50000 IU vitamin D daily toxic after 3 months
Hypervitaminosis D Associated with a Vitamin D Dispensing Error
Ann Pharmacother September 13, 2011 aph.1Q330
Ryan B Jacobsen, PharmD, Clinical Pharmacy Specialist?1 ryan-jacobsen@uiowa.edu
Brett W Hronek, MD, Resident Physician?2,
Ginelle A Schmidt, PharmD, Assistant Professor?3 and
Margo L Schilling, MD, Professor?1*
1 University of Iowa Hospitals and Clinics; Assistant Professor (Clinical), College of Pharmacy, University of Iowa, Iowa City, IA
2 Department of Internal Medicine, University of Iowa Hospitals and Clinics
3 College of Pharmacy, Drake University, Des Moines, IA; Clinical Pharmacist, Penn Avenue Internal Medicine, Des Moines
4 Department of Internal Medicine, University of Iowa Hospitals and Clinics
OBJECTIVE: To report a case of hypervitaminosis D resulting in hypercalcemia and acute kidney injury in a 70-year-old female who was prescribed a standard dose of vitamin D but given a toxic dose of vitamin D 50,000 IU (1.25 mg) daily resulting from a dispensing error.
CASE SUMMARY: A 70-year-old female in her usual state of health was instructed to begin supplementation with vitamin D 1000 IU daily. Three months later she developed confusion, slurred speech, unstable gait, and increased fatigue . She was hospitalized for hypercalcemia and acute kidney injury secondary to hypervitaminosis D. All vitamin D supplementation was discontinued and 5 months after discharge, the patient's serum calcium and vitamin D concentrations, as well as renal function, had returned to baseline values. Upon review of the patient's records, it was discovered that she had been taking vitamin D 50,000 IU daily.
DISCUSSION: There is an increased interest in vitamin D, resulting in more health care providers recommending-and patients taking-supplemental vitamin D. Hypervitaminosis D is rarely reported and generally only in the setting of gross excess of vitamin D. This report highlights a case of hypervitaminosis D in the setting of a prescribed standard dose of vitamin D that resulted in toxic ingestion of vitamin D 50,000 IU daily due to a dispensing error . As more and more people use vitamin D supplements, it is important to recognize that, while rare, hypervitaminosis D is a possibility and dosage conversion of vitamin D units can result in errors.
CONCLUSIONS: Health care providers and patients should be educated on the advantages and risks associated with vitamin D supplementation and be informed of safety measures to avoid hypervitaminosis D. In addition, health care providers should understand dosage conversion regarding vitamin D and electronic prescribing and dispensing software should be designed to detect such errors.
Note: Her body naturally reduced the vitamin D level. No drugs required
See also VitaminDWiki
- Overview Toxicity of vitamin D which has the following graph
