APPENDIX 17
Vitamins and minerals: Indications and dosages Refer to manufacturer’s instructions for complete prescribing and safety information.
ferrous fumarate FAIR-us
Euro-Fer, Femiron, Feostat, Ferrate, Ferretts, Ferrocite, Hemocyte, Iron, Neo-Fer, Nephro-Fer, Palafer Therapeutic class: Iron supplements Pharmacologic class: Hematinics AVAILABLE FORMS Each 100 mg of ferrous fumarate provides 33 mg of elemental iron. Capsules : 300 mg Oral suspension: 300 mg/5 mL Tablets : 90 mg, 150 mg, 200 mg, 300 mg, 324 mg, 325 mg, 350 mg Tablets (chewable): 100 mg Tablets (extended-release) : 18 mg INDICATIONS & DOSAGES
➤➤Iron deficiency
Adults: 1 or 2 tablets P.O. daily between meals or as directed by prescriber. Or, 100-mg chewable tablet P.O. once daily to q.i.d. For extended-release tablets, give 1 tablet P.O. daily. Children: 3 to 6 mg/kg/day P.O. in three divided doses. ➤➤As a supplement during pregnancy Women: 30 mg elemental iron P.O. daily.
ferrous gluconate FAIR-us
Fergon, Novo-ferrogluc Therapeutic class: Iron supplements Pharmacologic class: Hematinics AVAILABLE FORMS Each 100 mg of ferrous gluconate provides 11.6 mg of elemental iron. Tablets : 225 mg, 240 mg, 300 mg, 324 mg, 325 mg INDICATIONS & DOSAGES ➤➤Iron deficiency Adults: 100 to 200 mg P.O. elemental iron daily in three divided doses. Children: 3 to 6 mg/kg/day P.O. in three divided doses. ➤➤As a supplement during pregnancy Women: 15 to 30 mg elemental iron P.O. daily during last two trimesters.
ferrous sulfate FAIR-us
Feosol*, Fer-Gen-Sol*, Fer-In-Sol*, FeroSul
ferrous sulfate (dried)
Feosol, Feratab, Novoferrosulfate, Slow FE, Slow Release Iron
Therapeutic class: Iron supplements Pharmacologic class: Hematinics AVAILABLE FORMS Each 100 mg of ferrous sulfate provides 20 mg of elemental iron or 30 mg of elemental iron in ferrous sulfate dried products. Caplets (extended-release) : 160 mg (dried) Capsules: 190 mg (dried) Drops: 125 mg/mL Elixir: 220 mg/5 mL* Liquid: 150 mg/5 mL, 300 mg/5 mL Tablets: 195 mg, 200 mg (dried), 300 mg (dried), 325 mg Tablets (slow-release) : 142 mg, 160 mg (dried) INDICATIONS & DOSAGES
➤➤Iron deficiency
Adults: 100 to 200 mg P.O. daily in two or three divided doses. Extended- or slow-release tablets are intended for once-daily use. Children: 3 to 6 mg/kg/day P.O. in three divided doses.
vitamin A (retinol)
Aquasol A, Vitamin A Palmitate AVAILABLE FORMS Capsules: 7,500 international units, 8,000 international units, 10,000 international units, 25,000 international units Injection: 2-mL vials (50,000 international units/mL) Tablets: 10,000 international units, 15,000 international units INDICATIONS & DOSAGES
➤➤RDA
Men and boys older than age 14: 900 mcg retinol equivalent (RE) or 3,000 international units. Women and girls older than age 14: 700 mcg RE or 2,330 international units. Children ages 9 to 13: 600 mcg RE or 2,000 international units. Children ages 4 to 8: 400 mcg RE or 1,330 international units.
