Oral solution Aquadetrim Vitamin D3 Medana Prevention of rickets, osteoporosis (10ml)

The most important function of Vitamin D is with calcitonin and parathomon (parathyroid hormone) that controls calcium and phosphate metabolism. Vitamin D3 is an anti -rickets, it is essential for the normal functioning of the parathyroid gland. The most important target organ of vitamin D is intestines, kidneys and skeletal systems.

Vitamin D plays a major role in the absorption of calcium and phosphate from the intestine, transporting mineral salts, participating in bone calcification process, adjusting the amount of calcium and phosphate is discharged through the kidneys. Vitamin D stimulates the absorption of Ca2+ and phosphate in the intestine (stimulates the synthesis of Ca2+ (CABP) protein in the intestine, these proteins are not found in the intestinal mucus of people with vitamin D deficiency).

All of these processes to support maintaining appropriate calcium and blood phosphate levels. Calcium ionic concentration affects a number of important biochemical processes that help maintain normal muscle tone, stimulate nerves and coagulation. Vitamin D is related to the synthesis of adenosin triphosphoric acid and antagonism with cortisol, which is an inhibitor of calcium absorption.

In addition, vitamin D participates in the normal function of the immune system by influencing the synthesis of lymphokin and this does not lead to any morphological changes of peripheral blood.

Vitamin D deficiency due to diet, absorption disorders, calcium deficiency, liver disease and due to certain drugs, lack of exposure to sunlight will lead to rickets during the rapid growth of children and osteoporosis in adults.

Using Vitamin D to prevent rickets is necessary for most babies and young children. Women during menopause suffered from osteoporosis due to hormonal changes need to increase the daily dose of vitamin D. Vitamin D is supplied from whether or not the source satisfies the needs or not depends on each individual.

pharmacokinetics

absorption:

After drinking, Cholecalciferol is absorbed from the small intestine. The absorption process is adjusted by bile and specific proteins. Absorb cholecalciferol increases when fat. Liver disorder reduces cholecalciferol absorption.

Distribution:

cholecalciferol is transported from blood to liver, where it is metabolized by 25 hydroxylase into calcidiol (25-hydroxycholecifo 1, 25 (OH) 23). Calcidiol formed in the liver is transferred by specific proteins (protein with vitamin D) to the kidney, where this substance is metabolized by 1α-hydroxylase-25 (OH) D3 to form Calcitriol (1.25 (OH) 2D3). Vitamin D3 and active metabolites can be stored in the liver and fat tissue for a long time.

In healthy people, the blood vitamin D3 level is 1.3 mmol/l and half -life T1/2 is 19 to 25 hours. The half -life of Calcidiol is approximately 16 days and the half -life of Calcitriol is 3 to 6 hours.

Metabolism:

Vitamin D3 is converted into pharmacological activity. In the liver, Vitamin D3 undergo 25-hydroxylated process into 25 (OH) D3 (Calcidiol). This process is catalyzed by 25-hydroxylase and reaction speed depends on the source of substrate. The activity of this enzyme is lower than in premature babies and in patients with liver damage. Calcidiol is a low -active metabolic substance.

The physiological concentration of 25 (OH) D3 is 10 to 125 nmol/l, and the sale time t1/2 from 10 to 20 days. The final transformation process into Calcitriol occurs at 1α position in the nearby renal tubules and a smaller part in the placenta, macrophages, lymphatic cells.

The activity of 1α-hydroxylase 25 (OH) D3 in the kidney is adjusted through hormones and metabolism. This activity increased by parathemmones (parathyroid hormones), prolactin, growth hormones, sex hormones, insulin, and prostaglandin pge2.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Be cautious when using

avoid overdose.

Medicines should be used with caution for immovable patients, patients taking thiazid diuretics, patients with kidney stones, heart disease and patients taking cardiac glycosides (including digitalis).

Precautions for vitamin D for patients with sarcoid disease, because it can increase the metabolism of activated vitamin D. In these patients, blood calcium and calcium calcium levels need to be monitored.

