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 Formulary Chapter 9: Nutrition and blood - Full Chapter
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09.06.04  Expand sub section  Vitamin D
Colecalciferol  (Invita D3® )
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First Choice
Green
  • Preferred brand when prescribed in Primary Care for the treatment of deficiency for adults 18 years and above:
    • Invita D3 50,000 IU soft gel capsules: ONE capsule once weekly for 6 weeks. 
    • Invita D3 50,000IU/ml oral solution: ONE ml oral solution ampoule once weekly for 6 weeks. 
    • The FULL course should be prescribed as an ACUTE prescription.  
    • Patients requiring maintenance doses of vitamin D for insufficiency should be recommended to SELF-CARE where the patient is both willing and able.
  • NWAFT, CUHFT and RPH:
    • Non formulary (alternative brands are recommended). 
    • Trust to provide full treatment course for vitamin D deficiency.



 

 
Colecalciferol  (Thorens® 10,000 units/ml oral drops )
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First Choice
Green
  • Preferred brand when prescribed in Primary Care for treatment of deficiency for paediatric patients 1 month of age and above - see link to guideline below for dosing details dependent upon age.
  • The FULL course should be prescribed as an ACUTE prescription.
  • Self-care for maintenance doses
    • Vitamin D supplementation for insufficiency or aligned to national prevention recommendations, parents/guardians should be requested to purchase over the counter, where the parent/guardian is willing and able.
    • Healthy Start Vitamin Drops are available for those who qualify from local distribution points. See guideline below for further details. 
  • NWAFT, CUHFT and RPH:
    • Non formulary (alternative brands are recommended). 
    • Trust to provide full treatment course for vitamin D deficiency.



 

 
Colecalciferol 3200 unit capsules (Fultium D3®)
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Second Choice
Green
  • Primary Care - Second line formulary choice for treatment of deficiency for adults 18 years and above including pregnant or breastfeeding women:
    • Fultium-D3 3,200 IU capsules: ONE capsule daily for 12 weeks.  
    • Peanut-oil free capsules have been formulated since October 2014 but the peanut (arachis) oil version will continue to be available at wholesalers for some time, so it is recommended that the product formulation is checked before dispensing to patients with a known peanut or soya allergy. 
    • The FULL course should be prescribed as an ACUTE prescription.
    • Patients requiring maintenance doses of vitamin D for insufficiency should be recommended to SELF-CARE where the patient is both willing and able. 
  • NWAFT, CUHFT and RPH:
    • Non formulary (alternative brands are recommended). 
    • Trust to provide full treatment course for vitamin D deficiency.
 
Link  C & P CCG: Vitamin D deficiency in Adults
   
Colecalciferol  (Invita D3® 25,000IU single-dose oral solution unit )
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Second Choice
Green
  • Primary Care - Second line formulary choice for treatment of deficiency for paediatric patients 1 month of age and above who require weekly dosing due to compliance - see link to guideline below for dosing details dependent upon age.
  • The FULL course should be prescribed as an ACUTE prescription.
  • Self-care for maintenance doses
    • Vitamin D supplementation for insufficiency or aligned to national prevention recommendations, parents/guardians should be requested to purchase over the counter, where the parent/guardian is willing and able.
    • Healthy Start Vitamin Drops are available for those who qualify from local distribution points. See guideline below for further details. 
  • NWAFT, CUHFT and RPH:
    • Non formulary (alternative brands are recommended).
    • Trust to provide full treatment course for vitamin D deficiency.



 

 
Link  C & P CCG: Vitamin D deficiency in Paediatrics
   
Alfacalcidol (One-Alpha®)
(Capsule, Oral Drops, Injection)
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Formulary
Advice
 
   
Calcitriol
(Capsule)
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Formulary
Advice
 
   
Colecalciferol
(50,000 unit capsules)
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Restricted Drug Restricted
Red Hospital

RPH only - Restricted to cystic fibrosis patients 

 
   
Colecalciferol
(20,000 unit capsule)
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Formulary
Red Hospital

  • CUHFT - Delristol brand. 


    • 20,000 units = 500 micrograms

    • Dekristol is contraindicated for peanut or soya allergy sufferers, as capsules contain arachis oil (peanut oil).

    • Therapeutically equivalent to ergocalciferol (ref: Martindale)



Preferred treatment choice in primary care is currently Invita D3 range (licensed product)

 
   
Colecalciferol 800 units (Desunin®)
(Tablets )
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Restricted Drug Restricted
Amber No SCG

  • CUHFT only

  • Non - formulary at all other trusts


 

 
   
Ergocalciferol
(Injection)
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Formulary
Red Hospital

 




    • 300,000 units in 1ml



 

 
   
Colecalciferol 3,000 units per ml liquid
(Solution)
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Restricted Drug Restricted
Amber No SCG

  • NWAFT - Paediatric use only  


1mL = 3,000 units = 75 micrograms.


Therapeutically equivalent to ergocalciferol (ref: Martindale).


Unlicensed formulation. Use licensed product where available.

