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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.06.04  Expand sub section  Vitamin D
Colecalciferol and Calcium Carbonate
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First Choice
Green

Available as:
- Calci-D chewable tablets (£2.25pm). (1 tablet od)
- Adcal D3 caplets (£2.95pm). (2 small caplets bd)
- Adcal D3 chewable tablets (£3.65pm). (1 tablet bd)
- Adcal D3 soluble tablets (£5.99pm). (1 tablet bd)

 
Colecalciferol with calcium phosphate (Calfovit D3®)
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Formulary
Green
 
Link  Link to reviews
Link  Nottinghamshire vitamin D guidelines
   
Colecalciferol
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Formulary
Green

OTC Patients should be advised to purchase vitamin D supplements for maintenance and prevention over the counter. See local vitamin D position statements for details and exceptions.

Low dose for maintenance or prevention (only prescribed in exceptional circumstances where self-care is not possible):
-Tablet: Stexerol-D3® (1000 units = 25 micrograms), Generic and Desunin® tablets (800 units = 20 micrograms)
-Capsule: Strivit-D3®, InVita-D3® or Fultium-D3® (800 units = 20 micrograms).
-Liquid: Fultium-D3® Drops 2740 units/ml. 25ml bottle. 12 drops contain 800 units.

High dose for treatment of deficiency (see guideline for doses):
-Capsule: InVita-D3® , Strivit-D3® or Fultium-D3®
-Liquid: InVita-D3 oral liquid in snap and squeeze ampoules.
-Tablet: Stexerol-D3®

  • Primary care prescribers encouraged to prescribe by brand name to avoid unlicensed specials being dispensed.
  • Therapeutically equivalent to ergocalciferol (ref: Martindale)
  • For routine dosing schedules see Nottinghamshire guidelines below. Higher doses may be used when a loading dose of Vitamin D is required prior to IV bisphosphonates (see zoledronic acid SPC).
 
Link  NICE ES28: Vitamin D, no evidence for preventing/ treating Covid-19
Link  Nottinghamshire APC Vitamin D guideline - Adults
Link  Nottinghamshire APC Vitamin D guideline - Children
Link  Nottinghamshire APC Vitamin D Patient Information Leaflet
Link  Link to reviews
Link  NUH: Memo re Desunin use
   
Alfacalcidol (One-Alpha®)
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Restricted Drug Restricted
Amber 2

Capsule, Oral Drops (expensive) and injection (Red-hospital only)

 
   
Calcitriol
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Restricted Drug Restricted
Amber 2

Capsule

 
   
Ergocalciferol
(Injection)
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Formulary
Amber 2

Injection (300,000 units or 600,000 units)

 
   
Paricalcitol (Zemplar®)
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Restricted Drug Restricted
Red
Capsules, Injection
  • NUH only. If needed at SFH, supplied direct to dialysis unit from NUH pharmacy.
  • Decision to prescribe should be made by a consultant nephrologist. 
  • Link  Guidelines for the Management of Chronic Kidney Disease Mineral Bone Disease in Adults
       
     ....
     Non Formulary Items
    Calcitriol  (Calcijex®)

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    Non Formulary
    Grey
     
    Calcitriol  (Rocaltrol®)

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    Non Formulary
    Grey
     
    Calcium and Ergocalciferol

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    Non Formulary
    Grey
    Tablet
     
    Calcium Carbonate with Colecalciferol

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    Non Formulary
    Grey
    See formulary Adcal-D3® entry above. Other brand names include:
  • Accrete D3®
  • Cacit® D3 effervescent granules sachet
  • Calceos® chewable tablet
  • Calcichew-D3® caplet
  • Calcichew-D3® chewable tablet
  • Calcichew-D3® Forte chewable tablet
  • Evacal D3® chewable tablet
  • Kalcipos-D® chewable tablet
  • Natecal D3® chewable tablet
  • TheiCal-D3® chewable tablet
  •  
    Colecalciferol
    (With alendronic acid )

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    Non Formulary
    Grey
     
    Colecalciferol 1,000 units  (Sunvit D3®)

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    Non Formulary
    Grey
    Tablet (unlicensed)
  • 1,000units = 25micrograms
  • Now use Desunin 800 unit tablets (licensed)
  • Link  Link to reviews
     
    Colecalciferol 10,000units/ml drops  (Thorens®)

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    Non Formulary
    Grey
    No formal assessment
     
    Colecalciferol 2,400 units/ml drops  (Invita D3® oral drops)

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    Non Formulary
    Grey

    No formal assessment

    • See above formulary entry for Invita D3 25,000u/ml liquid.
     
    Colecalciferol 3,000 units per ml liquid

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    Non Formulary
    Grey
  • No longer on formulary as other preparations are available at significantly lower cost (~£120 per bottle. This preparation is not recommended in either paediatric or adult vitamin D guidelines.
  • The licensed product (Thame labs) contains nuts and is therefore not suitable for patients with nut allergy.
  • An alternative unlicensed product is available for those with nut allergies - named patient use only. Cost in primary care may differ significantly.
  • 1mL = 3,000 units = 75 micrograms.
  • Link  Link to reviews
    Link  NUH: colecalciferol liquid memo July 2015
     
    Colecalciferol 3200 unit capsules  (Fultium D3®)

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    Non Formulary
    Grey
    Dosing doesn’t fit with local Vitamin D guidelines. Formulary options for Vitamin D products will be reviewed alongside the guideline update.
     
    Colecalciferol 4000 units  (Desunin®)
    (Tablets)

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    Non Formulary
    Grey
    No formal assessment. Assessed by September 2016 APC.
     
    Dihydrotachysterol  (AT 10®)

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    Non Formulary
    Grey
     
    Ergocalciferol
    (Oral)

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    Non Formulary
    Grey
    Ongoing supply problems since May 2010
  • Also known as calciferol or Vitamin D2.
  • Therapeutically equivalent to colecalciferol (ref: Martindale)
  •  
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

    OTC

      

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