Children ages 1 to 3: 300 mcg RE or 1,000 international units. Infants ages 7 to 12 months: 500 mcg RE or 1,665 international units. Neonates and infants younger than age 6 months: 400 mcg RE or 1,330 international units. Pregnant women ages 14 to 18: 750 mcg RE or 2,500 international units. Pregnant women ages 19 to 50: 770 mcg RE or 2,564 international units. Breast-feeding women ages 14 to 18: 1,200 mcg RE or 4,000 international units. Breast-feeding women ages 19 to 50: 1,300 mcg RE or 4,330 international units. ➤➤Severe vitamin A deficiency Adults and children older than age 8: 100,000 international units I.M. or 100,000 to 500,000 international units P.O. for 3 days; then 50,000 international units P.O. or I.M. daily for 2 weeks, followed by 10,000 to 20,000 international units P.O. for 2 months. Follow with adequate dietary nutrition and RE vitamin A supplements. Children ages 1 to 8: 17,500 to 35,000 international units I.M. daily for 10 days. Infants: 7,500 to 15,000 international units I.M. daily for 10 days. ➤➤Maintenance dose to prevent recurrence of vitamin A deficiency Adults and children older than age 8: 10,000 to 20,000 international units P.O. daily for 2 months. Children infants to age 8: Give 5,000 to 10,000 international units P.O. daily for 2 months; then adequate dietary nutrition and RE vitamin A supplements.
vitamin B complex cyanocobalamin (vitamin B12)
Nascobal, Rapid B-12 Energy
hydroxocobalamin (vitamin B12) AVAILABLE FORMS cyanocobalamin Capsules: 1,000 mcg, 3,000 mcg Injection: 1,000 mcg/mL Intranasal spray: 500 mcg/spray Liquid: 1,000 mcg, 3,000 mcg, 5,000 mcg Lozenges: 50 mcg, 100 mcg, 250 mcg, 500 mcg, 1,000 mcg, 3,000 mcg, 5,000 mcg Oral spray: 200 mcg/spray Tablets: 50 mcg, 100 mcg, 250 mcg, 500 mcg, 1,000 mcg, 5,000 mcg Tablets (extended-release): 1,000 mcg, 1,500 mcg Tablets (S.L.): 500 mcg, 1,000 mcg, 1,500 mcg, 2,500 mcg, 3,000 mcg, 5,000 mcg, 6,000 mcg hydroxocobalamin Injection: 1,000 mcg/mL Canada
OTC
Off-label use
INDICATIONS & DOSAGES
➤➤RDA for cyanocobalamin
Adults and children age 14 and older: 2.4 mcg. Children ages 9 to 13: 1.8 mcg. Children ages 4 to 8: 1.2 mcg. Children ages 1 to 3: 0.9 mcg. Infants ages 6 months to 1 year: 0.5 mcg. Neonates and infants younger than age 6 months: 0.4 mcg. Pregnant women: 2.6 mcg. Breast-feeding women: 2.8 mcg. ➤➤Vitamin B12 deficiency from inadequate diet, subtotal gastrectomy, or other condition, disorder, or disease, except malabsorption, related to pernicious anemia or other GI disease Adults: 30 mcg hydroxocobalamin I.M. daily for 5 to 10 days, depending on severity of deficiency. Maintenance dose is 100 to 200 mcg I.M. once monthly or 500 mcg gel intranasally once weekly. For subsequent prophylaxis, advise adequate nutrition and daily RDA vitamin B12 supplements. Children: 1 to 5 mg hydroxocobalamin in single doses of 100 mcg I.M. over 2 or more weeks, depending on severity of deficiency. Maintenance dose is 30 to 50 mcg I.M. every 4 weeks. For subsequent prophylaxis, advise adequate nutrition and daily RDA vitamin B12 supplements. ➤➤Pernicious anemia or vitamin B12 malabsorption Adults: Initially, 100 mcg cyanocobalamin I.M. or Subcut. daily for 6 to 7 days. If response is observed, 100 mcg I.M. or Subcut. every other day for 7 doses, then 100 mcg every 3 to 4 days for 2 to 3 weeks; then 100 mcg I.M. or Subcut. once monthly. ➤➤Maintenance therapy for remission of pernicious anemia after I.M. vitamin B12 therapy in patients without nervous system involvement; dietary deficiency, malabsorption disorders, and inadequate secretion of intrinsic factor Adults: Initially, 1 spray in one nostril once weekly (Nascobal). Give at least 1 hour before or after hot foods or liquids. Or 1 spray in each nostril daily. May increase to 1 spray in each nostril b.i.d. (total daily dose of 100 mcg) as needed. ➤➤Schilling test flushing dose Adults and children: 1,000 mcg hydroxocobalamin I.M. as single dose. ➤➤Cyanide poisoning Adults: Initially, 5 g hydroxocobalamin I.V. over 15 minutes. Based on patient’s condition, may repeat 5 g dose I.V. over 15 minutes to 2 hours.