 
   
Paricalcitol (Zemplar®)
(Capsules, Injection)
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Restricted Drug Restricted
Red Hospital

  • CUHFT and NWAFT only - Consultant nephrologists for IDU/C5 only in patients on dialysis who have failed on alfacalcitriol therapy.

  • Non formulary at all other trusts

 
   
09.06.04  Expand sub section  Vitamin D with Calcium
Calcium and colecalciferol  (Accrete D3®, Evacal D3®, )
(Tablets, Chewable Tablets)
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Formulary
OTC

  • First choice in primary care

  • Accrete D3: Each film-coated tablet contains 600 mg calcium (as calcium carbonate 1500 mg) and 10 micrograms of colecalciferol (equivalent to 400 IU vitamin D3). Twice daily formulation

  • Accrete D3: Each film-coated tablet contains 0.3 mg hydrogenated soya-bean oil

  • Accrete D3: Each chewable tablet contains 2,500 mg of calcium carbonate (equivalent to 1,000 mg of calcium) and 8.8 mg of colecalciferol concentrate (powder form) (equivalent to 22 micrograms of colecalciferol = 880 IU of vitamin D3). Once daily formulation.

  • Evacal D3: Each chewable tablet contains 1,500 mg of calcium carbonate (equivalent to 600 mg of calcium) and 4.0 mg of colecalciferol concentrate (powder form) (equivalent to 10 micrograms of
    colecalciferol = 400 IU of vitamin D3). Twice daily formulation.

  • Alternative brands will be prescribed in Secondary Care due to difference in contract prices

  • Can be purchased from a Community Pharmacist. However, if a prescriber has particular concerns that a patient might not be able to, or is unwilling to self-care and treatment with a medication is required, then a prescription (FP10) should be considered.

 
   
Calcium and colecalciferol  (Calfovit D3®)
(Powder for oral suspension)
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Formulary
OTC

  • First choice in primary care for adult patients who are unable to take tablets or chewable tablets

  • Calfovit D3: Each sachet contains calcium phosphate 3100 mg (equivalent to 1200 mg or 30 mmol of elemental calcium per sachet) and 20 micrograms colecalciferol (equivalent to 800 IU). Once daily formulation

  • Alternative brands will be prescribed in Secondary Care due to difference in contract prices

  • Calcium and Vitamin D products can be purchased from a Community Pharmacist. However, if a prescriber has particular concerns that a patient might not be able to, or is unwilling to self-care and treatment with a medication is required, then a prescription (FP10) should be considered.

 
   
Calcium and colecalciferol  (Adcal D3®)
(caplets, chewable tablets, effervescent tablets)
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Formulary
Red Hospital

  • Caplets contain 7.5mmol calcium and 200units colecalciferol

  • Chewable tablets contain 15mmol calcium and 400units 

  • Effervescent tablets are restricted only for use when chewable tablets not tolerated, contains 15mmol calcium and 400units colecalciferol per tablet 

  • Accrete D3 or Evacal D3 should be prescribed in Primary Care. Where a patient has swallowing difficulties Calfovit D3 can be considered in Primary Care.

 
   
Calcium and colecalciferol  (Calcichew D3 Forte®, ®)
(Chewable tablets)
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Formulary
Red Hospital

  • Calcichew-D3 Forte 500 mg/400 IU chewable tablets contain calcium carbonate 1250 mg (equivalent to 500 mg of elemental calcium) and colecalciferol 400 IU (equivalent to 10 micrograms vitamin D3). Twice daily formulation.

  • Accrete D3 or Evacal D3 should be prescribed in Primary Care

 
   
 ....
 Non Formulary Items
Calcitriol  (Rocaltrol®)

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Non Formulary
Grey
 
Calcium and colecalciferol  (Calceos®)

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Non Formulary
Grey
 
Calcium and colecalciferol  (Kalcipos-D®)

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Non Formulary
Grey
 
Calcium and Ergocalciferol

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Non Formulary
Grey

Tablet

 
Calcium Carbonate and colecalciferol  (Calchichew-D3 Once Daily)

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Non Formulary
Grey

No formal submission

 
Calcium Carbonate with Colecalciferol  (Cacit® D3)

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Non Formulary
Grey

Sachets

 
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)
  •  
    Colecalciferol 2,400 units/ml drops  (Invita D3® oral drops)

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    Non Formulary
    Grey
    No formal assessment
     
    Colecalciferol and Calcium Carbonate  (Calcichew-D3®)

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    Non Formulary
    Grey

    Tablet

    • Only contains 5 micrograms (200 units) of D3 (inadequate for osteoporosis prophylaxis)
     
    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

    OTC

    Available Over the Counter. Consider Self Care   

    Green

    Formulary - Can be prescribed in both secondary and primary care.   

    Advice

    Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

    Amber No SCG

    Formulary - Specialist initiation without shared care guidance.  

    Amber SCG

    Formulary - Specialist initiation with shared care guidance.  

    Red Hospital

    Restricted - Hospital only, not to be prescribed in primary care.  

    Switch

    Not recommended for prescribing. Switch to alternative cost-effective option.   

    Black

    Not recommended for prescribing in primary or secondary care.  

    Grey

    Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

    Non Formulary

    Non-Formulary (category under review).  

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