Pharmacologic therapy for vitamin D deficiency
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Cholecalciferol (vitamin D3) supplementation should be used for vitamin D repletion because it may be more effective in preventing nonvertebral fractures. (Strength of Recommendation [SOR]: B, based on subgroup analysis of randomized controlled trials [RCTs].) Cholecalciferol produces higher serum 25-hydroxyvitamin D levels than ergocalciferol (vitamin D2). Vitamin D therapy may be given daily or weekly with equal effectiveness; the dosage depends on the degree of deficiency. (SOR: C, based on an RCT and cohort study.) The cumulative dosage is more important than dosing frequency, so the choice of daily, weekly, or monthly dosing can be based on patient preference. (SOR: C, based on an RCT.) Vitamin D levels should be rechecked after three months to ensure adequate response. (SOR: C, based on an observational study.)
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