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What is cholecalciferol?
Cholecalciferol is a vitamin D3. Vitamin D is important for the absorption of calcium from the stomach and for the functioning of calcium in the body. Cholecalciferol is used to treat or prevent many conditions caused by a lack of vitamin D, especially conditions of the skin or bones. Cholecalciferol may also be used for other purposes not listed in this medication guide.

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What are the possible side effects of cholecalciferol?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking cholecalciferol and call your doctor at once if you have a serious side effect such as:

• thinking problems, changes in behavior, feeling irritable;

• urinating more than usual;

• chest pain, feeling short of breath; or

• early signs of vitamin D overdose (weakness, metallic taste in your mouth, weight loss, muscle or bone pain, constipation, nausea, and vomiting).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take cholecalciferol?
Take this medication exactly as directed on the label, or as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Cholecalciferol is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must eat or avoid to help control your condition.

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What is the most important information I should know about cholecalciferol?
Do not use this medication if you have ever had an allergic reaction to vitamin D, or if you have high levels of calcium or vitamin D in your blood, or if you have any condition that makes it hard for your body to absorb nutrients from food (malabsorption). Before taking cholecalciferol, tell your doctor if you are allergic to any drugs, or if you have heart disease, kidney disease, or an electrolyte imbalance. Do not take other vitamin or mineral supplements unless your doctor has told you to.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

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What other drugs will affect cholecalciferol?
Before taking cholecalciferol, tell your doctor if you are taking any of the following medicines: seizure medication; cholestyramine (Prevalite, Questran); colestipol (Colestid); steroids (prednisone and others); digoxin (digitalis, Lanoxin); or a diuretic (water pill) such as chlorothiazide (Diuril), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), chlorthalidone (Hygroton, Thalitone), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), and others. This list is not complete and there may be other drugs that can interact with cholecalciferol. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Cholecalciferol (vitamin D3) has not been officially assigned to a pregnancy category. When used within the recommended daily allowance for pregnant women, cholecalciferol is considered to be safe. The recommended daily allowance of cholecalciferol in pregnant women is 400 to 600 intl units.

Supplementation of vitamin D during the third trimester with vitamin D2 or vitamin D3 has been studied. Dosages of 1000 intl units per day given daily during the third trimester did not result in any adverse fetal outcome. Neonatal calcium homeostasis was affected, resulting in significantly higher concentrations of calcium, 25-OH vitamin D3, and 1,25-(OH)2 vitamin D3. Earlier literature expressed concerns over the development of supravalvular aortic stenosis, craniofacial abnormalities, and dental abnormalities in infants and children with idiopathic hypercalcemia. Whether or not prenatal factors predisposed these children to the development of hypercalcemia is not known. Fifteen hypoparathyroid women receiving 50,000 to 250,000 intl units of vitamin D2 experienced 27 uneventful births. No cardiovascular or craniofacial abnormalities were reported.

The American RDA for vitamin D in the lactating woman is 400 to 600 intl units. Vitamin D supplements may be necessary if maternal vitamin D nutrition is insufficient. The American Academy of Pediatrics considers cholecalciferol or vitamin D3 to be compatible with breast-feeding. If the mother is receiving pharmacological doses, serum calcium levels in the breast-fed infant should be monitored.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of vitamin D can cause serious or life-threatening side effects. Overdose symptoms may include headache, weakness, drowsiness, dry mouth, nausea, vomiting, constipation, muscle or bone pain, metallic taste in the mouth, weight loss, itchy skin, changes in heart rate, loss of interest in sex, confusion, unusual thoughts or behavior, feeling unusually hot, severe pain in your upper stomach spreading to your back, or fainting.

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What should I discuss with my healthcare provider before taking cholecalciferol?
Do not use this medication if you have ever had an allergic reaction to vitamin D, or if you have: high levels of calcium in your blood (hypercalcemia); high levels of vitamin D in your body (hypervitaminosis D); or any condition that makes it hard for your body to absorb nutrients from food (malabsorption). Before taking cholecalciferol, tell your doctor if you are allergic to any drugs, or if you have: heart disease; kidney disease; or an electrolyte imbalance. If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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