Is this prescription too high?

[daffodilqueen]

Good morning, concerned that Rheumatologist has given me a prescription for Calciferol 20,000 IU's = 500 micrograms which I have to take three days a week for five weeks prior to Reclast infusion. It gives me severe indigestion and I feel incredibly sick, is this dose too high? Your valued comments would be appreciated.

[MrsNails]

Hi, l can’t comment on the actual usual dose but the best person to check with, is the Rheumatologist’s Secretary. If it had been an unusually large dose the Pharmacist should have picked up on it.

I’ll check the dose out online & add it to my answer shortly.

Kind Regards

MrsN

[daffodilqueen in reply to MrsNails]

Thank you

[MrsNails in reply to daffodilqueen]

Hi Daffodil

It seems to be a ready available product at that dose, as it’s in advance of your Reclast Infusion it maybe a very specific dose.

Have you read the Patient Information Leaflet about how to take it & warnings contraindications etc. I had some Antibiotics a couple of weeks ago that advised Standing Up to take them with a full glass of water & they caused me problems which are only now settling.

I’d check in with your Pharmacist for advice on the best way to take them.

This is some information

medicines.org.uk/emc/produc...

Patient Information Leaflet

medicines.org.uk/emc/files/...

[daffodilqueen in reply to MrsNails]

Thank you for your valued advice, I will speak to pharmacy today and ring my Rheumatologist on Monday.

[PMRpro Ambassador]

Had you had a blood test showing that your vit D level was low?

Reclast (or any other bisphosphonate) will only work if the vit D and calcium levels in the body are correct. The dose you have been given is a normal dose in terms of replenishing vit D levels but some people do struggle with it given in big dollops. The recommended approach in most Trusts is 60,000 IU per week given over 8-10 weeks before rechecking the blood level. The dose can be in one once a week or divided over a few days as yours is.

Are you taking it with food? My husband was given drops to sprinkle onto a slice of bread which worked (even for him) but now he buys a spray form for regular use which he prefers.

If your blood level is low you do need it - but 5 weeks of feeling sick wouldn't appeal to me either.

[daffodilqueen in reply to PMRpro]

Thank you for responding I did have blood tests and my vitamin d level was borderline. Perhaps a lower dose over longer would be preferable I will speak to rheumatologist hopefully on Monday your advices are really appreciated thank you

[daffodilqueen in reply to daffodilqueen]

Yes I do take it with food

[PMRpro Ambassador in reply to daffodilqueen]

I gather there is evidence that a lower dose over longer is more effective at increasing the blood level - here I think the usual weekly dose is about 25000 IU. I must say, I don't understand the hurry - as far as I klnow, the infusion works over a long period after it is given so the need for vit D (and calcium) is ongoing.

[daffodilqueen]

Interesting info will update after Monday thank you for your help

[piglette]

Do you know why you were prescribed Calciferol by the rheumatologist and also Reclast. Did you have a Dexascan of your bones showing low bone density? Do you know what your actual vitamin D reading was? You should be able to get copies of your blood tests. I find it is a good idea as I find doctors do not always check.

[Rugger]

My vitamin D level was found to be low and I was prescribed 50,000 IU once a week for 8 weeks to top me up, before being prescribed a lower daily dose. The information leaflet for the megadose said to be taken "preferably with a large meal"!

Best wishes.

[daffodilqueen in reply to Rugger]

Thank you