Vitamin D₃ (colecalciferol) is the vitamin D preparation of choice for treatment of vitamin D deficiency.

Vitamin D₂ (ergocalciferol) can be used in people who cannot take vitamin D₃ for cultural, dietary, or religious reasons because of the animal sourcing of vitamin D, or the use of gelatine in some preparations.

Local protocols should be consulted where they exist.

 The prescribing of high-dose vitamin D as a short-course treatment, for the correction of deficiency and insufficiency is recommended only following confirmation by vitamin D assay.

• The prescribing of Vitamin D for prophylaxis or maintenance following treatment of deficiency and insufficiency is not recommended.
• Adults (including women who are pregnant or breastfeeding), young people and children over 4 years should consider taking a daily supplement between October and early March. The prescribing of Vitamin D and Vitamin D testing are not recommended.
• Adults, young people and children over 4 years should consider taking a daily supplement throughout the year if they have little or no sunshine exposure or if they have dark skin. The prescribing of Vitamin D and Vitamin D testing are not recommended.
• Do not offer a vitamin D supplement to people to treat or prevent COVID-19.

These positions are not intended to affect the management of patients with osteoporosis, osteopenia, multiple sclerosis or hypoparathyroidism.

**Product choices to be confirmed with ICB. To be updated when resolved**

Capsules 250 nanograms, 500 nanograms, 1 microgram
Oral drops 2 micrograms/mL (1 drop contains approximately 100 nanograms alfacalcidol)

For patients with severe renal impairment requiring vitamin D therapy.

Secondary care prescribers initiating treatment should clearly outline monitoring requirements when transferring prescribing responsiblity to primary care.

Capsules 250 nanograms

Injection 300,000 units/1ml

For the correction of deficiency and insufficiency in high-risk, symptomatic patients as a short-course treatment.

Ergocalciferol 400 units is equivalent to 10 micrograms.

Plastic syringes can be used 'off label' providing the injection is administered immediately after being drawn up into the syringe.