Dekristol® (colecalciferol)

Dekristol® contains the active ingredient colecalciferol (vitamin D3) in high-dose form and is used to treat a confirmed vitamin D deficiency. It is available as a soft capsule in a strength of 20,000 IU (international units).

Vitamin D3 is essential for calcium absorption, bone health, and the immune system. According to the Robert Koch Institute, about 60% of the population in Germany has suboptimal vitamin D levels, especially in the winter months.

Dekristol® 20,000 IU is prescription-only and is used for the initial loading therapy of a severe deficiency. Lower doses (up to 1,000 IU) are available without a prescription.

Mechanism of action:

• Colecalciferol (vitamin D3) is converted in the liver to 25-OH vitamin D (calcidiol)
• In the kidney, it is further activated to 1,25-(OH)2 vitamin D (calcitriol)
• Calcitriol is the biologically active hormone

Effects of vitamin D:

• Increases calcium absorption in the intestine
• Promotes bone mineralization
• Regulates calcium and phosphate metabolism
• Supports immune function (T cells, macrophages)
• Influences muscle function
• Modulates cell growth

Vitamin D deficiency (25-OH vitamin D < 20 ng/ml) can lead to:

• Osteomalacia (softening of the bones)
• Osteoporosis (bone loss)
• Muscle weakness and an increased risk of falls
• Increased susceptibility to infections

Dekristol® is suitable for:

• Adults with a confirmed vitamin D deficiency (25-OH vitamin D < 20 ng/ml)
• Loading therapy in severe deficiency (< 12 ng/ml)
• Prevention and treatment of osteoporosis (as an adjunct)
• Older people with a confirmed vitamin D deficiency

Not suitable:

• Hypercalcemia (elevated calcium level)
• Hypercalciuria (increased calcium excretion in the urine)
• Kidney stones (calcium stones)
• Severe renal insufficiency (conversion impaired)

Loading therapy for severe deficiency:

• 20,000 IU (1 soft capsule) once a week
• Duration: usually 4 to 5 weeks, depending on your doctor's decision

Maintenance therapy:

• After the first month, your doctor may consider a lower dose depending on your vitamin D level and your response to treatment
• Or switch to daily dosing (800–2,000 IU, available without a prescription)

Target level:

• 25-OH vitamin D: 30–60 ng/ml (75–150 nmol/L)

Monitoring:

• Check blood levels 6–8 weeks after starting therapy
• Also measure calcium levels during high-dose therapy

How to take:

• Swallow the soft capsule whole with water
• Ideally with a meal containing fat (improves absorption)
• With weekly dosing: always on the same day of the week

Important information:

• Do not take without a confirmed deficiency (blood test!)
• Overdosing over months can cause hypercalcemia
• Pay attention to calcium intake (important together with vitamin D)
• Do not take at the same time as other high-dose vitamin D preparations

Dekristol® must not be taken in cases of:

• Hypercalcemia
• Hypercalciuria
• Nephrolithiasis (calcium stones)
• Severe renal insufficiency
• Vitamin D overdose
• Hypersensitivity to colecalciferol

Caution in cases of:

• Sarcoidosis, tuberculosis (elevated calcium levels possible)
• Impaired renal function (elevated calcium levels possible)
• Concomitant use of thiazide diuretics (increase calcium)
• Cardiac glycoside therapy (digitalis → risk of arrhythmia with hypercalcemia)
• Immobilization (increased risk of hypercalcemia)

Rare when dosed correctly:

• Gastrointestinal complaints (nausea, constipation)
• Headache
• Allergic reactions (very rare)

With overdose (hypercalcemia):

• Nausea, vomiting, loss of appetite
• Thirst, increased urination
• Constipation
• Fatigue, weakness
• Muscle pain
• In extreme cases: kidney calcification, kidney stones, cardiac arrhythmias

Note: An overdose is very unlikely when used as intended under medical supervision. During treatment with doses above 1,000 IU of vitamin D per day, calcium levels in the blood and urine must be monitored and kidney function must be checked.