coenzyme Q10
Chew Q, CoQ10, H2Q, LiQsorb, Qunol Mega CoQ10, Q-Gel Mega, Vitaline CoQ10 AVAILABLE FORMS Capsules: 10 mg, 30 mg, 50 mg, 60 mg, 75 mg, 100 mg, 120 mg, 150 mg, 200 mg, 400 mg Capsules (extended-release): 100 mg Do not crush
*Liquid contains alcohol.
Oral liquid: 2.5 mg/drop, 6 mg/mL, 20 mg/mL, 100 mg/mL Tablets: 50 mg, 60 mg, 100 mg Tablets (chewable): 30 mg, 100 mg Wafers: 60 mg, 100 mg, 300 mg, 400 mg, 600 mg INDICATIONS & DOSAGES ➤➤Dietary supplement for conditions associated with coenzyme Q10 deficiency Adults: 10 to 300 mg/day P.O. in one or divided doses. Higher doses (up to 3,000 mg/day) have been used.
folic acid (vitamin B9) FA-8
AVAILABLE FORMS Injection: 10-mL vials (5 mg/mL with 1.5% benzyl alcohol, 5 mg/mL with 1.5% benzyl alcohol and 0.2% ethylenediaminetetraacetic acid) Capsules: 5 mg, 20 mg Tablets: 0.4 mg, 0.8 mg, 1 mg INDICATIONS & DOSAGES
➤➤RDA
Adults and children age 14 and older: 400 mcg. Children ages 9 to 13: 300 mcg. Children ages 4 to 8: 200 mcg. Children ages 1 to 3: 150 mcg. Infants ages 7 months to 1 year: 80 mcg. Neonates and infants younger than age 6 months: 65 mcg. Pregnant women: 600 mcg. Breast-feeding women: 500 mcg. ➤➤Megaloblastic or macrocytic anemia from folic acid or other nutritional deficiency, hepatic disease, alcoholism, intestinal obstruction, or excessive hemolysis Adults and children age 4 and older: 0.4 to 1 mg P.O., I.M., or Subcut. daily. After anemia caused by folic acid deficiency is corrected, proper diet and RDA supplements are needed to prevent recurrence. Children younger than age 4: Up to 0.3 mg P.O., I.M., or Subcut. daily. Pregnant and breast-feeding women: 0.8 mg P.O., I.M., or Subcut. daily. ➤➤To prevent fetal neural tube defects during pregnancy Adults: 400 to 800 mcg P.O. daily before conception through at least first 4 to 12 weeks of fetal formation. For women at high risk, recommended dosage is 4 mg daily starting up to 3 months before conception and through first 3 months of pregnancy. ➤➤Methotrexate-induced toxicity Adults with Crohn disease: 5 mg P.O. once a week beginning 3 days after methotrexate. Adults with psoriasis: 5 mg P.O. 48 hours after methotrexate for 1 to 3 days. Adults with RA: At least 5 mg P.O. per week. Children with Crohn disease: 5 mg P.O. beginning 24 hours after each dose of methotrexate. Canada
OTC
Off-label use
leucovorin calcium (citrovorum factor, folinic acid) AVAILABLE FORMS Injection: 50-mg, 100-mg, 200-mg, 350-mg, 500-mg vials for reconstitution (contains no preservatives) Tablets: 5 mg, 10 mg, 15 mg, 25 mg INDICATIONS & DOSAGES
➤➤Leucovorin rescue after high-dose
