Ergocalciferol (Vitamin D2)

Ergocalciferol is a form of vitamin D that is also known as vitamin D2. It is one of the two main types of vitamin D, the other type being called cholecalciferol (vitamin D3). Ergocalciferol is usually made from ergosterol, which is found in plants, and can also be synthesized in small amounts in human skin when exposed to ultraviolet (UV) radiation.

Vitamin D plays a key role in the human body, including calcium and phosphate absorption, bone and muscle health, immune system function, and regulation of various body processes. Ergocalciferol, like cholecalciferol, is a preform of vitamin D that, after entering the body, undergoes several transformations that allow it to fulfill its functions.

Ergocalciferol is often used as a dietary supplement or medicine to prevent or treat vitamin D deficiency. It may be recommended by a doctor for people who have insufficient sun exposure or who have developed vitamin D deficiency as a result of other factors. It is important to note that the dosage and regimen should be determined by a physician according to the individual needs of the patient.

Indications Ergocalciferol

1. Prevention and Treatment of Vitamin D Deficiency: Ergocalciferol can be used to prevent or treat deficiency vitamin D, especially in people who do not get enough sunlight or have dietary restrictions that can lead to vitamin D deficiency.
2. Osteopenia and osteoporosis: Vitamin D plays an important role in bone health, so the drug may be used to treat osteopenia (decreased bone density) and osteoporosis (decreased bone mass and increased risk of fractures).
3. Maintaining bone health in people at risk of fractures: Ergocalciferol may be recommended for people at increased risk of fractures, such as the elderly or those with a history of fractures, to maintain bone health.
4. Maintaining muscle health: Vitamin D is important not only for bone health but also for muscle function. The drug may help maintain muscle health and reduce the risk of sarcopenia (loss of muscle mass) in older adults.
5. Immune System Support: Vitamin D plays a role in regulating the immune system, so ergocalciferol can be used to support its function.

Release form

Ergocalciferol, which is also known as vitamin D2, is commonly available in several dosage forms including:

1. Capsulesand tablets: Ergocalciferol may be supplied as capsules or tablets for oral (by mouth) administration. This form of release is often used to treat or prevent vitamin D deficiency.
2. Solution: The drug may also be available as a liquid solution for oral administration. This is convenient for patients who have difficulty swallowing capsules or tablets.
3. Injections: In some cases, especially when treating severe cases of vitamin D deficiency or other medical conditions, ergocalciferol may be given as a solution for injection. This is usually done in a medical setting under the supervision of medical personnel.

Pharmacodynamics

The mechanism of action of ergocalciferol is based on its ability to affect the metabolism of calcium and phosphorus, as well as the regulation of immune system functions.

Major aspects of the pharmacodynamics and mechanism of action of ergocalciferol include:

1. Calcium and phosphorus absorption: Ergocalciferol, like other forms of vitamin D, increases the absorption of calcium and phosphorus from food in the intestine. It stimulates the expression of proteins involved in the transport of calcium and phosphorus across enterocyte cell membranes.
2. Regulation of blood calcium levels: Stimulates calcium reabsorption in the kidneys, which helps maintain stable blood calcium levels. High blood calcium levels can inhibit the release of parathormone (PTH), which in turn reduces the mobilization of calcium from the bones.
3. Regulation of bone mineralization: Promotes bone mineralization by stimulating the synthesis of proteins necessary for the formation of bone matrix.
4. Immunomodulatory action: Vitamin D is involved in the regulation of the immune system, including reducing inflammation and stimulating immunity. It influences the production of cytokines and regulatory T cells.

Pharmacokinetics

1. Absorption: Ergocalciferol is usually taken into the body from food or vitamin supplements. After oral ingestion, it is absorbed in the intestine by bile salts.
2. Transport and metabolism: Ergocalciferol binds to blood proteins such as vitamin D-binding protein. In the liver, it undergoes hydroxylation to form 25-hydroxyergocalciferol, which is the major metabolite of vitamin D2.
3. Conversion to the active form: 25-hydroxyergocalciferol is further metabolized in the kidneys and other body tissues to the active form of vitamin D, 1,25-dihydroxyvitamin D, or calcitriol.
4. Distribution: Vitamin D and its metabolites are distributed to various tissues in the body, including bones, intestines, kidneys, and immune system cells.
5. Excretion: Vitamin D metabolites are eliminated from the body mainly through the kidneys with urine, and a small amount through the intestines with feces.
6. Pharmacodynamics: The active form of vitamin D is involved in the regulation of calcium metabolism and also influences many other biological processes in the body, such as immune responses, cell differentiation and antiproliferative effects.
7. Interactions with other drugs: Vitamin D may interact with a variety of medications, including drugs that increase blood calcium levels, such as thiazide diuretics, or drugs that decrease calcium levels, such as glucocorticoids.

Dosing and administration

The method of use and dosage of ergocalciferol depends on your specific medical situation, your level of vitamin D deficiency, and your doctor's recommendations. The following are general recommendations for use and dosage:

1. Vitamin D deficiency:

   • It is generally recommended to start with low doses, such as 400-1000 IU (international units) of ergocalciferol per day for adults, depending on the level of deficiency.
   • For children, the dosage may be less or more similar to that of adults, but again, this depends on age and level of deficiency.
   • Blood levels of vitamin D are usually monitored at a certain time after the start of treatment, and the dose can be adjusted according to these results.

2. Prevention of vitamin D deficiency:

   • A lower dose than for treating a deficiency, such as 400 IU daily for adults and children, is generally recommended.

3. Other states:

   • For certain diseases or medical conditions such as osteoporosis, psoriasis, chronic kidney failure, and others, the dosage of ergocalciferol can be individualized based on the patient's needs and the doctor's recommendations.

