Vigantol

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

The result of such regulation is the replenishment of the deficiency of cholecalciferol in the body, the potentiation of Ca absorption in the gastrointestinal tract, and along with this, intrarenal phosphate reabsorption. In addition, the drug 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 occurs in 2 hydroxylation phases: the initial one - inside the liver (state 25), and the subsequent one - 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 phosphate and calcium metabolism. The bioactive form of cholecalciferol potentiates calcium absorption inside the intestine, and in addition, stimulates the passage of Ca into the osteoid and its removal from bone tissue.

In case of calciferol deficiency, the process of skeletal calcification does not develop, resulting in rickets, or bone decalcification occurs, causing osteomalacia. With a deficiency of Ca or calciferol, the release of parathyroid hormone is potentiated (this is a reversible process). Due to such secondary hyperparathyroidism, the metabolic process inside bone tissue increases, which can cause fractures, increasing bone fragility. [ 2 ]

Taking into account physiological regulation, production and the principle of influence, cholecalciferol should be considered a precursor of steroid hormones. In addition to physiological production inside the epidermis, this component enters the body with food or medications. Since 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 with cholecalciferol. The substance demonstrates a similar quantitative and qualitative therapeutic effect.

Pharmacokinetics

Absorption occurs within the gastrointestinal tract. The active ingredient is synthesized with α2-globulins, as well as with albumins (a small part).

Cholecalciferol accumulation is realized within fatty and bone tissues, kidneys with adrenal glands, liver, myocardium and skeletal muscles. The drug reaches tissue Cmax values 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, along with it, be excreted in mother's milk.

During intrarenal and intrahepatic biotransformation, inactive metabolic elements (calcifediol with dihydroxycholecalciferol) are formed, as well as calcitriol, which exhibits therapeutic activity.

Excretion occurs mainly with bile; a small portion of the drug is excreted in urine.

Dosing and administration

Vigantol is prescribed to newborns for oral administration - the medicine is mixed in a spoon with milk or another liquid.

To prevent rickets in healthy or premature infants up to 2 months of age, a daily dose of 1 drop of solution is used. The medication should be used for 5 days, after which a 2-day break is required. Children aged 1-2 years should not use the drug in the summer.

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

When treating rickets, the medication should be taken in larger doses. For example, infants over 10 days old are given 2-8 drops of the drug daily.

For other disorders, the duration of the cycle and the dosage are selected individually by the attending physician. The level of cholecalciferol deficiency is determined in advance (this indicator must also be monitored during therapy).

Use Vigantol during pregnancy

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

Daily servings less than 500 IU of calciferol.

There is no information regarding the risks of complications when administering calciferol within the indicated dosages. Prolonged overdose of calciferol should not be allowed due to the possibility of hypercalcemia, which can provoke a delay in intellectual and physical development in the fetus, as well as the occurrence of retinopathy and supravalvular aortic stenosis.

Daily doses over 500 IU of calciferol.

During pregnancy, the medication is prescribed only under strict indications in a strictly limited dose to eliminate the vitamin deficiency.

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

Contraindications

Main contraindications:

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

Side effects Vigantol

Side effects include:

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

Overdose

Usually, drug poisoning occurs due to the accumulation of excess cholecalciferol in the child's body. Signs of hypervitaminosis D3 include headaches, thirst, polyuria or pollakiuria, metallic taste, diarrhea or constipation, nocturia, nausea, anorexia, systemic weakness, vomiting, etc. In addition, more severe disorders may be observed: increased blood pressure, arrhythmia, bone pain, epidermal itching, cloudy urine, myalgia, conjunctival hyperemia, etc.

Therapy is performed for the onset of hypercalcemia (determined by its intensity). Drugs may be discontinued, a diet with a low Ca level prescribed, large amounts of fluid consumed, and retinol, pantothenic acid, riboflavin with thiamine, vitamin C, and vitamin E prescribed.

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

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

Interactions with other drugs

The administration of the drug with primidone, phenytoin and barbiturates increases the rate of biotransformation processes, which increases the need to obtain cholecalciferol.

Long-term use with magnesium- or aluminum-containing antacids may increase their blood levels and lead to the risk of developing poisoning.

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

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

The combination of the drug and SG increases the toxic risk associated with hypercalcemia. In such patients, it is necessary to monitor ECG readings and Ca values, and also to change the dosage of SG. The likelihood of hypercalcemia also 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.

Thiazide-type diuretics have been shown to slow down calcium excretion in urine, causing hypercalcemia. With such combinations, blood Ca levels should be monitored constantly.

The therapeutic properties of Vigantol are weakened when combined with isoniazid or rifampicin, since they increase the rate of its biotransformation.

Storage conditions

Vigantol should be stored in a place closed to children and sunlight. The temperature level is in the range of 15-25°C.

Shelf life

Vigantol can be used for a period of 5 years from the date of sale of the medicinal substance.

Analogues

Analogues of the drug are Cholecalciferol, Aquadetrim, Cholecalciferol with Videhol, as well as Vitamin D, etc.

Reviews

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