ethotrexate therapy m Adults: 15 mg (approximately 10 mg/m2) P.O., I.M., or I.V. every 6 hours for 10 doses starting 24 hours after start of methotrexate infusion. Continue treatment until methotrexate level is less than 5 × 10–8 M, as follows: If serum methotrexate level is approximately 10 micromolar at 24 hours after administration, 1m icromolar at 48 hours, and less than 0.2 micromolar at 72 hours, give 15 mg every 6 hours for 60 hours; if serum methotrexate level remains above 0.2 micromolar at 72 hours and more than 0.05 micromolar at 96 hours, continue 15 mg every 6 hours until methotrexate level is less than 0.05 micromolar; if serum methotrexate level is 50 micromolar or more at 24 hours, or 5 micromolar or more at 48 hours, or if there is a 100% increase in serum creatinine level at 24 hours, give 150 mg I.V. every 3 hours until methotrexate level is less than 1 micromolar; then 15 mg I.V. every 3 hours until methotrexate level is less than 0.5 micromolar. ➤➤Impaired methotrexate elimination or inadvertent overdose Adults: 10 mg/m2 P.O., I.M., or I.V. every 6 hours until serum methotrexate level is less than 10–8 M. If 24-hour serum creatinine level increases 50% over baseline or if 24-hour methotrexate level is greater than 5 × 10–6 M or 48-hour level is greater than 9 × 10–7 M, increase dosage to 100 mg/m2 I.V. every 3 hours until methotrexate level is less than 10–8 M. ➤➤Folate-deficient megaloblastic anemia Adults and children: Up to 1 mg I.M. daily. ➤➤Palliative treatment of advanced colorectal cancer Adults: 20 mg/m2 I.V. followed by 5-FU 425 mg/m2 I.V. Or, 200 mg/m2 I.V. (over 3 minutes or longer) followed by 5-FU 370 mg/m2 daily for 5 consecutive days. Repeat at 4-week intervals for two additional courses; then at intervals of 4 to 5 weeks, if tolerated.
niacin (nicotinic acid, vitamin B3)
Endur-Acin, Niacor, Niaspan, Slo-Niacin
niacinamide (nicotinamide) AVAILABLE FORMS niacin Capsules (timed-release): 250 mg, 500 mg Do not crush
*Liquid contains alcohol.
Tablets: 50 mg, 100 mg, 250 mg, 500 mg Tablets (extended-release): 250 mg, 400 mg, 500 mg, 750 mg, 1,000 mg niacinamide Tablets: 100 mg, 500 mg Tablets (extended-release): 500 mg INDICATIONS & DOSAGES
➤➤RDA
Adult men and boys ages 14 to 18: 16 mg. Adult women and girls ages 14 to 18: 14 mg. Children ages 9 to 13: 12 mg. Children ages 4 to 8: 8 mg. Children ages 1 to 3: 6 mg. Infants ages 7 months to 1 year: 4 mg. Neonates and infants younger than age 6 months: 2 mg. Pregnant women: 18 mg. Breast-feeding women: 17 mg. ➤➤Pellagra Adults: Initially, 500 mg Niaspan P.O. daily at bedtime. Titrate to patient response and tolerance. Maximum dose is 2,000 mg daily. ➤➤Niacin deficiency Adults: Up to 100 mg P.O. daily. ➤➤Hyperlipidemias, especially with hypercholesterolemia Adults: 250 mg Niacor P.O. daily after evening meal. Increase at 4- to 7-day intervals up to 1 to 2 g P.O. daily in two or three divided doses. Maximum 6 g daily. Or, 1 to 2 g extended-release tablets P.O. daily at bedtime.