Total doses of vitamin D supplement should take into account the treatment for vitamin D, foods rich in vitamin D, milk rich in vitamin D and the level of sun exposure of the patient.

There is no clear evidence of the relationship causing the results between vitamin D and kidney stones, but the risk is available, especially when supplementing at the same time. The need for additional calcium should be considered in each patient. When supplementing calcium, there must be strict medical supervision.

High doses of vitamin D (500,000 IU annual doses) have been reported to increase the risk of fractures in the elderly, the highest risk in the first 3 months after drinking.

When treating this drug, calcium and blood phosphate and urinary phosphate should be controlled periodically. When long -term treatment with a dose exceeds 1,000 IU of Vitamin D per day, need to monitor blood calcium concentration.

Do not take high doses of calcium simultaneously with vitamin D3.

Daily needs and how to use vitamin D3 in children must be based on each individual and be redefined after each regular examination, especially for children in the first months of birth.

very careful when using vitamin D for babies with small before small.

Excessive dose of vitamin D in a long period or high starting dose can lead to chronic vitamin poisoning.

This drug contains Benzyl alcohol (Benzyl alcohol) that can cause allergies.

This drug contains macrogolglycerol ricinoleat excipients that can cause allergies.

Patients with hyperthyroidism need advice from a doctor.

The decision to supplement vitamin D per specific case depends on the relationship of risk and benefits for patients.

The ability to drive and operate machinery

aquadetrim does not affect the ability to drive or operate machinery.

Pregnancy

No or few data on the use of cholecalciferol in pregnant women. Animal studies have shown toxicity on reproduction. The daily dose for pregnant women is recommended for 500 IU, however, in women who are considered to be a shortage of vitamin D may need higher doses (up to 2000 IU/day).

During pregnancy, women should comply with the doctor's requirements because their needs may change according to the degree of deficiency and respond to treatment. Avoid using vitamin D overdose during pregnancy, as hypercalcemia can lead to physical and mental growth, such as narrowing of the holes of the africa and retinopathy in the child.

breastfeeding period

Women who are breastfeeding may be prescribed vitamin D if necessary. However, this supplement cannot be replaced directly with vitamin D in children. Vitamin D and metabolites are excreted through breast milk. There has not been an overdose of the baby due to breastfeeding, but when the prescription is supplemented for the baby who is breastfeeding, the doctor needs to take into account the additional dose for the mother.

Drug interaction

anti -epileptic drugs, especially phenytoin and phenobarbital (and other drugs that can act on liver enzymes) as well as rifampicin reduces vitamin D3 absorption.

Using vitamin D3 simultaneously with the diuretic diuretics increases the risk of hypercalcemia, so it is necessary to monitor blood calcium levels.

When used simultaneously with cardiac glycosides, vitamin D may increase their toxicity (increasing the risk of arrhythmia). Need to monitor medical closely, and monitor blood calcium and electrocardiograms if required.

Simultaneously used with glucocorticoids can reduce the effect of vitamin D.

When the drug is used simultaneously with acid neutralizing drugs containing aluminum and magnesium, it can lead to aluminum toxicity on the bone and increase blood magnesia in patients with renal impairment.

Concentrated with drugs similar to vitamin D will lead to an increased risk of toxicity. Any product contains high levels of calcium or phosphorus increases the risk of hyperchemical phosphate. Vitamin D may have antagonistic activity with medications for hypercalcemia, such as calcitonin, etidronate, pamidronate.

Simultaneous treatment with ion exchange resin such as cholestyramin, colestipol hydrochlorid, orlistat or laxative such as paraffin oil can reduce vitamin D absorption in the digestive tract.

Concentrated with rifampicin or isoniazid can reduce the effect of vitamin D.

Actinomycin cellular toxicity and imidazol antifungal drug intervene in the activity of vitamin D by inhibiting 25-hydroxyvitamin d to 1.25-dihydroxyvitamin D catalyzed by enzyme 25-hydroxyvitamin d-1-hygryylase in the kidney.