2 drops, taken over a period of 5 days (then a 2-day break is taken). In the summer, the medicine is not used.

When treating rickets, the medication should be consumed in larger portions. For example, infants over 10 days of age are daily used 2-8 drops of drugs.

In case of other violations, the duration of the cycle and the size of the dosage are selected personally by the attending doctor. The level of cholecalciferol deficiency is preliminarily determined (this indicator must be monitored during therapy).

Use Vigantol during pregnancy

During lactation or pregnancy, the body must receive the necessary volumes of calciferol. It is necessary to track the amount of calciferol received in the specified group of patients.

Daily servings less than 500 IU of calciferol.

There is no information regarding the risks of complications with the introduction of calciferol within the indicated dosages. A prolonged overdose of calciferol should not be tolerated due to the likelihood of hypercalcemia, which can provoke a delay in the fetus's intellectual and physical development, as well as the occurrence of retinopathy and stenosis of the aortic mouth of the supravalvular type.

Daily dosages over 500 IU of calciferol.

During pregnancy, the medication is prescribed only with strict indications in a clearly limited portion in order to eliminate the lack of vitamin.

Calciferol with its metabolic components is excreted in breast milk. There have been no cases of drug poisoning in infants.

Contraindications

The main contraindications:

• severe intolerance to the components of drugs;
• hypercalciuria or -calcemia;
• the presence of calcareous stones inside the kidneys;
• immobility of the patient;
• sarcoidosis.

Side effects Vigantol

Among the side signs:

• hypercalcemia or -calciuria;
• vomiting, weight loss, thirst, decreased appetite, nausea;
• disorders of the psyche and consciousness;
• polyuria or urolithiasis;
• arrhythmia;
• calcium deposits inside soft tissues.

Overdose

Usually, drug poisoning occurs due to the accumulation of excess cholecalciferol inside the child's body. Among the signs of hypervitaminosis-D3: headaches, thirst, polyuria or pollakiuria, metallic taste, diarrhea or constipation, nocturia, nausea, anorexia, systemic weakness, vomiting, etc. In addition, more severe disorders can be observed: an increase in blood pressure values, arrhythmia, bone pain, epidermal itching, clouding of urine, myalgia, conjunctival hyperemia, etc.

The therapy of the onset of hypercalcemia is carried out (determined by the degree of its intensity). Cancellation of drugs, the appointment of a diet with a low Ca value, the use of large amounts of fluids and the appointment of retinol, pantothenic acid, riboflavin with thiamine, C-vitamin and E-vitamin can be performed.

In severe disorders, an intravenous injection of 0.9% NaCl, electrolytes and furosemide with calcitonin is performed, and in addition, hemodialysis is performed.

To prevent overdose, it is necessary to constantly monitor blood Ca values.

Interactions with other drugs

Administration of drugs with primidone, phenytoin and barbiturates increases the rate of biotransformation processes, which increases the need for cholecalciferol production.

Prolonged use with magnesium or aluminum-containing antacids can increase their blood values and lead to the risk of developing poisoning.

The combination of Vigantol with bisphosphonates, calcitonin and plikamycin leads to a weakening of the drug activity of drugs.

Colestipol with cholestyramine reduces the absorption of certain vitamins of the fat-soluble group from the gastrointestinal tract, which is why it is necessary to increase their portion.

The combination of the drug and SG increases the toxicity associated with hypercalcemia. In such patients, it is necessary to monitor the ECG readings and Ca values, as well as change the dosage of SG. The likelihood of hypercalcemia increases with the introduction of benzodiazepine derivatives.

Cholecalciferol and its metabolic components or analogs can be used together, but only under strict indications and with constant monitoring of serum Ca levels.

It has been established that thiazide-type diuretics slow down calcium excretion in the urine, which causes hypercalcemia. With such combinations, you need to constantly monitor the blood levels of Ca.

The therapeutic properties of Vigantol are weakened in the case of a combination with isoniazid or rifampicin, since they increase the rate of its biotransformation.

Storage conditions

Vigantol should be kept out of the reach of children and sunlight. The temperature level is in the range of 15-25 ° C.

Shelf life

Vigantol can be used for a 5-year term from the date of sale of the medicinal substance.

Analogs

The analogues of the medication are Cholecalciferol, Aquadetrim, Colecalciferol with Videhol, as well as Vitamin D, etc.

Reviews

Vigantol is often used in the treatment of newborn babies - this is what reviews on medical forums say. The result of therapy is that no pathological changes are found in the structure of bones in infants over a 1-2-year period. In addition, there are no comments regarding the development of side symptoms, although the likelihood of their appearance in theory is quite high.