paricalcitol Zemplar
AVAILABLE FORMS Capsules: 1 mcg, 2 mcg, 4 mcg Injection: 2 mcg/mL, 5 mcg/mL
OTC
B-6, B-Natal, Vitamin B-6, Vitamin B-6 ER AVAILABLE FORMS Capsules: 250 mg Injection: 100 mg/mL Tablets: 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 500 mg Tablets (extended-release): 200 mg INDICATIONS & DOSAGES
➤➤RDA
Adults ages 19 to 50: 1.3 mg. Men age 51 and older: 1.7 mg. Women age 51 and older: 1.5 mg. Boys ages 14 to 18: 1.3 mg. Girls ages 14 to 18: 1.2 mg. Children ages 9 to 13: 1 mg. Children ages 4 to 8: 0.6 mg. Children ages 1 to 3: 0.5 mg. Infants ages 7 months to 1 year: 0.3 mg. Neonates and infants younger than age 6 months: 0.1 mg. Pregnant women: 1.9 mg. Breast-feeding women: 2 mg. ➤➤Dietary vitamin B6 deficiency Adults: 100 to 200 mg P.O. daily. Or, 10 to 20 mg I.M. or I.V. daily for 3 weeks; then maintenance dose is 2 to 5 mg P.O. daily for several weeks. ➤➤Antidote for isoniazid poisoning Adults: 4 g I.V.; then 1 g I.M. every 30 minutes until amount of pyridoxine given equals amount of isoniazid ingested.
sodium fluoride
INDICATIONS & DOSAGES ➤➤To prevent or treat secondary hyperparathyroidism in patients with stage 3 or 4 chronic kidney disease Adults: Initial dose is based on baseline intact parathyroid hormone (iPTH) levels. If iPTH is less than or equal to 500 picograms (pg)/mL, give 1 mcg P.O. daily or 2 mcg P.O. three times weekly, no more often than every other day. If iPTH is greater than 500 pg/mL, give 2 mcg P.O. daily or 4 mcg P.O. three times w eekly, no more often than every other day. Adjust dose at 2to 4-week intervals, based on iPTH levels. ➤➤To prevent or treat secondary hyperparathyroidism in patients with chronic renal failure Adults: 0.04 to 0.1 mcg/kg (2.8 to 7 mcg) I.V. no more often than every other day during dialysis. Doses as high as 0.24 mcg/kg (16.8 mcg) may be safely given. If satisfactory response isn’t observed, increase dosage by 2 to 4 mcg at 2- to 4-week intervals. Canada
pyridoxine hydrochloride (vitamin B6)
Off-label use
Fluor-A-Day, Fluoritab, Flura, Flura-Loz, Karidium, Ludent, Luride Lozi-Flur, Pedi-Dent, Pharmaflur df, Pharmaflur 1.1, Phos-Flur
sodium fluoride, topical
ACT, Denta5000 Plus, EtheDent, Fluorigard, Fluorinse, Gel-Kam, Gel-Tin, Just For Kids, Karigel, Karigel-N, Listerine Tooth Defense, Luride, MouthKote F/R, Point-Two, Prevident, SF 5000 Plus, Stop Gel, Thera-Flur, Thera-Flur-N AVAILABLE FORMS sodium fluoride Drops: 0.125 mg/drop, 0.25 mg/drop, 0.2 mg/mL, 0.5 mg/mL Lozenges: 1 mg Tablets: 1 mg Tablets (chewable): 0.25 mg, 0.5 mg, 1 mg Do not crush
*Liquid contains alcohol.