Use Ergocalciferol during pregnancy

Ergocalciferol (vitamin D2) may sometimes be prescribed during pregnancy to correct vitamin D deficiency in pregnant women. Vitamin D is important for bone and immune system health in both the mother and the developing fetus.

However, as with any medication, the use of ergocalciferol during pregnancy should be done under a doctor's supervision. A doctor will usually prescribe vitamin D only to pregnant women who are found to be vitamin D deficient or who are at risk of developing a deficiency, such as those who live in areas with insufficient sunlight or who have an inadequate intake of vitamin D-rich foods.

It is important to remember that taking any vitamin supplements, including ergocalciferol, should be done under the supervision of a doctor to avoid overabundance of vitamin D, which can also be harmful to both mother and fetus.

Contraindications

1. Hypercalcemia: Ergocalciferol should be avoided in case of hypercalcemia, i.e. Increased calcium content in the blood. This can be due to various causes such as hyperparathyroidism, sarcoidosis, severe hypervitaminosis D and other conditions.
2. Hypervitaminosis D: Patients with hypervitaminosis D, i.e. Excess of vitamin D in the body, should also not take the drug without consulting a doctor.
3. Hypercalciuria: Ergocalciferol may increase urinary excretion of calcium, which may aggravate hypercalciuria (increased calcium in the urine). It may therefore be contraindicated in hypercalciuria.
4. Hyperparathyroidism: Patients with hyperparathyroidism, especially if caused by primary hyperparathyroidism, may have contraindications to taking the drug.
5. Hyperphosphatemia: Ergocalciferol may increase blood phosphate levels, so it may be contraindicated in patients with hyperphosphatemia.
6. Allergies: People with known allergies to ergocalciferol or to any other components of the drug should also avoid using it.
7. Other conditions: The drug may have other contraindications, especially if you have certain health conditions such as kidney, liver, or heart disease.

Side effects Ergocalciferol

1. Hypercalcemia: Prolonged and/or excessive use of ergocalciferol may result in hypercalcemia, an elevated level of calcium in the blood. This condition can lead to symptoms such as nausea, vomiting, anorexia, fatigue, insomnia, and an increased risk of kidney stones and kidney damage.
2. Hypercalciuria: The drug may cause increased excretion of calcium in the urine, which may lead to hypercalciuria - increased calcium content in the urine. This may cause the formation of kidney stones and increase the risk of developing urinary tract diseases.
3. Gastrointestinal disorders: Some people may experience stomach discomfort, nausea, vomiting, diarrhea, or constipation as a result of taking the drug.
4. Allergic Reactions: In rare cases, allergic reactions to ergocalciferol may occur and may manifest as pruritus, skin rash, angioedema or anaphylactic shock.
5. Other side effects: Other rare side effects such as headache, high blood pressure, weakness, decreased appetite, increased sweating, and others may also occur.

Overdose

An overabundance of vitamin D can lead to hypercalcemia (high levels of calcium in the blood), which can cause a variety of symptoms and complications. Some of these include:

1. Symptoms of hypercalcemia: Include fatigue, weakness, loss of appetite, nausea, vomiting, rapid urination, dry mouth, constipation, and psychiatric symptoms such as depression, anxiety, and mental clouding.

2. Increased risk of calcinosis: This is the deposition of calcium in the tissues of organs such as kidneys, heart, blood vessels and others, which can lead to impaired function.

3. Increased risk of kidney stones: Excess calcium can contribute to the formation of kidney stones, causing pain and discomfort.

4. Prolonged overdose: More serious complications such as kidney damage, soft tissue and organ calcification, and cardiovascular complications may occur.

In case of suspected overdose of ergocalciferol or any other vitamin D, it is important to seek immediate medical attention. Treatment may include discontinuation of vitamin D intake, correction of blood calcium levels and symptomatic therapy to eliminate symptoms of hypercalcemia.

Interactions with other drugs

1. Drugs that increase calcium absorption: Some drugs, such as thiazide diuretics, may increase intestinal calcium absorption and therefore increase the risk of hypercalcemia when taken concomitantly with ergocalciferol.
2. Glucocorticoids: Glucocorticoids may decrease blood calcium levels and impair intestinal calcium absorption when taken concomitantly with ergocalciferol.
3. Antiepileptic drugs: Some antiepileptic drugs may increase the metabolism of vitamin D and decrease its level in the blood, which may require adjustment of the drug dose.
4. Drugs that increase the risk of hypercalcemia: Some drugs, such as lithium, may increase the risk of hypercalcemia when taken concomitantly with ergocalciferol.
5. Drugs that decrease calcium absorption: Some drugs, such as bisphosphonates, may decrease calcium absorption and therefore reduce the effectiveness of the drug.
6. Iron-containing preparations:Iron-containing preparations may reduce absorption of the drug from the intestine.

Storage conditions

Ergocalciferol (vitamin D2) is usually stored according to the manufacturer's recommendations and appropriate standards for storing vitamins. Common storage conditions for ergocalciferol include:

1. Temperature: Vitamin D2 should be stored at room temperature, usually 15 to 30 degrees Celsius (59 to 86 degrees Fahrenheit).
2. Light: Vitamin D2 preparations should be stored in a place protected from light. Ultraviolet rays can destroy vitamin D, therefore it is recommended to store the preparation in a dark container or packaging.
3. Humidity: Vitamin D2 preparations should be protected from moisture, so storage in damp places should be avoided.
4. Packaging: It is important to store the drug in its original package or container with a tightly closing lid.
5. Additional instructions: It is important to follow the instructions on the package or your doctor's instructions regarding storage of the drug. Some drugs may have specific storage requirements.