Resolution of the National interdisciplinary expert council «The use of high-dose vitamin D for the prevention and treatment of vitamin D deficiency, including in comorbid patients, in the use of endocrinologists, rheumatologists, gerontologists and internists/GPS»

Abstract

   We present a consensus on high dose cholecalciferol (Devilam 5000 IU and 50000IU) prescription in clinical settings. There was a expert committee meeting to reach a consensus on the recommendations for endorcrinologists, primary care physicians and primary care specialists to prevent and treat vitamin D deficiency in various groups of patients. The expert committee reached a consensus on prescribing prophylactic doses of vitamin D in daily, weekly and monthly regimes to prevent vitamin D deficiency without vitamin D measurements. A single dose of cholecalciferol 50 000 IU should be prescribed to patients with low traumatic fractures and/or requiring antiresorptive treatment for osteoporosis when vitamin D measurement is not available. Treatment doses (50 000 IU per week) of vitamin D should be reserved for patients with established vitamin D deficiency (< 30ng/ml). Considering the prevalence of vitamin D deficiency in Russia, the expert committee suggested that all people require prophylactic doses of vitamin D from November to April, whereas the elderly (65+) benefit from whole year vitamin D supplementation. There is a group of people with vitamin D metabolism abnormalities associated with hypercalcemia (genetic or granulomatosis disorders) who should avoid vitamin D. On the other hand, patients with obesity, malabsorption and osteomalacia require higher doses of vitamin D for longer periods of time. High-dose vitamin D formulation in matrix form (50,000 IU, 5,000 IU) is a high-dose vitamin D preparation within the framework of the registered instructions for the prevention (in intermittent dosing mostly) and treatment of vitamin D deficiency/insufficiency. Taking into account the rapid achievement of a therapeutic effect, good tolerability, safety of the drug and the convenience of intermittent administration to achieve greater patient compliance with the treatment, the expert committee has come to the conclusion that high-dose vitamin D formulation in matrix form should be recommended in different group of people to be given according to this consensus.