sodium fluoride, topical Cream: 1.1% Gel: 0.1%, 0.5%, 1.1%, 1.2%, 1.23% Rinse: 0.02%, 0.04% INDICATIONS & DOSAGES
➤➤To prevent dental caries
Adults and children older than age 6: 5 to 10 mL of rinse or thin ribbon of gel applied to teeth with toothbrush or mouth trays for at least 1 minute at bedtime. If fluoride ion level in drinking water is less than 0.3 parts/million (ppm) Children ages 6 to 16: 1 mg P.O. daily. Children ages 3 to 5: 0.5 mg P.O. daily. Infants and children ages 6 months to 2 years: 0.25 mg P.O. daily. If fluoride ion level in drinking water is 0.3 to 0.6 ppm Children ages 6 to 16: 0.5 mg P.O. daily. Children ages 3 to 5: 0.25 mg P.O. daily.
thiamine hydrochloride (vitamin B1) Betaxin, Thiamiject
AVAILABLE FORMS Capsules: 50 mg Injection: 100 mg/mL Tablets: 50 mg, 100 mg, 250 mg, 500 mg INDICATIONS & DOSAGES
➤➤RDA
Adult men: 1.2 mg. Adult women: 1.1 mg. Boys ages 14 to 18: 1.2 mg. Girls ages 14 to 18: 1.2 mg. Children ages 9 to 13: 0.9 mg. Children ages 4 to 8: 0.6 mg. Children ages 1 to 3: 0.5 mg. Infants ages 7 months to 1 year: 0.3 mg. Neonates and infants younger than age 6 months: 0.2 mg. Pregnant women: 1.4 mg. Breast-feeding women: 1.4 mg. ➤➤Beriberi Adults: Depending on severity, 10 to 20 mg I.M. t.i.d. for 2 weeks; then dietary correction and multivitamin supplement containing 5 to 10 mg thiamine daily for 1 month. Children: 25 mg I.V. daily. ➤➤Wet beriberi with myocardial failure Adults and children: 10 to 20 mg I.V. t.i.d. ➤➤Wernicke encephalopathy Adults: Initially, 100 mg I.V.; then 50 to 100 mg I.M. daily until patient is consuming a regular balanced diet. ➤➤Thiamine deficiency Adults: 100 mg/L I.V. as rapidly as possible. Continue daily parenteral doses at RDA if GI disturbances Canada
OTC
Off-label use
p revent adequate oral absorption. Or, 1 tablet or capsule P.O. daily. ➤➤Neuritis of pregnancy in patients unable to take adequate oral therapy due to vomiting Adults: 5 to 10 mg I.M. daily.
vitamin C (ascorbic acid)
Acerola, Ascocid, Ascor L 500, Asco-Tabs, C-Caps, Cemill, Chew-C, Halls Defense Vitamin C Drops AVAILABLE FORMS Capsules: 500 mg Capsules (timed-release): 500 mg Crystals: 1,000 mg/¼ tsp Injection: 500 mg/mL Lozenges: 60 mg Oral solution: 100 mg/mL, 500 mg/15 mL Powder: 60 mg/¼ tsp, 1,060 mg/¼ tsp Tablets: 250 mg, 500 mg, 1,000 mg, 1,500 mg Tablets (chewable): 250 mg, 500 mg Tablets (timed-release): 500 mg, 1,000 mg Wafer: 500 mg INDICATIONS & DOSAGES
➤➤RDA
Men age 19 and older: 90 mg. Women age 19 and older: 75 mg. Boys ages 14 to 18: 75 mg. Girls ages 14 to 18: 65 mg. Children ages 9 to 13: 45 mg. Children ages 4 to 8: 25 mg. Children ages 1 to 3: 15 mg. Infants ages 7 months to 1 year: 50 mg. Neonates and infants up to age 6 months: 40 mg. Pregnant women: 80 to 85 mg. Breast-feeding women: 115 to 120 mg. ➤➤Frank and subclinical scurvy Adults: Depending on severity, 100 to 300 mg P.O. or 300 to 1,000 mg I.V., I.M., or Subcut. daily. Children: Depending on severity, 100 to 300 mg P.O. daily. ➤➤Extensive burns, delayed fracture or wound healing, postoperative wound healing, severe febrile or chronic disease states Adults: 200 to 500 mg I.V., I.M., or Subcut. daily for 7 to 10 days; 1 to 2 g daily for extensive burns. Children: 100 to 200 mg P.O., I.V., I.M., or Subcut. daily.
