Onset of action: 10 to 24 hours Maximum effect: ~1 month following daily dosesĪbsorption: Absorbed in the small intestine fat soluble requires bile It is parathyroid hormone that is responsible for the regulation of such metabolism at the level of the kidneys There exists a period of 10 to 24 hours between the administration of cholecalciferol and the initiation of its action in the body due to the necessity of synthesis of the active vitamin D metabolites in the liver and kidneys. Conversely, these vitamin D metabolites also assist in mobilizing calcium and phosphate from bone and likely increase the reabsorption of calcium and perhaps also of phosphate via the renal tubules. These vitamin D metabolites subsequently facilitate the active absorption of calcium and phosphorus in the small intestine, serving to increase serum calcium and phosphate levels sufficiently to allow bone mineralization.
The first hydroxylation of vitamin D3 cholecalciferol (or D2) occurs in the liver to yield 25-hydroxyvitamin D while the second hydroxylation happens in the kidneys to give 1, 25-dihydroxyvitamin D. The in vivo synthesis of the predominant two biologically active metabolites of vitamin D occurs in two steps. Vitamin D supplementation is recommended in exclusively breast fed infants. Consider monitoring the infant’s serum calcium if the mother is receiving pharmacologic doses of vitamin D. Make allowance for any maternal dose if prescribing this product to a breast fed infant. Use is not recommended unless the clinical condition of the woman requires treatment. The required dose of vitamin D during lactation has not been adequately studied doses similar to those for pregnant women have been suggested.Ĭhronic ingestion of large doses of vitamin D by the mother may lead to hypercalcemia in the breastfed infant.
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