Do not crush
*Liquid contains alcohol.
vitamin D cholecalciferol (vitamin D3)
Baby Ddrops, Bio-D-Mulsion, Decara, Delta-D, D-Vi-Sol, D-Vita, JustD, Replesta, VitaMelts
ergocalciferol (vitamin D2) Calcidol, Calciferol, Drisdol
AVAILABLE FORMS cholecalciferol Capsules: 10 mcg (400 international units), 25 mcg (1,000 international units), 50 mcg (2,000 international units), 125 mcg (5,000 international units), 250 mcg (10,000 international units), 625 mcg (25,000 international units), 1.25 mg (50,000 international units) Liquid: 400 international units/mL, 400 international units/0.03 mL, 1,000 international units/0.03 mL, 2,000 international units/0.03 mL, 1,000 international units/spray, 1,000 international units/10 mL, 5,000 international units/mL Tablets: 10 mcg (400 international units), 25 mcg (1,000 international units), 50 mcg (2,000 international units), 75 mcg (3,000 international units), 125 mcg (5,000 international units) Tablets (chewable): 10 mcg (400 international units), 25 mcg (1,000 international units), 50 mcg (2,000 international units), 125 mcg (5,000 international units) Tablets (dispersible): 25 mcg (1,000 international units) Wafers: 350 mcg (14,000 international units), 1.25 mg (50,000 international units) ergocalciferol Capsules: 1.25 mg (50,000 international units) Oral liquid: 200 mcg (8,000 international units)/mL in 60-mL dropper bottle Tablets: 10 mcg (400 international units), 50 mcg (2,000 international units) INDICATIONS & DOSAGES
➤➤RDA for cholecalciferol
Adults older than age 70: 15 mcg (600 international units). Adults ages 51 to 70: 10 mcg (400 international units). Infants, children, and adults up to age 50: 5 mcg (200 international units). Pregnant or breast-feeding women: 5 mcg (200 international units). ➤➤RDA for ergocalciferol Adults older than age 70: 20 mcg (800 international units). Adults up to age 70 and children age 1 and older: 15 mcg (600 international units). Children from birth to less than 12 months: 10 mcg (400 international units). ➤➤Rickets and other vitamin D deficiency diseases Adults and children: Initially, 12,000 international units P.O. daily; expect to increase, based on response, Canada
OTC
Off-label use
to maximum of 500,000 international units daily. After correction of deficiency, maintenance includes adequate diet and RDA supplements. ➤➤Hypoparathyroidism Adults and children: 1.25 to 5 mg (50,000 to 200,000 international units) ergocalciferol P.O. daily with calcium supplement.
vitamin D analogue doxercalciferol Hectorol
AVAILABLE FORMS Capsules: 0.5 mcg, 1 mcg, 2.5 mcg Injection: 2 mcg/mL INDICATIONS & DOSAGES
➤➤Secondary hyperparathyroidism in dialysis
p atients with chronic kidney disease Adults: Initially, 10 mcg P.O. three times weekly at dialysis. Adjust dosage as needed to lower intact parathyroid hormone (iPTH) levels to 150 to 300 picograms (pg)/mL. Increase dose by 2.5 mcg at 8-week intervals if iPTH level hasn’t decreased by 50% and fails to reach target range. Maximum dose is 20 mcg P.O. three times weekly. If iPTH levels fall below 100 pg/mL, suspend drug for 1 week; then give dose of at least 2.5 mcg less than last dose. Or, 4 mcg I.V. bolus three times a week at the end of dialysis, about every other day. Adjust dose as needed to lower iPTH levels to 150 to 300 pg/mL. Dosage may be increased by 1 to 2 mcg at 8-week intervals if the iPTH level isn’t decreased by 50% and fails to reach target range. Maximum dose is 18 mcg weekly. If iPTH levels go below 100 pg/mL, suspend drug for 1 week, then resume at a dose that’s at least 1 mcg P.O. lower than the last dose. ➤➤Secondary hyperparathyroidism in predialysis patients with stage 3 or 4 chronic kidney disease Adults: 1 mcg P.O. daily. Adjust dosage as needed to lower iPTH levels to 35 to 70 pg/mL for stage 3 or 70 to 110 pg/mL for stage 4. Increase dosage at 2-week intervals by 0.5 mcg if levels are above 70 pg/ mL for stage 3 or above 110 pg/mL for stage 4. If level falls below 35 pg/mL for stage 3 or 70 pg/mL for stage 4, suspend treatment for 1 week, then give dose at least 0.5 mcg lower than last dose. Maximum dose, 3.5 mcg daily.
vitamin E (tocopherols)
Alpha-E, E 1000, Nutr-E-Sol AVAILABLE FORMS Capsules: 100 international units, 200 international units, 400 international units, 600 international units, 1,000 international units Liquid: 15 international units/0.3 mL, 100 international units/0.25 mL, 400 international units/15 mL Do not crush
*Liquid contains alcohol.
Tablets: 100 international units, 200 international units, 400 international units INDICATIONS & DOSAGES Note: RDAs for vitamin E have been converted to α-tocopherol equivalents (α-TE). One α-TE equals 1 mg of D-α tocopherol, or 1.49 international units. ➤➤RDA Adults and children ages 14 to 18: 15 mg. Children ages 9 to 13: 11 mg. Children ages 4 to 8: 7 mg. Children ages 1 to 3: 6 mg. Infants ages 7 months to 1 year: 5 mg. Neonates and infants younger than age 6 months: 4 mg. Pregnant women: 15 mg. Breast-feeding women: 19 mg.
vitamin K analogue phytonadione (vitamin K1)
K-100, Mephyton, Phytonadione, Vitamin K1 AVAILABLE FORMS Injection (emulsion): 1 mg/0.5 mL, 10 mg/mL Tablets: 100 mcg, 5 mg INDICATIONS & DOSAGES Black Box Warning Risk of severe and even fatal reactions using I.V. or I.M. routes; restrict their use to situations where the subcutaneous route isn’t feasible and the serious risk involved is considered justified. ➤➤RDA Men age 19 and older: 120 mcg. Women age 19 and older, including pregnant and breast-feeding women: 90 mcg. Children ages 14 to 18: 75 mcg. Children ages 9 to 13: 60 mcg. Children ages 4 to 8: 55 mcg. Children ages 1 to 3: 30 mcg. Infants ages 7 months to 1 year: 2.5 mcg. Neonates and infants younger than age 6 months: 2 mcg. ➤➤Hypoprothrombinemia caused by vitamin K malabsorption, drug therapy, or excessive vitamin A dosage Adults: Depending on severity, 2.5 to 25 mg P.O., I.M., or Subcut., repeated and increased up to 50 mg as needed. ➤➤Hypoprothrombinemia caused by effect of oral anticoagulants Adults: 2.5 to 10 mg P.O., I.M., or Subcut., based on PT and INR; repeat if needed within 12 to 48 hours after oral dose or within 6 to 8 hours after p arenteral dose. ➤➤To prevent hemorrhagic disease of newborn Neonates: 0.5 to 1 mg I.M. within 1 hour after birth. ➤➤Hemorrhagic disease of newborn Neonates: 1 mg Subcut. or I.M. Higher doses may be needed if mother has been receiving oral anticoagulants.
n
Canada
OTC
Off-label use
Do not crush
*Liquid contains alcohol.
